Association between low MCV in early pregnancy and perinatal mental health in the Japan Environment and Children's Study and the possible effect of iron deficiency

BACKGROUND

Postpartum anemia and iron deficiency are associated with postpartum depression. This study investigated the association between a low mean corpuscular volume (MCV) without anemia (which implies early-stage iron deficiency) in early pregnancy and perinatal mental health outcomes.

METHODS

The fixed data from the Japan Environment and Children's Study (JECS), a Japanese nationwide birth cohort, were used. Perinatal mental health was assessed using the Kessler 6-item psychological distress scale (K6) in mid-pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) at 1- and 6-months postpartum.

RESULTS

Among the 3635 women with MCVs <85 fL in early pregnancy, the proportions of women with K6 scores ≥13 in mid-pregnancy and EPDS scores ≥9 at 1- and 6-months postpartum were 2.7 %, 12.8 %, and 9.9 %, respectively, compared with the 33,242 women with MCVs ≥85 fL at 1.9 %, 11.9 %, and 9.0 %, respectively. Multivariate logistic regression models showed that an MCV <85 in early pregnancy was associated with a K6 score ≥ 13 in mid-pregnancy and an EPDS score ≥ 9 at 1- and 6-months postpartum (adjusted odds ratio (95 % confidence interval): 1.48 (1.16-1.87), 1.14 (1.01-1.28), and 1.09 (0.95-1.24), respectively).

LIMITATIONS

Low MCV values do not necessarily represent iron deficiency. Ferritin, currently the best indicator of iron deficiency, was not measured in the JECS.

CONCLUSIONS

This study results suggest that a low MCV without anemia in early pregnancy is associated with a slightly increased risk of perinatal mental health deterioration.

Analysis of pure pancreatic juice proteins by two-dimensional gel electrophoresis in cases of pancreatic cancer

To clarify the difference in the protein composition of pancreatic juice between patients with pancreatic cancer and normal controls, the proteins of pure pancreatic juice from three cases of cancer of the head of the pancreas and six apparently healthy adults were analyzed by two-dimensional gel electrophoresis (two-DE) followed by silver staining. Two minor proteins of Mr 59,000 and Mr 78,000 present in all the three patients were not detected in the six controls. We have identified the minor proteins with Mr 59,000 and Mr 78,000 as alpha 1-antitrypsin and transferrin, respectively, using Western blotting with anti-alpha 1-antitrypsin and anti-transferrin antibodies. In addition, serum albumin also identified by antibody binding was abundantly present in patients compared to controls. The increase in the amount of serum albumin in the patient was also confirmed by a quantitative analysis using SDS-PAGE and gel densitometry. The data indicate that not only serum albumin but also alpha 1-antitrypsin and transferrin are increased in the pancreatic juice of the patients with pancreatic cancer, as compared with apparently healthy adults. The data also suggests that the analysis of pancreatic juice proteins by two-DE with silver staining is useful for the diagnosis of pancreatic diseases.