1
|
Hu Q, Chen J, Ma J, Li Y, Xu Y, Yue C, Cong E. Causal effects of neuroticism on postpartum depression: a bidirectional mendelian randomization study. Arch Womens Ment Health 2024; 27:837-844. [PMID: 38634868 PMCID: PMC11405473 DOI: 10.1007/s00737-024-01466-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/28/2024] [Indexed: 04/19/2024]
Abstract
PURPOSE Postpartum depression (PPD) brings adverse and serious consequences to both new parents and newborns. Neuroticism affects PPD, which remains controversial for confounding factors and reverse causality in cross-sectional research. Therefore, mendelian randomization (MR) study has been adopted to investigate their causal relationship. METHODS This study utilized large-scale genome-wide association study genetic pooled data from three major databases: the United Kingdom Biobank, the European Bioinformatics Institute, and the FinnGen databases. The causal analysis methods used inverse variance weighting (IVW). The weighted median, MR-Egger method, MR-PRESSO test, and the leave-one-out sensitivity test have been used to examine the results' robustness, heterogeneity, and horizontal pleiotropy. The fixed effect model yielded the results of meta-analysis. RESULTS In the IVW model, a meta-analysis of the MR study showed that neuroticism increased the risk of PPD (OR, 1.17; 95% CI, 1.11-1.25, p < 0.01). Reverse analysis showed that PPD could not genetically predict neuroticism. There was no significant heterogeneity or horizontal pleiotropy bias in this result. CONCLUSION Our study suggests neuroticism is the risk factor for PPD from a gene perspective and PPD is not the risk factor for neuroticism. This finding may provide new insights into prevention and intervention strategies for PPD according to early detection of neuroticism.
Collapse
Affiliation(s)
- Qianying Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China
- School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Jianhua Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China
| | - Jingjing Ma
- School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China
| | - Yuting Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China
| | - Yifeng Xu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China.
| | - Chaoyan Yue
- Obstetrics and Gynecology Hospital of Fudan University, Fang Xie Road, No419, Shanghai, Shanghai, China.
| | - Enzhao Cong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wanping Road, Shanghai, 200030, China.
- School of Medicine, Shanghai Tenth People's Hospital, Tongji University, Shanghai, China.
| |
Collapse
|
2
|
Chen G, Zhang Y, Li R, Jin L, Hao K, Rong J, Duan H, Du Y, Yao L, Xiang D, Liu Z. Environmental enrichment attenuates depressive-like behavior in maternal rats by inhibiting neuroinflammation and apoptosis and promoting neuroplasticity. Neurobiol Stress 2024; 30:100624. [PMID: 38524250 PMCID: PMC10958482 DOI: 10.1016/j.ynstr.2024.100624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 02/25/2024] [Accepted: 03/10/2024] [Indexed: 03/26/2024] Open
Abstract
Gestational stress can exacerbate postpartum depression (PPD), for which treatment options remain limited. Environmental enrichment (EE) may be a therapeutic intervention for neuropsychiatric disorders, including depression, but the specific mechanisms by which EE might impact PPD remain unknown. Here we examined the behavioral, molecular, and cellular impact of EE in a stable PPD model in rats developed through maternal separation (MS). Maternal rats subjected to MS developed depression-like behavior and cognitive dysfunction together with evidence of significant neuroinflammation including microglia activation, neuronal apoptosis, and impaired synaptic plasticity. Expanding the duration of EE to throughout pregnancy and lactation, we observed an EE-associated reversal of MS-induced depressive phenotypes, inhibition of neuroinflammation and neuronal apoptosis, and improvement in synaptic plasticity in maternal rats. Thus, EE effectively alleviates neuroinflammation, neuronal apoptosis, damage to synaptic plasticity, and consequent depression-like behavior in mother rats experiencing MS-induced PPD, paving the way for new preventive and therapeutic strategies for PPD.
