Low Vitamin D Concentration Is Associated with Increased Depression Risk in Adults 20-44 Years Old, an NHANES 2007-2018 Data Analysis with a Focus on Perinatal and Breastfeeding Status.

The objective was to investigate associations of serum vitamin D concentration with depressive symptoms and assess the impact that vitamin D concentration has on the occurrence of depressive symptoms in 20-44-year-old pregnant women, postpartum women, non-pp women (non-pregnant/postpartum women), and men, including a separate subgroup analysis of postpartum breastfeeding and non-breastfeeding women. The study populations were selected from the 2007-2018 NHANES public data. Subjective interview data and objective laboratory data including depressive symptoms, serum vitamin D concentration, nutrient intake, and demographic information were utilized. Two diet patterns were created using principal component analysis, and a Bayesian multinomial model was fit to predict the depression outcomes for each subpopulation. The estimates for the log vitamin D slope parameter were negative for all cohorts; as vitamin D increased, the probability of having no depression increased, while the probability of depression decreased. The pregnant cohort had the steepest vitamin D slope, followed by postpartum women, then non-pp women and men. Higher vitamin D concentration had more impact on decreasing depression risk in pregnant and postpartum women compared to non-pp women and men. Among postpartum women, higher vitamin D concentration had a greater influence on decreasing breastfeeding women's depression risk than non-breastfeeding women.

Investigation and Analysis of Emotional State and Oxytocin Level in Patients with Postpartum Depression.

BACKGROUND: Postpartum depression (PPD) is a common mental disorder in postpartum women, negatively impacting physical and mental health. Correlation analysis can predict the relationship between variables. By detecting the abnormal level of oxytocin, clinicians can timely know the emotional states of parturients to guide clinical practice. This study aimed to investigate the relationship between emotional states and oxytocin (OT) levels in patients with PPD. MATERIALS AND METHODS: The medical records of 166 PPD patients admitted to Cangzhou Central Hospital from May 2020 to March 2023 were retrospectively analyzed. After excluding 9 patients who did not meet the inclusion criteria, the remaining 157 patients were included in this study. The 7-item Generalized Anxiety Disorder Scale and Patient Health Questionaire-9 items were used to evaluate the emotional states of 157 patients, and the included subjects were grouped according to the results of the scale. The serum OT levels of patients was measured, and the relationship between the OT levels and emotional states was analyzed. RESULTS: In this study, 75 patients were included in the mild anxiety group, and 82 patients were included in the moderate and severe anxiety group. Seventy-nine patients were selected as the mild depression group, and 78 patients were included in the moderate and severe depression group. The mild anxiety group had a higher OT level than the moderate and severe anxiety group (Z = -10.121, p < 0.001). The mild depression group had a higher OT level than the moderate and severe depression group (Z = -9.758, p < 0.001). OT level was negatively correlated with anxiety and depression scores (r = -0.676, r = -0.665, p < 0.001). CONCLUSION: There is a specific relationship between the emotional states of PPD patients and the OT levels in the body, and active clinical management strategies need to be implemented.

Blood metabolomic and postpartum depression: a mendelian randomization study.

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.

Inflammatory biomarkers and perinatal depression: A systematic review.

