Relationship between inflammatory biomarkers and depressive symptoms during late pregnancy and the early postpartum period: a longitudinal study

Objective: Perinatal depressive symptoms often co-occur with other inflammatory morbidities of pregnancy. The goals of our study were 1) to examine whether changes in inflammatory markers from the third trimester of pregnancy to 12 weeks postpartum were associated with changes in depressive symptoms; 2) to examine whether third trimester inflammatory markers alone were predictive of postpartum depressive symptoms; and 3) to examine the relationship between inflammatory markers and depressive symptoms during the third trimester of pregnancy and at 12 weeks postpartum. Methods: Thirty-three healthy pregnant women were recruited from the Women’s Health Concerns Clinic at St. Joseph’s Healthcare in Hamilton, Canada. The impact of depressive symptoms on the levels of interleukin (IL)-6, IL-10, tumor necrosis factor alpha (TNF-α), and C-reactive protein (CRP) at the third trimester of pregnancy, at 12 weeks postpartum, and across time was assessed using linear and mixed-model regression. Results: Regression analysis revealed no significant association between depressive symptoms and any of the candidate biomarkers during pregnancy, at 12 weeks postpartum, or over time. Pregnancy depressive symptoms (p > 0.001), IL-6 (p = 0.025), and IL-10 (p = 0.006) were significant predictors of postpartum Edinburgh Perinatal Depression Scale (EPDS) score. Conclusions: Our study supports previous reports from the literature showing no relationship between inflammatory biomarkers and depressive symptoms during late pregnancy, early postpartum, or across time. Our study is the first to observe an association between late pregnancy levels of IL-6 and IL-10 and postpartum depressive symptoms. Further studies with larger samples are required to confirm these findings.

Asociación entre la ansiedad materna y el parto pretérmino en Lima, Perú / Association between maternal anxiety and preterm delivery in Lima, Peru

Introducción: el parto pretérmino se define como el parto antes de las 37 semanas. Se han establecido diversos factores desencadenantes, entre los cuales se encuentra la ansiedad. En Perú se han realizado pocos estudios en relación con el tema. Objetivo: determinar la asociación entre la ansiedad materna durante el tercer trimestre de embarazo y el desarrollo de parto pretérmino. Métodos: estudio de tipo cohorte prospectiva realizado en un hospital público de Lima-Perú, que incluyó a 247 gestantes (enero de 2014 a enero de 2015). Se evaluó a gestantes entre las semanas 28 y 35 de embarazo, durante la visita prenatal. Los datos perinatales se obtuvieron del libro de partos y de la historia clínica materna. El instrumento utilizado para medir la ansiedad fue la encuesta State Trait Anxiety Inventori (STAI). El análisis de datos se realizó mediante STATA versión 11.1. Resultados: la mediana de edad de las participantes fue 27, 68,1 por ciento fueron convivientes y 58 por ciento tuvieron secundaria completa. Se encontró una incidencia de parto pretérmino de 11,6 por ciento. En el análisis multivariado ajustado, se encontró un riesgo relativo de 1,23 (IC 95 por ciento: 0,57-2,65) para ansiedad de estado y un riesgo relativo de 0,97 (IC 95 por ciento: 0,45-2,06) para ansiedad de rasgo. En el análisis bivariado se encontró una asociación significativa con preeclampsia. Conclusión: Se recomienda realizar más estudios longitudinales para establecer mejor la asociación ansiedad materna - parto pretérmino(AU)

Introduction: preterm delivery is defined as delivery before 37 weeks of gestational age. Several triggering factors have been established, anxiety being one of them. Few studies on the subject have been conducted in Peru. Objective: determine the association between maternal anxiety during the third trimester of pregnancy and preterm delivery. Methods: a prospective cohort study was conducted at a public hospital in Lima, Peru, from January 2014 to January 2015. The study sample consisted of 247 pregnant women of 28-35 weeks of pregnancy. Evaluation was performed during prenatal visits. Perinatal data were obtained from the labor and delivery registry and the patients' medical records. The tool used to measure anxiety was the survey State Trait Anxiety Inventory (STAI). Data were analyzed with STATA version 11,1. Results: mean age of participants was 27 years; 68,1 percent cohabitated with their partners, and 58 percent had completed high school. Preterm delivery had an incidence of 11,6 percent. Adjusted multivariate analysis revealed a relative risk of 1,23 (95 percent CI 0,57-2,65) for state anxiety and ,.97 (95 percent CI 0,45-2,06) for trait anxiety. Bivariate analysis found a significant association with preeclampsia. Conclusion: anxiety during the third trimester of pregnancy was found to be a risk factor for preterm delivery. It is recommended to perform other longitudinal studies to more clearly determine the association between maternal anxiety and preterm delivery(AU)