Collapse
Affiliation(s)
- Guopeng Chen
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yuhui Zhang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Ruiling Li
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Liuyin Jin
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Keke Hao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jingtong Rong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Hao Duan
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Yiwei Du
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Lihua Yao
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Dan Xiang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
- Taikang Center for Life and Medical Sciences, Wuhan University, Wuhan, 430071, China
| |
Collapse
|
3
|
Bateineh S, Atoum MF. Association between Vitamin D Levels During Pregnancy and Postpartum Depression: A Narrative Reviews. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2024; 29:290-296. [PMID: 39100406 PMCID: PMC11296599 DOI: 10.4103/ijnmr.ijnmr_49_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 02/04/2024] [Accepted: 02/20/2024] [Indexed: 08/06/2024]
Abstract
Background Postpartum Depression (PPD) is a serious depression that develops in the first year, with unknown explained reasons. Many studies evaluated the impact of Vitamin D (VD) levels on depression during pregnancy and postnatal. This narrative review aims to review any association between serum VD levels during pregnancy and the development of PPD. Materials and Methods PPD data from published trials and research articles (period from 2012 to 2022) were assessed through PubMed, Scopus, Science Direct, and Google Scholar using the following terms: Depression, pregnancy, 25-hydroxyvitamin D (25OH VD), vitamin D deficiency (VDD) and postpartum (PP). Articles were selected manually and with careful tracking to avoid duplication. Articles that investigated any association between VD levels during pregnancy and PPD in the time frame were included in the study, while articles investigating VD levels of PP without depression were excluded. Results In this narrative review, five out of seven studies showed an association between PPD and VDD during pregnancy. Danish National Birth Cohort (DNBC), Edinburgh Postnatal Depression Scale (EPDS) and Center for Epidemiologic Studies Depression Scale (CES-D) enrolled among different studies from 3 days to 1 year PP to assess PPD. Conclusions Pregnant women with VDD are significantly associated with PPD. Longitudinal follow-up studies are needed to evaluate the association between VDD with PPD. Screening VD levels among pre-postnatal mothers may be essential for awareness programs that can be implemented to promote remission of postnatal depression.
Collapse
Affiliation(s)
- Sajedah Bateineh
- Department of Medical Laboratory Sciences, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| | - Manar Fayiz Atoum
- Department of Medical Laboratory Sciences, Faculty of Applied Health Sciences, The Hashemite University, Zarqa, Jordan
| |
Collapse
|
4
|
Wang P, Yim IS, Lindsay KL. Maternal Diet Quality and Prenatal Depressive Symptoms: The Moderating Role of Economic Well-Being. Nutrients 2023; 15:2809. [PMID: 37375713 DOI: 10.3390/nu15122809] [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] [Received: 05/22/2023] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023] Open
Abstract
Prenatal depression is prevalent and adversely impacts maternal and infant health. This study addresses a critical literature gap and investigates the association between maternal diet quality and prenatal depressive symptoms, as well as the moderating effect of economic well-being on this link. A cross-sectional design was used, including 43 healthy pregnant women in the second trimester aggregated from two research projects. Prenatal depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale. Dietary quality was evaluated using two non-consecutive 24 h dietary recalls, from which the Adapted Dietary Inflammatory Index (ADII) and the Healthy Eating Index (HEI)-2015 were derived. Economic well-being was indicated by the income-to-poverty ratio. A higher HEI-2015 (adherence to dietary guidelines; β = -0.53, p = 0.01) and negative ADII (anti-inflammatory diet; β = 0.40, p = 0.06) were associated with fewer prenatal depressive symp-toms. Among pregnant women with worse economic well-being, a pro-inflammatory diet was as-sociated with more prenatal depressive symptoms (b = 1.69, p = 0.004), but among those with better economic well-being, the association was not significant (b = 0.51, p = 0.09). Dietary interventions aimed at reducing dietary inflammation might hold some promise for improving mental health among pregnant women who are economically vulnerable.