BACKGROUND: Approximately 10 to 20% of pregnant women worldwide experience perinatal depression (PND), a depressive episode with onset during pregnancy or after childbirth. We performed a systematic review to identify, summarize and discuss studies on inflammatory biomarkers described in relation to PND. METHOD: Inclusion criteria defined the selection of observational studies written in English, French, Spanish or Portuguese, that evaluate analytical levels of inflammatory molecules (protein levels) in biological fluids in women, with a diagnosis of depression using ICD/DSM diagnostic criteria or depressive symptoms assessed by standardized psychometric instruments, during pregnancy and/or postpartum. Case reports, experimental studies, reviews, qualitative analysis, meta-analysis, gray literature or replicated data were excluded. Three electronic databases were used for search (Pubmed, Web of Science and PsychInfo) and quality assessment of selected studies were performed using the Newcastle-Ottawa Scale. Data extraction included study design; number of subjects; obstetric information; tools and timepoints of depression and inflammatory markers assessment. RESULTS: 56 studies (sample size for cross-sectional and case-control studies ranging from 10 to 469; sample size for longitudinal studies ranging from 26 to 467), where the major aim was to analyze the association between depression and inflammatory biomarkers during pregnancy and postpartum period were included in this systematic review. Overall, the findings of our systematic review lend support to the hypothesis that several inflammatory markers may be associated with peripartum depressive symptoms. The associations were somewhat different looking at pregnancy compared to the delivery time-point and postpartum, and mainly referred to increased levels of IL-6, IL-8, CRP and TNF-α among depressed. DISCUSSION: In summary, our systematic review findings provide evidence supporting the hypothesis that several inflammatory markers may correlate with peripartum depressive symptoms. However, our work also highlighted notable differences in the timing of biological sampling for inflammatory markers and in the methodologies used to assess depression during the perinatal period. Additionally, variations were observed in how inflammatory biomarkers and depression were approached, including their classification as exposure or outcome variables, and the timing of assessments. It is essential for future research to investigate the influence of biological fluids and the timing of assessments for both inflammatory biomarkers and depression to gain a deeper understanding of their association. This comprehensive exploration is pivotal for elucidating the intricate relationship between inflammation and perinatal depression.

Allopregnanolone in the peripartum: Correlates, concentrations, and challenges - A systematic review.

BACKGROUND: Allopregnanolone (ALLO) is a metabolite of progesterone and a neuroactive steroid hormone. As a positive allosteric modulator of gamma-aminobutyric acid (GABA) receptors, ALLO seems to have antidepressant and anxiolytic effects, and was therefore approved as a specific medication for the treatment of postpartum depression in 2019. Despite the growing number of publications investigating ALLO levels, results on the biological and psychological correlates in the peripartum period remain inconsistent, possibly due to methodological challenges regarding measurement. To date, however, there is no systematic review examining the correlates, concentrations, and challenges in measuring ALLO in peripartum women. METHOD: A systematic literature search of PubMed and PsycINFO was conducted in August 2023. Original research articles that measured ALLO concentrations in peripartum women were included. Reports were excluded if they were not original research, included non-human subjects, did not include peripartum women, did not include ALLO measurement as an outcome, included (pharmacological) interventions, constituted method validations, or used the same cohort as another study. RESULTS: The literature search yielded 234 articles, and two articles were identified from other sources. After full-text screening, 19 articles (N = 1401) met the inclusion criteria, of which seven focused on biological correlates of ALLO and 12 on mood correlates. Of the latter, six found no association between ALLO and mood, four found a negative association, and two found a positive association. Overall, the results show an increase in ALLO levels during pregnancy and a decrease after birth, with levels then remaining low until six months postpartum. ALLO was most commonly measured in blood plasma and by gas chromatography-mass spectrometry (GC-MS). A significant matrix effect was found for blood serum and a significant method effect for radioimmunoassays (RIAs). A significant effect of time of measurement was found. CONCLUSION: ALLO measurement shows method and matrix effects. ALLO levels are higher when measured in serum compared to in plasma, and when measured using RIA compared to other methods. Time of measurement, study design, and standardization of measurement also influence the reliability of measurement and the interpretation of results.

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.

919 granules improve postpartum depression through the regulation of abnormal peripheral blood IL-1ß.

Postpartum depression (PPD) has a significant impact on the physical and mental health of mothers, potentially leading to symptoms such as low mood, fatigue, and decreased appetite. It may also affect the healthy growth of the infant. The onset of PPD is closely related to abnormalities in inflammation and the immune system. PPD patients exhibit abnormalities in the proportion of peripheral blood immune cells, along with an increase in pro-inflammatory cytokines. Excessive pro-inflammatory cytokines in peripheral blood can disrupt the blood-brain barrier (BBB) by activating astrocytes and reducing transendothelial electrical resistance (TEER), allowing peripheral immune cells or cytokines to enter the brain and trigger inflammation, ultimately leading to the onset of depression. In addition, PPD lacks safe and effective treatment medications. In this study, we collected peripheral blood from both healthy postpartum women and those with PPD, conducted single cell RNA sequencing (scRNA-seq), and used an in-house analytical tool scSTAR to reveal that PPD patients exhibit elevated proportions of peripheral blood cDC2 and Proliferation B cells, which are significantly correlated with IL-1ß. Additionally, animal experiments were designed to validate that 919 granules can improve PPD by modulating the levels of peripheral blood IL-1ß, providing a potential therapeutic mechanism for PPD treatment.

