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Suthar H, Tanghal RB, Chatzi L, Goodrich JA, Morello-Frosch R, Aung M. Metabolic Perturbations Associated with both PFAS Exposure and Perinatal/Antenatal Depression in Pregnant Individuals: A Meet-in-the-Middle Scoping Review. Curr Environ Health Rep 2024:10.1007/s40572-024-00451-w. [PMID: 38898328 DOI: 10.1007/s40572-024-00451-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2024] [Indexed: 06/21/2024]
Abstract
PURPOSE OF REVIEW Depression during the perinatal or antenatal period affects at least 1 in 10 women worldwide, with long term health implications for the mother and child. Concurrently, there is increasing evidence associating maternal exposure to per- and poly-fluoroalkyl substances (PFAS) to adverse pregnancy outcomes. We reviewed the body of evidence examining both the associations between PFAS exposure and perturbations in the maternal metabolome, and the associations between the maternal metabolome and perinatal/antenatal depression. Through this, we sought to explore existing evidence of the perinatal metabolome as a potential mediation pathway linking PFAS exposure and perinatal/antenatal depression. RECENT FINDINGS There are few studies examining the metabolomics of PFAS exposure-specifically in pregnant women-and the metabolomics of perinatal/antenatal depression, let alone studies examining both simultaneously. Of the studies reviewed (N = 11), the majority were cross sectional, based outside of the US, and conducted on largely homogenous populations. Our review identified 23 metabolic pathways in the perinatal metabolome common to both PFAS exposure and perinatal/antenatal depression. Future studies may consider findings from our review to conduct literature-derived hypothesis testing focusing on fatty acid metabolism, alanine metabolism, glutamate metabolism, and tyrosine metabolism when exploring the biochemical mechanisms conferring the risk of perinatal/antenatal depression due to PFAS exposure. We recommend that researchers also utilize heterogenous populations, longitudinal study designs, and mediation approaches to elucidate key pathways linking PFAS exposures to perinatal/antenatal depression.
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Affiliation(s)
- Himal Suthar
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 225R, 1845 N Soto St., Los Angeles, CA, 90032, USA
| | - Roselyn B Tanghal
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 225R, 1845 N Soto St., Los Angeles, CA, 90032, USA
| | - Lida Chatzi
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 225R, 1845 N Soto St., Los Angeles, CA, 90032, USA
| | - Jesse A Goodrich
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 225R, 1845 N Soto St., Los Angeles, CA, 90032, USA
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy, and Management, University of California, 130 Mulford Hall #3114, Berkeley, CA, 94720, USA
| | - Max Aung
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, SSB 225R, 1845 N Soto St., Los Angeles, CA, 90032, USA.
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Ling K, Hong M, Jin L, Wang J. Blood metabolomic and postpartum depression: a mendelian randomization study. BMC Pregnancy Childbirth 2024; 24:429. [PMID: 38877415 PMCID: PMC11177545 DOI: 10.1186/s12884-024-06628-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 06/09/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Postpartum depression is a complex mental health condition that often occurs after childbirth and is characterized by persistent sadness, anxiety, and fatigue. Recent research suggests a metabolic component to the disorder. This study aims to investigate the causal relationship between blood metabolites and postpartum depression using mendelian randomization (MR). METHODS This study used a bi-directional MR framework to investigate the causal relationship between 1,400 metabolic biomarkers and postpartum depression. We used two specific genome-wide association studies datasets: one with single nucleotide polymorphisms data from mothers diagnosed with postpartum depression and another with blood metabolite data, both of which focused on people of European ancestry. Genetic variants were chosen as instrumental variables from both datasets using strict criteria to improve the robustness of the MR analysis. The combination of these datasets enabled a thorough examination of genetic influences on metabolic profiles associated with postpartum depression. Statistical analyses were conducted using techniques such as inverse variance weighting, weighted median, and model-based estimation, which enabled rigorous causal inference from the observed associations. postpartum depression was defined using endpoint definitions approved by the FinnGen study's clinical expert groups, which included leading experts in their respective medical fields. RESULTS The MR analysis identified seven metabolites that could be linked to postpartum depression. Out of these, one metabolite was found to be protective, while six were associated with an increased risk of developing the condition. The results were consistent across multiple MR methods, indicating a significant correlation. CONCLUSIONS This study emphasizes the potential of metabolomics for understanding postpartum depression. The discovery of specific metabolites associated with the condition sheds new insights on its pathophysiology and opens up possibilities for future research into targeted treatment strategies.
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Affiliation(s)
- Keng Ling
- Jiaxing Women and Children's Hospital, Wenzhou Medical University, Jiaxing, China
| | - Minping Hong
- Jiaxing Hospital of Traditional Chinese Medical, Jiaxing, China
| | - Liqin Jin
- Jiaxing Women and Children's Hospital, Wenzhou Medical University, Jiaxing, China
| | - Jianguo Wang
- Jiaxing Women and Children's Hospital, Wenzhou Medical University, Jiaxing, China.
- Central Laboratory, Jiaxing Maternity and Child Health Care Hospital, Affiliated Women and Children Hospital, Jiaxing University, Jiaxing, 314000, China.