Collapse
Affiliation(s)
- Peiyi Wang
- Department of Psychological Science, University of California, Irvine, CA 92617, USA
| | - Ilona S Yim
- Department of Psychological Science, University of California, Irvine, CA 92617, USA
| | - Karen L Lindsay
- Department of Pediatrics, School of Medicine, University of California, Irvine, CA 92617, USA
- UCI Susan Samueli Integrative Health Institute, College of Health Sciences, Irvine, CA 92617, USA
| |
Collapse
|
5
|
Shelke A, Chakole S. A Review on Risk Factors of Postpartum Depression in India and Its Management. Cureus 2022; 14:e29150. [PMID: 36258936 PMCID: PMC9573019 DOI: 10.7759/cureus.29150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/13/2022] [Indexed: 11/05/2022] Open
|
6
|
Jacques N, Mesenburg MA, Murray J, Bertoldi AD, Domingues MR, Stein A, Silveira MF. Antenatal and Postnatal Maternal Depressive Symptoms and Trajectories and Child Hospitalization up to 24 Months of Life: Findings From the 2015 Pelotas (Brazil) Birth Cohort Study. THE JOURNAL OF PEDIATRICS: X 2021; 6:100065. [PMID: 33898965 PMCID: PMC8047811 DOI: 10.1016/j.ympdx.2021.100065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 01/03/2023] Open
Abstract
Objective To examine the association between antenatal and postnatal maternal depression symptoms, and child hospitalization during the first 2 years of life in the 2015 Pelotas Birth Cohort Study. Study design This is an observational study. Maternal depressive symptoms of 4275 mothers were measured using the Edinburgh Postnatal Depression Scale. Hospitalization of the child for any reason was assessed using maternal report. Bivariate analysis and multivariate Poisson regressions were used to assess the association between maternal depressive symptoms and child hospitalization. Results Compared with children of mothers with low depressive symptoms, children whose mothers experienced significant antenatal depressive symptoms were 1.74 (95% CI, 1.16-2.60) times more likely to be hospitalized by 3 months of age, and 2.14 (95% CI, 1.46-3.14) times more likely up to 24 months. For children whose mothers experienced severe postnatal depressive symptoms at 3 months, the risks for hospitalization by age 12 months were 1.84 (95% CI, 1.39-2.45) higher than children whose mothers had low depressive symptoms. There was an increased risk of hospitalization for children according to the severity of depressive trajectories across time. Conclusions Maternal depressive symptoms are a risk factor for hospitalization in children up to 2 years of age, and this risk increases with increased severity of depression. These results have public health relevance for decreasing the risk factors in mothers that can lead to hospitalization in children.
Collapse
Affiliation(s)
- Nadège Jacques
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Marilia Arndt Mesenburg
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Federal University of Health Sciences of Porto Alegre, Porto Alegre, RS, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | | | | | - Alan Stein
- Department of Psychiatry, University of Oxford and MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | |
Collapse
|
7
|
Payne JL, Maguire J. Pathophysiological mechanisms implicated in postpartum depression. Front Neuroendocrinol 2019; 52:165-180. [PMID: 30552910 PMCID: PMC6370514 DOI: 10.1016/j.yfrne.2018.12.001] [Citation(s) in RCA: 162] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 11/13/2018] [Accepted: 12/11/2018] [Indexed: 02/06/2023]
Abstract
This review aims to summarize the diverse proposed pathophysiological mechanisms contributing to postpartum depression, highlighting both clinical and basic science research findings. The risk factors for developing postpartum depression are discussed, which may provide insight into potential neurobiological underpinnings. The evidence supporting a role for neuroendocrine changes, neuroinflammation, neurotransmitter alterations, circuit dysfunction, and the involvement of genetics and epigenetics in the pathophysiology of postpartum depression are discussed. This review integrates clinical and preclinical findings and highlights the diversity in the patient population, in which numerous pathophysiological changes may contribute to this disorder. Finally, we attempt to integrate these findings to understand how diverse neurobiological changes may contribute to a common pathological phenotype. This review is meant to serve as a comprehensive resource reviewing the proposed pathophysiological mechanisms underlying postpartum depression.
Collapse
Affiliation(s)
- Jennifer L Payne
- Department of Psychiatry, Women's Mood Disorders Center, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Jamie Maguire
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA 02111, USA.