The effect of vitamin D and calcium supplementation on inflammatory biomarkers, estradiol levels and severity of symptoms in women with postpartum depression: a randomized double-blind clinical trial.

Objectives: Postpartum depression (PPD) is a major depressive disorder. Vitamin D deficiency may play a role in PPD pathogenesis. This study was designed to determine the effect of vitamin D and calcium supplementation on the severity of symptoms and some related inflammatory biomarkers in women with PPD.Materials and Methods: Eighty-one women with a PPD score >12 participated in this study. A total of 27 patients were randomly assigned into three groups (1:1:1 ratio) to receive either 50,000 IU vitamin D3 fortnightly + 500 mg calcium carbonate daily; or 50,000 IU vitamin D3 fortnightly + placebo of calcium carbonate daily, or placebo of vitamin D3 fortnightly + placebo of calcium carbonate daily (placebo group) for 8 weeks. At the baseline and end of the study, the severity score of PPD, levels of 25-hydroxy vitamin D, calcium, tumor necrosis factor-alpha (TNFα), interleukin 6 (IL6) and estradiol were measured.Results: The PPD score had more reduction in the vitamin D + calcium and vitamin D + calcium placebo groups than that of the placebo group (-1.7 ± 3.44, -4.16 ± 5.90 and 0.25 ± 2.81, respectively; p = 0.008). The effect of vitamin D on the PPD score was larger when vitamin D was given alone than given together with calcium (p = 0.042 and p = 0.004, respectively). No significant differences in estradiol, IL6 and TNFα were observed between the three groups.Discussion: Vitamin D may be effective in improving the clinical symptoms of PPD; however, the mechanism of the effect might not entirely operate through inflammatory and/or hormonal changes.

Combined identification of lncRNA NONHSAG004550 and NONHSAT125420 as a potential diagnostic biomarker of perinatal depression.

BACKGROUND: Perinatal depression (PD) is one of the most common complications of pregnancy, and timely diagnosis and treatment are still challenging in China due to the scarcity of psychiatrists. This study aimed to investigate whether long noncoding RNAs (lncRNAs) are potential diagnostic biomarkers of PD. METHODS: Using RT-PCR, six downregulated major depressive disorder (MDD)-associated lncRNAs (NONSUSG010267, NONHSAT140386, NONHSAG004550, NONHSAT125420, NONHSAG013606, and NONMMUG014361) were assessed in 39 pregnant women with PD (PD group), 20 PD patients undergoing mindfulness-integrated cognitive behavior therapy (MiCBT) (treatment group (TG)), and 51 normal pregnant women (normal control (NC) group) to identify significantly differentially expressed lncRNAs during the second trimester and at 42 days postpartum. RESULTS: Compared with the NC group, the six lncRNAs were significantly downregulated in the PD group during the second trimester and at 42 days postpartum (p<0.01~0.001). Expression of NONHSAG004550 and NONHSAT125420 was significantly upregulated after MiCBT therapy in TG (p<0.01~0.001), and no significant differences were observed between TG and the NC group at 42 days postpartum (p>0.05). NONHSAG004550 and NONHSAT125420 were significantly differentially expressed in the PD group, and this expression was altered according to the amelioration of depressive symptoms. Receiver operating characteristic (ROC) curve analysis revealed that the two lncRNAs combined had a good value in predicting PD, with an area under the curve (AUC) of 0.764 (95% confidence interval (CI): 0.639-0.888). CONCLUSION: The combination of lncRNAs NONHSAG004550 and NONHSAT125420 is a novel potential diagnostic biomarker of PD.

The Effect of Dialectic Behavioral Counseling on Depression, Anxiety, and Postpartum Hematocrit Level.

