深入研究产后抑郁症的心血管和代谢预测因素。
Closer look at the cardiovascular and metabolic predictors of postpartum depression.
作者信息
Kalawatia Mihit, Lucke-Wold Brandon, Mehrunkar Aabhali
机构信息
Department of Neurosurgery, Rajarshi Chattrapati Shahu Maharaj Government Medical College, Kolhapur 416003, Mahārāshtra, India.
Lillian S. Wells Department of Neurosurgery, University of Florida, Gainesville, FL 32608, United States.
出版信息
World J Psychiatry. 2025 Jun 19;15(6):106283. doi: 10.5498/wjp.v15.i6.106283.
Postpartum depression (PPD) is a severe mental health disorder affecting 10% to 15% of postpartum women worldwide. Pre-eclampsia is a hypertensive disorder of pregnancy that has been identified as a significant factor for PPD due to its vascular dysfunction, systemic inflammation and neurobiological alterations. The neuroinflammatory mechanisms common to both pre-eclampsia and PPD, that contribute to depressive symptoms include elevated proinflammatory cytokines (interleukin-6, tumor necrosis factor-alpha), activation of the kynurenine pathway, and oxidative stress. To critically evaluate Wu 's study, which investigates blood pressure variability (BPV) and gestational body mass index (BMI) as independent predictors of PPD. To integrate recent findings on the metabolic and cardiovascular links between depression, pre-eclampsia, and postpartum mental health outcomes. Pre-pregnancy BMI is found to be a stronger predictor of PPD than gestational weight gain. A vascular-neuropsychiatric connection has been indicated in pre-eclamptic women, indicating a significant correlation between BPV and depressive postpartum symptoms. There is increased susceptibility to depression due to neuroinflammation contributed by blood pressure fluctuations and metabolic dysregulation. The incidence of PPD could be reduced by early identification and intervention for BP fluctuations. Early detection and intervention in high-risk pregnancies should be conducted through public health strategies that prioritize awareness, education, and accessibility to mental health care.
产后抑郁症(PPD)是一种严重的心理健康障碍,影响着全球10%至15%的产后女性。子痫前期是一种妊娠期高血压疾病,由于其血管功能障碍、全身炎症和神经生物学改变,已被确定为PPD的一个重要因素。子痫前期和PPD共有的神经炎症机制,导致抑郁症状的包括促炎细胞因子(白细胞介素-6、肿瘤坏死因子-α)升高、犬尿氨酸途径激活和氧化应激。批判性地评估吴的研究,该研究调查了血压变异性(BPV)和妊娠体重指数(BMI)作为PPD的独立预测因素。整合近期关于抑郁症、子痫前期和产后心理健康结果之间代谢和心血管联系的研究结果。发现孕前BMI比孕期体重增加是PPD更强的预测因素。子痫前期女性存在血管-神经精神联系,表明BPV与产后抑郁症状之间存在显著相关性。由于血压波动和代谢失调导致的神经炎症,抑郁症易感性增加。通过早期识别和干预血压波动可降低PPD的发病率。应通过优先考虑提高认识、教育和获得心理保健服务的公共卫生策略,对高危妊娠进行早期检测和干预。