| |
Collapse
|
8
|
Farioli Vecchioli S, Sacchetti S, Nicolis di Robilant V, Cutuli D. The Role of Physical Exercise and Omega-3 Fatty Acids in Depressive Illness in the Elderly. Curr Neuropharmacol 2018; 16:308-326. [PMID: 28901279 PMCID: PMC5843982 DOI: 10.2174/1570159x15666170912113852] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 06/20/2017] [Accepted: 07/30/2017] [Indexed: 02/07/2023] Open
Abstract
Background: In adulthood, depression is the most common type of mental illness and will be the second leading cause of disease by 2020. Major depression dramatically affects the function of the central nervous system and degrades the quality of life, especially in old age. Several mechanisms underlie the pathophysiology of depressive illness, since it has a multifactorial etiology. Human and an-imal studies have demonstrated that depression is mainly associated with imbalances in neurotransmitters and neurotrophins, hypothalamic-pituitary-adrenal axis alterations, brain volume changes, neurogenesis dysfunction, and dysregulation of in-flammatory pathways. Also the gut microbiota may influence mental health outcomes. Although depression is not a consequence of normal aging, depressive disorders are common in later life, even if often undi-agnosed or mis-diagnosed in old age. When untreated, depression reduces life expectancy, worsens medical illnesses, en-hances health care costs and is the primary cause of suicide among older people. To date, the underpinnings of depression in the elderly are still to be understood, and the pharmacological treatment is the most commonly used therapy. Objective: Since a sedentary lifestyle and poor eating habits have recently emerged as crucial contributors to the genesis and course of depression, in the present review, we have focused on the effects of physical activity and omega-3 fatty acids on depressive illness in the elderly. Results: A growing literature indicates that both exercise and dietary interventions can promote mental health throughout one’s lifespan. Conclusion: There thus emerges the awareness that an active lifestyle and a balanced diet may constitute valid low-cost pre-vention strategies to counteract depressive illness in the elderly.
Collapse
Affiliation(s)
- Stefano Farioli Vecchioli
- Institute of Cell Biology and Neurobiology, CNR/Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy
| | - Stefano Sacchetti
- Laboratory of Experimental and Behavioral Neurophysiology, Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy.,Department of Psychology, University Sapienza of Rome, Via dei Marsi 78, 00185, Rome, Italy
| | - V Nicolis di Robilant
- Institute of Cell Biology and Neurobiology, CNR/Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy
| | - Debora Cutuli
- Laboratory of Experimental and Behavioral Neurophysiology, Fondazione Santa Lucia, Via del Fosso di Fiorano 64, 00143, Rome, Italy.,Department of Psychology, University Sapienza of Rome, Via dei Marsi 78, 00185, Rome, Italy
| |
Collapse
|
9
|
Determinants of polyunsaturated fatty acid concentrations in erythrocytes of pregnant Japanese women from a birth cohort study: study protocol and baseline findings of an adjunct study of the Japan environment & Children's study. Environ Health Prev Med 2017; 22:22. [PMID: 29165130 PMCID: PMC5664798 DOI: 10.1186/s12199-017-0636-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/08/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND N-3 polyunsaturated fatty acids (n-3 PUFA) may have multiple beneficial effects on the outcome of pregnancy, maternal health and child development. The present study introduced the protocol of a birth cohort study to examine the beneficial effects of n-3 PUFA status in pregnant Japanese women as an adjunct study of the Japan Environment and Children's Study (JECS). METHODS The JECS participants in the coastal areas of Miyagi Prefecture were further invited to participate in this adjunct study, and 1,878 pregnant women were enrolled prior to delivery. Their n-3 PUFA status was evaluated with fatty acid profiles in erythrocytes of maternal blood collected from 1,623 mothers at 24-30 weeks of gestation and cord blood from 1,505 deliveries. RESULTS The baseline results, including comprehensive data on the fatty acid status and determinants affecting the PUFA status, were analyzed. In stepwise multivariate analyses, the cord blood docosahexaenoic acid (DHA) level was found to be significantly influenced by the DHA level in maternal blood, the child's sex, and the gestational period. The maternal DHA level was influenced by fish intake, maternal age, and the prepregnancy body mass index. While cord blood eicosapentaenoic acid (EPA) was influenced by maternal EPA, fish intake, and season at birth, additional factors such as maternal education, household income, and smoking habits affected the maternal EPA content. CONCLUSION Further studies are warranted to clarify the nutritional impacts of n-3 PUFA in pregnant Japanese women of the cohort study.