OBJECTIVE: Childbirth is a biological, psychological, and sociological event that can be a positive or negative experience, and, without support, this period may be potentially damaging. Parturition may distort maternal emotions and lead to short- or long-term disorders such as postpartum depression and anxiety. The present research aims to study the effects of dialectic behavioral therapy-based counseling on depression, anxiety symptoms, and postpartum hematocrit level. METHODS: The current research is a clinical trial study, and the sample was selected using parturients who were referred to the Health General Center with a diagnosis of postpartum depression and anxiety. The sample size consisted of 116 subjects who agreed to participate in the study. The patients in intervention group underwent group dialectic behavioral counseling (10 sessions/one session per week) and the control group did not receive any type of intervention. The patients were assessed in the first and last sessions as well as 2 months after the end of the sessions, using the Beck depression scale and Spielberg anxiety scale as well as the results of hematocrit tests. Data were analyzed using the IBM SPSS Statistics for Windows, Version 21.0 (IBM Corp., Armonk, NY, USA) RESULTS: The results implied the effectiveness of dialectic behavioral therapy on reduction of the depression score, anxiety symptoms (p-value ≤ 0.0001), and hematocrit level (p-value = 0.04). The participants' depression, anxiety, and hematocrit levels decreased in the experiment group compared to the control group, and this decrease has remained until the 2-month follow-up. CONCLUSION: It seems that dialectic behavioral counseling reduces the levels of postpartum depression, anxiety, and hematocrits.

The effect of dialectic behavioral counseling on depression, anxiety, and postpartum hematocrit levelprotocolo 20210073553284 prefeitura

Abstract Objective Childbirth is a biological, psychological, and sociological event that can be a positive or negative experience, and, without support, this period may be potentially damaging. Parturition may distort maternal emotions and lead to short- or long-term disorders such as postpartum depression and anxiety. The present research aims to study the effects of dialectic behavioral therapy-based counseling on depression, anxiety symptoms, and postpartum hematocrit level. Methods The current research is a clinical trial study, and the sample was selected using parturients who were referred to the Health General Center with a diagnosis of postpartum depression and anxiety. The sample size consisted of 116 subjects who agreed to participate in the study. The patients in intervention group underwent group dialectic behavioral counseling (10 sessions/one session per week) and the control group did not receive any type of intervention. The patients were assessed in the first and last sessions as well as 2 months after the end of the sessions, using the Beck depression scale and Spielberg anxiety scale as well as the results of hematocrit tests. Data were analyzed using the IBMSPSS Statistics for Windows, Version 21.0 (IBMCorp., Armonk, NY, USA) Results The results implied the effectiveness of dialectic behavioral therapy on reduction of the depression score, anxiety symptoms (p-value ≤ 0.0001), and hematocrit level (p-value=0.04). The participants' depression, anxiety, and hematocrit levels decreased in the experiment group compared to the control group, and this decrease has remained until the 2-month follow-up. Conclusion It seems that dialectic behavioral counseling reduces the levels of postpartum depression, anxiety, and hematocrits.

Cross-sectional association between vitamin B12 status and probable postpartum depression in Indian women.

BACKGROUND: Vitamin B12 is an essential micronutrient for neurological function, as it leads to the regeneration of methionine from homocysteine, which is precursor of biologically active molecule S-Adenosyl Methionine (SAM). Pregnancy is a state of increased demand and delayed postpartum repletion of nutrients may predispose women to depression. METHODS: We included women who visited the hospital at 6-weeks postpartum for a regular checkup. Inclusion criteria were age (18-50 years), and willingness to donate venous sample for analysis. Exclusion criteria included previous history of mood disorders or antidepressant medication use, and any systemic illness like hypothyroidism, epilepsy, diabetes, and hypertension. Based on EPDS score of 10 as a cutoff, 217 women with probable postpartum depression (PPD) and equal number of age and BMI matched controls were included. Plasma total vitamin B12, holotranscobalamin (holotc), homocysteine (hcy), methyl malonic acid (MMA), 5-methyl tetrahydrofolate (THF), SAM and serotonin levels were estimated using commercially available ELISA kits. Combined B12 (cB12) score was calculated from study parameters. Multivariate analysis was performed to assess the risk of probable postpartum depression. RESULTS: Total vitamin B12 and combined B12 score were found to be significantly lower (p = 0.001) and MMA (p = 0.002) and 5-methyl THF (p < 0.001) levels were higher in women with probable depression than women without probable PPD. Women in the lowest vitamin B12 quartile had 4.53 times higher likelihood of probable postpartum depression (p < 0.001). Multivariate analysis demonstrated that decreasing vitamin B12 (OR = 0.394; 95% CI: 0.189-0.822) and cB12 (OR = 0.293; 95% CI: 0182-0.470) and increasing MMA (OR = 2.14; 95% CI: 1.63-2.83) and 5-methyl THF levels (OR = 3.29; 95% CI: 1.59-6.83) were significantly associated with the risk of probable PPD. CONCLUSION: Low vitamin B12 may contribute to depressive symptoms in vulnerable postpartum period.