Health-related uuality of life of pregnant women with heartburn and regurgitation / Qualidade de vida em gestantes com pirose e regurgitação

Background Heartburn and regurgitation frequently occur in the third trimester of pregnancy, but their impact on quality of life has not been thoroughly investigated. Objective To measure health-related quality of life of third-trimester pregnant women with heartburn and regurgitation. Methods Data on obstetric history, heartburn and regurgitation frequency and intensity, history of heartburn and regurgitation and health-related quality of life were collected of 82 third-trimester pregnant women. Results Sixty-two (76%) women had heartburn, and 58 (71%), regurgitation; 20 were asymptomatic. Mean gestational age was 33.8±3.7 weeks; 35 (43%) women had a family history of heartburn and/or regurgitation, and 57 (70%) were asymptomatic before pregnancy. The following quality of life concepts were significantly reduced: physical problems and social functioning for heartburn; physical problems and emotional functioning for regurgitation. There was agreement between heartburn in present and previous pregnancies. Conclusion Heartburn and/or regurgitation affected health-related quality of life of third trimester pregnant women .

Contexto A pirose e a regurgitação ocorrem com frequência no terceiro trimestre de gestação, mas o seu impacto na qualidade de vida não foi completamente investigado. Objetivo Avaliar a qualidade da vida de gestantes do terceiro trimestre com pirose e regurgitação. Métodos Os dados sobre a história obstétrica, frequência, intensidade e história de pirose e regurgitação, bem como a qualidade de vida foram coletados de 82 mulheres do terceiro trimestre de gestação. Resultados Sessenta e duas (76%) mulheres tinham pirose e, 58 (71%), regurgitação; 20 eram assintomáticas. A idade gestacional média foi de 33,8 ± 3,7 semanas; 35 (43%) mulheres tinham história familiar de pirose e/ou regurgitação e 57 (70%) eram assintomáticos antes da gestação. Os seguintes domínios de qualidade de vida estavam significativamente reduzidos: limitação física e aspectos sociais pela pirose; limitação física e aspectos emocionais pela regurgitação. Houve concordância entre pirose nas gestações atuais e prévias. Conclusão A pirose e/ou regurgitação afetam a qualidade de vida de gestantes de terceiro trimestre. .

Is positive affect in pregnancy protective of postpartum depression?

OBJECTIVE: To investigate the predictive/protective role of negative affect/positive affect in late pregnancy on the outcome of postpartum depression. METHODS: A total of 491 pregnant women participated in the study. The participants were asked to fill out a series of questionnaires, which included the Profile of Mood States, the Beck Depression Inventory-II, psychosocial variables and socio-demographic characteristics and were asked to participate in a psychiatric interview. After delivery, 272 mothers participated again in the study and filled out a similar series of questionnaires. RESULTS: Negative affect was associated with more intense depressive symptomatology, more self-perceived stress, lower self-reported social support, lower quality of life and perception of having a more difficult infant. By contrast, positive affect was negatively associated with these variables. Negative affect in late pregnancy increased the likelihood of experiencing postpartum depression (DSM-IV/OR = 2.1, 95%CI = 1.3-3.4, p = .003; ICD-10/OR = 2.1, 95%CI = 1.5-3.0, p < .001), while positive affect increased the odds of not having this condition (DSM-IV/OR = 2.0, 95%CI = 1.5-2.7, p = .042). CONCLUSION: In pregnancy, negative affect was a predictor of postpartum depression, whereas positive affect showed a protective role. Future studies are required to explore whether psychotherapeutic strategies focusing on decreasing negative affect and enhancing positive affect in the last trimester of pregnancy can reduce the risk of postpartum depression.

Encontro de gestantes do terceiro trimestre: uma experiência facilitadora para vivenciar o processo do nascimento / A meeting of third-trimester pregnants: in preparation for a full-lived experience of the birth process

Trata-se de um relato de experiência, acerca de um trabalho interdisciplinar, que está sendo desenvolvido na Maternidade do Hospital Universitário, desde dezembro de 1995, intitulado Encontro de Gestantes do Terceiro Trimestre. O objetivo é "criar" um momento no qual a gestante e seu acompanhante possam expressar suas dúvidas e ansiedades inerentes ao processo do nascimento, conhecerem as rotinas e área física da maternidade. Este trabalho tem contribuído para que as gestantes vivenciem de forma mais tranquila o momento da internaçäo, e todo o processo do nascimento.