Collapse
|
10
|
Serum n-3 polyunsaturated fatty acids are inversely associated with longitudinal changes in depressive symptoms during pregnancy. Epidemiol Psychiatr Sci 2017; 26:157-168. [PMID: 27026507 PMCID: PMC6998689 DOI: 10.1017/s204579601500116x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUNDS N-3 polyunsaturated fatty acids (PUFAs) have been hypothesised to be protective for depression during pregnancy. However, there are few data and no consensus regarding this association. In this line, we aim to evaluate if the concentration of n-3 and n-6 PUFAs, and their ratio, are associated with depressive symptoms throughout pregnancy. METHOD A prospective cohort of 172 Brazilian women was followed at 5-13th, 20-26th and 30-36th weeks of gestation. The presence of depressive symptoms was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) at each pregnancy trimester. Depression was defined as an EPDS score ≥11. The concentrations of n-3 [α-linolenic acid; eicosapentaenoic acid (EPA); docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA)] and n-6 PUFAs [linoleic acid; γ linolenic acid; eicosadienoic acid; eicosatrienoic acid; arachidonic acid; docosatetraenoic acid and docosapentaenoic acid] were expressed as absolute (μg/ml) values. The total n-6/n-3 ratio was calculated. Statistical analyses were performed using univariate and adjusted random intercept logistic model for each fatty acid (FA) considering the longitudinal nature of data. Covariates were selected as potential confounders based on their biological plausibility of having an association with the concentration of FA and depressive symptoms during pregnancy. RESULTS The prevalence of depressive symptoms was high in all pregnancy trimesters (1st = 33.7%; 2nd = 18.9%; 3rd = 17.4%). We did not find differences in means FA concentrations by depressive symptom classification, for each follow-up visit. The women presented a 5% decrease in the odds of having depressive symptoms for each one-week increase in the gestational age. As individual women progressed through pregnancy, higher concentrations of EPA (odds ratio (OR) = 0.92; 95% CI: 0.86-0.99), DHA (OR = 0.96; 95% CI: 0.93-0.99), DPA (OR = 0.87; 95% CI: 0.77-0.99) and total n-3 (OR = 0.98; 95% CI: 0.96-0.99) were associated with a lower odds of depressive symptoms, while higher total n-6/n-3 ratio were associated with greater odds of depressive symptoms (OR = 1.40; 95% CI: 1.09-1.79). We detected a decrease in the probability of depressive symptoms as concentrations of total n-3 FA, α-linolenic acid, DPA, and DHA increased. We also observed a sharper decline for women with initial greater chance of depressive symptoms compared with those with lower chance of having these symptoms. CONCLUSIONS We found a high prevalence of depressive symptoms in low-income Brazilian pregnant women and no significant associations between n-6 FA and depressive symptoms. Lower serum concentrations of DHA, EPA and DPA and a higher n-6/n-3 ratio at each pregnancy trimester were associated with higher odds of depressive symptoms throughout pregnancy.
Collapse
|
11
|
Ghaedrahmati M, Kazemi A, Kheirabadi G, Ebrahimi A, Bahrami M. Postpartum depression risk factors: A narrative review. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2017; 6:60. [PMID: 28852652 PMCID: PMC5561681 DOI: 10.4103/jehp.jehp_9_16] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/21/2016] [Accepted: 01/16/2017] [Indexed: 05/03/2023]
Abstract
Postpartum depression is a debilitating mental disorder with a high prevalence. The aim of this study was review of the related studies. In this narrative review, we report studies that investigated risk factors of postpartum depression by searching the database, Scopus, PubMed, ScienceDirect, Uptodate, Proquest in the period 2000-2015 published articles about the factors associated with postpartum depression were assessed in Farsi and English. The search strategy included a combination of keywords include postpartum depression and risk factors or obstetrical history, social factors, or biological factors. Literature review showed that risk factors for postpartum depression in the area of economic and social factors, obstetrical history, and biological factors, lifestyle and history of mental illness detected. Data from this study can use for designing a screening tools for high-risk pregnant women and for designing a prevention programs.