Association between the serum insulin-like growth factor-1 concentration in the first trimester of pregnancy and postpartum depression.

AIM: Patients with major depression present with an increased serum insulin-like growth factor-1 (IGF-1) concentration. However, the longitudinal relationship between serum IGF-1 levels and depression development remains unclear. This study aimed to investigate the longitudinal association between the serum IGF-1 concentration in the first trimester of pregnancy and postpartum depression development using data obtained from the Japan Environment and Children's Study (JECS). METHODS: The JECS included 97 415 pregnant women; among them, 8791 were enrolled in this study. Data regarding depression in the first trimester, postpartum depression development at 1 month after childbirth, and other covariates were collected using a self-administered questionnaire. Serum IGF-1 levels were measured in the first trimester of pregnancy. The participants were divided into four groups according to the serum IGF-1 level. RESULTS: In the first trimester, serum IGF-1 levels were not significantly associated with psychological distress in pregnant women. In the longitudinal analyses, however, postpartum depression development in mothers within the highest quartile for serum IGF-1 concentration in the first trimester was significantly less common than in those within the lowest quartile (odds ratio 0.48, 95% confidence interval 0.30-0.79). CONCLUSION: Pregnant women with a high serum IGF-1 concentration in the first trimester were less likely to develop postpartum depression than those with a low concentration. A high serum IGF-1 concentration during pregnancy may help to protect against postpartum depression development.

Plasma level of brain-derived neurotrophic factor (BDNF) in patients with postpartum depression.

Postpartum depression occurs in 10-15% of mothers. Brain-derived neurotrophic factor (BDNF) is a nerve growth factor that plays a role in neuroplasticity. We hypothesized that the concentration of BDNF is related to reproduction and childbirth, and that women with postpartum depression show alteration in BDNF level. A total of 104 pregnant women was selected as subjects, and 60 non-pregnant women were selected as normal controls. Symptoms of depression were evaluated in the pregnant study subjects using the diagnostic criteria outlined in the Edinburgh Postnatal Depression Scale (EPDS). The pregnant subjects were divided into three groups of perinatal non-depressed controls (n = 61), postpartum depression-recovery (n = 18), and postpartum depression (n = 25). The plasma concentration of BDNF was higher in the pregnant group than in non-pregnant controls and lower in the postpartum depression group at 6 weeks after delivery than in the perinatal non-depressed group. In the postpartum depression-recovery group, the BDNF concentration increased at 6 weeks after delivery compared to that at 24 weeks of gestation. This study found significant changes in plasma BDNF concentration in depressed pregnant women.

The relationship between oxytocin blood concentrations and antidepressants over pregnancy and the postpartum.

Antidepressant treatment of perinatal depression is increasingly common and accepted in clinical guidelines. It has been suggested that serotonergic antidepressants may effect changes in the oxytocinergic system, including oxytocin levels, and that this may be one of the beneficial mechanisms of action for these drugs. Furthermore, oxytocin has been associated with the quality of the parent-child relationship, which may be important in treatment of perinatal depression. This study will explore if there is a relationship between antidepressant use over the perinatal period and oxytocin levels. Data from a pregnancy cohort study are used from 279 women across three groups: women taking antidepressants in pregnancy (n = 48), women with untreated depression (n = 31) and healthy control women (n = 200). Data included antidepressant use, maternal depression and oxytocin plasma concentrations in pregnancy and up to 12 months postpartum. We found that concurrent oxytocin blood concentrations were not associated with perinatal antidepressant use. However, oxytocin blood concentrations increased more steeply in those on antidepressants across the perinatal period compared to control women. A steeper increase for Selective Serotonergic Reuptake Inhibitors was observed, however, this effect was on the boarder of statistical significance. In conclusion, although antidepressant use and oxytocin was not associated at any time point, women taking antidepressants during pregnancy had larger increases in oxytocin over the perinatal period. Future research could examine specific agents and class of antidepressant and the relationship to parenting.