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D'Agostino A, Garbazza C, Malpetti D, Azzimonti L, Mangili F, Stein HC, Del Giudice R, Cicolin A, Cirignotta F, Manconi M. Optimal risk and diagnosis assessment strategies in perinatal depression: A machine learning approach from the life-ON study cohort. Psychiatry Res 2024; 332:115687. [PMID: 38157709 DOI: 10.1016/j.psychres.2023.115687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 12/15/2023] [Accepted: 12/20/2023] [Indexed: 01/03/2024]
Abstract
This study aimed to assess the concordance of various psychometric scales in detecting Perinatal Depression (PND) risk and diagnosis. A cohort of 432 women was assessed at 10-15th and 23-25th gestational weeks, 33-40 days and 180-195 days after delivery using the Edinburgh Postnatal Depression Scale (EPDS), Visual Analogue Scale (VAS), Hamilton Depression Rating Scale (HDRS), Montgomery-Åsberg Depression Rating Scale (MADRS), and Mini International Neuropsychiatric Interview (MINI). Spearman's rank correlation coefficient was used to assess agreement across instruments, and multivariable classification models were developed to predict the values of a binary scale using the other scales. Moderate agreement was shown between the EPDS and VAS and between the HDRS and MADRS throughout the perinatal period. However, agreement between the EPDS and HDRS decreased postpartum. A well-performing model for the estimation of current depression risk (EPDS > 9) was obtained with the VAS and MADRS, and a less robust one for the estimation of current major depressive episode (MDE) diagnosis (MINI) with the VAS and HDRS. When the EPDS is not feasible, the VAS may be used for rapid and comprehensive postpartum screening with reliability. However, a thorough structured interview or clinical examination remains necessary to diagnose a MDE.
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Affiliation(s)
- Armando D'Agostino
- Department of Health Sciences, Università degli Studi di Milano, Italy; Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy.
| | - Corrado Garbazza
- Centre for Chronobiology, University of Basel, Basel, Switzerland; Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland; Sleep Medicine Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland
| | - Daniele Malpetti
- Istituto Dalle Molle di Studi sull'Intelligenza Artificiale (IDSIA), USI/SUPSI, Lugano, Switzerland
| | - Laura Azzimonti
- Istituto Dalle Molle di Studi sull'Intelligenza Artificiale (IDSIA), USI/SUPSI, Lugano, Switzerland
| | - Francesca Mangili
- Istituto Dalle Molle di Studi sull'Intelligenza Artificiale (IDSIA), USI/SUPSI, Lugano, Switzerland
| | | | - Renata Del Giudice
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, Milan, Italy
| | - Alessandro Cicolin
- Department of Neuroscience, Sleep Medicine Center, University of Turin, Turin, Italy
| | | | - Mauro Manconi
- Sleep Medicine Unit, Neurocenter of Southern Switzerland, Lugano, Switzerland; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland; Department of Neurology, University Hospital, Inselspital, Bern, Switzerland
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Konjevod M, Gredicak M, Vuic B, Tudor L, Nikolac Perkovic M, Milos T, Svob Strac D, Pivac N, Nedic Erjavec G. Overview of metabolomic aspects in postpartum depression. Prog Neuropsychopharmacol Biol Psychiatry 2023; 127:110836. [PMID: 37541332 DOI: 10.1016/j.pnpbp.2023.110836] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 07/24/2023] [Accepted: 07/26/2023] [Indexed: 08/06/2023]
Abstract
Along with the typical biochemical alterations that occur during pregnancy, certain metabolic changes might be associated with the development of several psychiatric disorders, including postpartum depression (PPD), which is the most common type of psychiatric disorder during pregnancy or first postpartum year, and it develops in about 15% of women. Metabolomics is a rapidly developing discipline that deals with the metabolites as the final products of all genetically controlled biochemical pathways, highly influenced by external and internal changes. The aim of this paper was to review the published studies whose results suggest or deny a possible association between the fine regulation of the metabolome and PPD, enabling conclusions about whether metabolomics could be a useful tool in defining the biochemical pathways directly involved in the etiology, diagnosis and course of PPD. Beside numerous hormonal changes, a lot of different metabolic pathways have been discovered to be affected in women with PPD or associated with its development, including alterations in the energy metabolism, tryptophan and amino acid metabolism, steroid metabolism, purine cycle, as well as neurotransmitter metabolism. Additionally, metabolomics helped in defining the association between PPD and the exposure to various endocrine disrupting metabolites during pregnancy. Finally, metabolome reflects different PPD therapies and exposure of fetus or breastfed infants to pharmacotherapy prescribed to a mother suffering from PPD. This review can help in creating the picture about metabolomics' broad application in PPD studies, but it also implies that its potential is still not completely used.
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Affiliation(s)
| | - Martin Gredicak
- General Hospital Zabok and Hospital for the Croatian Veterans, Bracak 8, p.p. 36, 49210 Zabok, Croatia
| | - Barbara Vuic
- Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb, Croatia.
| | - Lucija Tudor
- Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb, Croatia.
| | | | - Tina Milos
- Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb, Croatia.
| | | | - Nela Pivac
- Rudjer Boskovic Institute, Bijenicka 54, 10000 Zagreb, Croatia; University of Applied Sciences Hrvatsko Zagorje Krapina, Setaliste hrvatskog narodnog preporoda 6, 49000 Krapina, Croatia.
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