Collapse
Affiliation(s)
- Maryam Ghaedrahmati
- Reproductive Health Department Student Research Committee, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ashraf Kazemi
- Women's Health Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
- Address for correspondence: Dr. Ashraf Kazemi, Women's Health Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. E-mail:
| | - Gholamreza Kheirabadi
- Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amrollah Ebrahimi
- Behavioral Sciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masood Bahrami
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| |
Collapse
|
12
|
Fish-Oil Supplementation and Maternal Mental Health: A Triple-Blind, Randomized Controlled Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2016. [DOI: 10.5812/ircmj.36237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
13
|
Serati M, Redaelli M, Buoli M, Altamura AC. Perinatal Major Depression Biomarkers: A systematic review. J Affect Disord 2016; 193:391-404. [PMID: 26802316 DOI: 10.1016/j.jad.2016.01.027] [Citation(s) in RCA: 98] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2015] [Revised: 12/04/2015] [Accepted: 01/12/2016] [Indexed: 12/20/2022]
Abstract
Postpartum depression, now termed perinatal depression by the DSM-5, is a clinically relevant disorder reaching 15% of incidence. Although it is quite frequent and associated with high social dysfunction, only recently its underpinning biological pathways have been explored, while multiple and concomitant risk factors have been identified (e.g. psychosocial stress). Peripartum depression usually has its onset during the third trimester of pregnancy or in the postpartum, being one of the most common medical complications in new mothers. Purpose of the present review is to summarize the state of art of biological biomarkers involved in the pathogenesis of perinatal depression, in view of the fact that suboptimal prenatal milieu can induce permanent damage in subsequent offspring life and have a negative impact on mother-child relationship. Furthermore, parents' biological changes due to medical/psychiatric disorders or stress exposure could influence offspring life: a concept known as 'intergenerational transmission', acting by variations into gametes and the gestational uterine environment. Given the evidence that perinatal mental disorders involve risks for the mother and offspring, the search for reliable biomarkers in high-risk mothers actually represents a medical priority to prevent perinatal depression.
Collapse
Affiliation(s)
- M Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy.
| | - M Redaelli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - M Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| | - A C Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, 20122 Milan, Italy
| |
Collapse
|
14
|
Procter SB, Campbell CG. Position of the Academy of Nutrition and Dietetics: Nutrition and Lifestyle for a Healthy Pregnancy Outcome. J Acad Nutr Diet 2014; 114:1099-1103. [PMID: 24956993 DOI: 10.1016/j.jand.2014.05.005] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2014] [Indexed: 11/15/2022]
|
15
|
Kim DR, Epperson CN, Weiss AR, Wisner KL. Pharmacotherapy of postpartum depression: an update. Expert Opin Pharmacother 2014; 15:1223-34. [PMID: 24773410 DOI: 10.1517/14656566.2014.911842] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Postpartum depression (PPD) is a common and serious illness that affects up to 14% of women in the first month after childbirth. We present an update on the pharmacologic treatment of PPD, although there continues to be a lack of large, randomized controlled trials (RCTs). AREAS COVERED A review of the literature on the use of antidepressants, hormonal supplements and omega-3 fatty acids for the prevention and the treatment of PPD published since the original review in 2009 and the authors' opinion on the current status of the pharmacological treatment of PPD are covered. An electronic search was performed by using PubMed, Medline and PsychINFO. Inclusion criteria were: i) empirical articles in peer-reviewed English-language journals; ii) well-validated measures of depression; and iii) a uniform scoring system for depression among the sample. EXPERT OPINION Since the last Expert Opinion review, four antidepressant treatment studies and one prevention study of PPD have been published. Six RCTs evaluating the use of omega-3 fatty acids (four for prevention and two for treatment) have been published. There continues to be lack of data regarding the pharmacotherapy of PPD. However, serotonin reuptake inhibitors should be considered first-line for women with PPD after it has been determined that the proper diagnosis is not bipolar disorder. It is important to individualize treatment for women with PPD and consider the risks and benefits of treatment while breastfeeding.
Collapse
Affiliation(s)
- Deborah R Kim
- University of Pennsylvania, Perelman School of Medicine, Penn Center for Women's Behavioral Wellness, Department of Psychiatry , Philadelphia, PA 19104 , USA
| | | | | | | |
Collapse
|
16
|
Ferreira CF, Bernardi JR, Bosa VL, Schuch I, Goldani MZ, Kapczinski F, Salum GA, Dalmaz C, Manfro GG, Silveira PP. Correlation between n-3 polyunsaturated fatty acids consumption and BDNF peripheral levels in adolescents. Lipids Health Dis 2014; 13:44. [PMID: 24593295 PMCID: PMC3974009 DOI: 10.1186/1476-511x-13-44] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 02/20/2014] [Indexed: 12/21/2022] Open
Abstract
Background Although several studies have reported an association between mental disorders and serum levels of brain-derived neurotrophic factor (BDNF), this association is still poorly understood. The study of factors associated with both BDNF levels and mental disorders, such as n-3 polyunsaturated fatty acids (n-3 PUFAs), may help to elucidate the mechanisms mediating the relationship between the two variables. Therefore, the present study aimed to evaluate whether the intake n-3 PUFAs correlates with serum levels of BDNF. Findings This study involved 137 adolescents drawn from a community sample, including a group with high levels of anxiety, assessed using the Screen for Children and Anxiety Related Emotional Disorders. Blood samples were collected and serum BDNF levels were measured. n-3 PUFAs were estimated using a food frequency questionnaire for adolescents. Correlations were performed to assess the association between n-3 PUFAs intake and BDNF levels. Effects of potential confounders (total fat consumption, age, gender and anxiety) were examined using linear regression models. There was a direct correlation between n-3 PUFAs consumption and serum BDNF levels, which remained significant even after accounting for potential confounders. Conclusions We were able to detect a correlation between n-3 PUFAs intake and peripheral BDNF levels. Our study was limited by its small sample size, and our external validity may be restricted by the oversampling of anxious adolescents. Our findings may help determine the nature of the association between mental disorders and serum levels of BDNF. However, more studies are needed to elucidate the possible mechanisms by which n-3 PUFAs intake affects BDNF levels, and how this may lead to an increased vulnerability to psychiatric disorders.