Reduced Maternal Serum Total, Free and Bioavailable Vitamin D Levels and its Association with the Risk for Postpartum Depressive Symptoms.

BACKGROUND: Low vitamin D levels have been implicated in postpartum depressive disorders. However, studies on bioavailable vitamin D levels in postpartum depression are limited. Our study aimed to assess the serum concentrations of total, free and bioavailable 25-hydroxyvitamin D (25(OH)D) levels in women with postpartum depressive symptoms (PPD) and the association between 25(OH)D levels and PPD at 6 week post-delivery. METHODS: In this cross-sectional study, a total of 330 cases and 330 age and BMI matched controls were recruited from the tertiary care hospital in South India. Women with depressive symptoms were assessed using the validated Edinburg Postnatal Depression Scale (EPDS) and cut-off score ≥10 was used. Serum 25(OH)D and VDBP levels were measured using commercially available ELISA kits. RESULTS: Serum total, free and bioavailable 25(OH)D levels were significantly lower in postpartum depressive women compared to non-depressive women (p <0.001, p = 0.01). A significant negative correlation was observed between 25(OH)D, free 25(OH)D and bioavailable 25(OH)D with EPDS score in total study subjects (p <0.001, r = -0.19; p <0.001, r = -0.14 and p <0.001, r = -0.14). Multivariate linear regression analysis further confirmed a significant association between serum total, free and bioavailable 25(OH)D levels and EPDS score (p <0.001∗). CONCLUSIONS: Our study demonstrated that lower serum total, free and bioavailable 25(OH)D levels were associated with postpartum depressive symptoms. Hypovitaminosis D after delivery may be a risk factor for postpartum depression.

A prospective study to explore the relationship between MTHFR C677T genotype, physiological folate levels, and postpartum psychopathology in at-risk women.

BACKGROUND: The etiology of postpartum psychopathologies are not well understood, but folate metabolism pathways are of potential interest. Demands for folate increase dramatically during pregnancy, low folate level has been associated with psychiatric disorders, and supplementation may improve symptomatology. The MTHFR C677T variant influences folate metabolism and has been implicated in depression during pregnancy. OBJECTIVE: To conduct a prospective longitudinal study to explore the relationship between MTHFR C677T genotype, folate levels, and postpartum psychopathology in at-risk women. HYPOTHESIS: In the first three months postpartum, folate will moderate a relationship between MTHFR genotype and depression, with TT homozygous women having more symptoms than CC homozygous women. METHODS: We recruited 365 pregnant women with a history of mood or psychotic disorder, and at 3 postpartum timepoints, administered the Edinburgh Postnatal Depression Scale (EPDS); Clinician-Administered Rating Scale for Mania (CARS-M) and the Positive and Negative Symptom Scale (PANSS) and drew blood for genotype/folate level analysis. We used robust linear regression to investigate interactions between genotype and folate level on the highest EPDS and CARS-M scores, and logistic regression to explore interactions with PANSS psychosis scores above/below cut-off. RESULTS: There was no significant interaction effect between MTHFR genotype and folate level on highest EPDS (p = 0.36), but there was a significant interaction between genotype, folate level and log(CARS-M) (p = 0.02); post-hoc analyses revealed differences in the effect of folate level between CC/CT, and TT genotypes, with folate level in CC and CT having an inverse relationship with symptoms of mania, while there was no relationship in participants with TT genotype. There was no significant interaction between MTHFR genotype and folate level on the likelihood of meeting positive symptom criteria for psychosis on the PANSS (p = 0.86). DISCUSSION: These data suggest that perhaps there is a relationship between MTHFR C677T, folate level and some symptoms of postpartum psychopathology.