Collapse
Affiliation(s)
- Charles Francisco Ferreira
- Post Graduate Program in Neuroscience, Institute of Basic Sciences/Health, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Markhus MW, Skotheim S, Graff IE, Frøyland L, Braarud HC, Stormark KM, Malde MK. Low omega-3 index in pregnancy is a possible biological risk factor for postpartum depression. PLoS One 2013; 8:e67617. [PMID: 23844041 PMCID: PMC3701051 DOI: 10.1371/journal.pone.0067617] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 05/19/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Depression is a common disorder affecting 10-15% women in the postpartum period. Postpartum depression can disrupt early mother-infant interaction, and constitutes a risk factor for early child development. Recently, attention has been drawn to the hypothesis that a low intake of seafood in pregnancy can be a risk factor for postpartum depression. Seafood is a unique dietary source of the marine omega-3 fatty acids and is a natural part of a healthy balanced diet that is especially important during pregnancy. METHODS In a community based prospective cohort in a municipality in Western Norway, we investigated both nutritional and psychological risk factors for postpartum depression. The source population was all women who were pregnant within the period November 2009 - June 2011. The fatty acid status in red blood cells was assessed in the 28(th) gestation week and participants were screened for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS) three months after delivery. The aim of the present study was to investigate if a low omega-3 index in pregnancy is a possible risk factor for postpartum depression. RESULTS In a simple regression model, the omega-3 index was associated with the EPDS score in a nonlinear inverse manner with an R square of 19. Thus, the low omega-3 index explained 19% of the variance in the EPDS score. The DPA content, DHA content, omega-3 index, omega-3/omega-6 ratio, total HUFA score, and the omega-3 HUFA score were all inversely correlated with the EPDS score. The EPDS scores of participants in the lowest omega-3 index quartile were significantly different to the three other omega-3 index quartiles. CONCLUSION In this study population, a low omega-3 index in late pregnancy was associated with higher depression score three months postpartum.
Collapse
Affiliation(s)
- Maria Wik Markhus
- National Institute of Nutrition and Seafood Research, NIFES, Bergen, Norway.
| | | | | | | | | | | | | |
Collapse
|
18
|
Abstract
Postpartum depression (PPD) is common, occurring in 10%-15% of women. Due to concerns about teratogenicity of medications in the suckling infant, the treatment of PPD has often been restricted to psychotherapy. We review here the biological underpinnings to PPD, suggesting a powerful role for the tryptophan catabolites, indoleamine 2,3-dixoygenase, serotonin, and autoimmunity in mediating the consequences of immuno-inflammation and oxidative and nitrosative stress. It is suggested that the increased inflammatory potential, the decreases in endogenous anti-inflammatory compounds together with decreased omega-3 poly-unsaturated fatty acids, in the postnatal period cause an inflammatory environment. The latter may result in the utilization of peripheral inflammatory products, especially kynurenine, in driving the central processes producing postnatal depression. The pharmacological treatment of PPD is placed in this context, and recommendations for more refined and safer treatments are made, including the better utilization of the antidepressant, and the anti-inflammatory and antioxidant effects of melatonin.
Collapse
Affiliation(s)
- George Anderson
- CRC Clincial Research Centre/Communications, Glasgow, Scotland
| | | |
Collapse
|