Relationship between vitamin D deficiency and both gestational and postpartum depression.

INTRODUCTION: Introduction: vitamin D deficiency (VDD) has been associated with depressive symptoms in pregnancy and postpartum, which can result in increased adverse outcomes in the maternal-infant segment. A possible explanation in the literature is VDD relationship with genetic and neurological mechanisms. Objective: to evaluate VDD relationship with gestational and postpartum depression. Methods: this review followed the recommendations proposed by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Research was conducted in electronic databases, PubMed and LILACS, including studies of the analytical type (cross-sectional and longitudinal), systematic reviews, meta-analyses, and controlled clinical trials carried out in humans; inclusion and exclusion criteria were applied. Results and conclusions: in this systematic review, eight articles were analyzed comprising 8,583 women from seven different countries. Among the selected articles, six found an association between VDD and gestational and postpartum depression. Considering the data collection, it was possible to conclude that there is a probable relationship between VDD and a higher predisposition to gestational and postpartum depression. Also, we concluded that vitamin D supplementation has proven to be a promising strategy for reducing the risk of depressive symptoms.

INTRODUCCIÓN: Introducción: la deficiencia de vitamina D (VDD) se ha asociado a síntomas depresivos en el embarazo y el posparto, lo que puede resultar en un aumento de los resultados adversos en el segmento materno-infantil. Una posible explicación en la literatura es la relación de la VDD con mecanismos genéticos y neurológicos. Objetivo: evaluar la relación de la VDD con la depresión gestacional y posparto. Métodos: esta revisión siguió las recomendaciones propuestas por los Elementos de Informes Preferidos para revisiones sistemáticas y metaanálisis. La investigación se llevó a cabo en bases de datos electrónicas, PubMed y LILACS, incluyendo estudios de tipo analítico (sección transversal y longitudinal), revisiones sistemáticas, metaanálisis y ensayos clínicos controlados realizados en seres humanos; se aplicaron criterios de inclusión y exclusión. Resultados y conclusiones: en esta revisión sistemática se analizaron ocho artículos que comprenden a 8716 mujeres de siete países diferentes. Entre los artículos seleccionados, seis encontraron asociación entre la VDD y la depresión gestacional y posparto. Teniendo en cuenta la recopilación de datos, fue posible concluir que existe una relación probable entre la VDD y una mayor predisposición a la depresión gestacional y posparto. También llegamos a la conclusión de que la suplementación con vitamina D ha demostrado ser una estrategia prometedora para reducir el riesgo de síntomas depresivos.

Biological reflect of Adiponectin hormone in postpartum marital satisfaction and depression scores.

BACKGROUND: There is a growing body of evidence regarding the association between Adiponectin and mental disorders. We aim to evaluate the association between serum level of Adiponectin hormone and postpartum depression and marital satisfaction scores. METHODS: A prospective cohort study of 90 pregnant women was conducted in Mahdieh Hospital, Tehran, Iran. Blood samples were collected during the first 24 h after delivery. The serum Adiponectin concentration was measured with an Enzyme-Linked Immunosorbent Assay (ELISA) kit. The depression score was measured using a validated Iranian version of the Edinburgh Postnatal Depression Scale (EPDS) questionnaire at six weeks (6-weeks) and twelve weeks (12-weeks) after delivery. Using the Kansas questionnaire at twelve weeks (12-weeks) after delivery, the marital satisfaction score was measured. The measurements were compared between two groups, satisfied and dissatisfied mothers. P-values lower than 0.05 were considered significant. RESULTS: The mean serum level of Adiponectin was significantly higher in the dissatisfied group. It was 10.9 ± 13.4 µg/ml and 15.2 ± 17.7 µg /ml in the satisfied and dissatisfied groups, respectively (P = 0.04). The postpartum depression scores of 6- and 12-weeks after delivery were significantly higher in the dissatisfied group. At 6-weeks after delivery, the postpartum depression scores were 3.6 ± 3 and 8.7 ± 5.6 in satisfied and dissatisfied groups, respectively. Those were 2.7 ± 2.7 and 7.6 ± 5 at 12-weeks after delivery, respectively. There was a significant difference statistically (P <  0.001). CONCLUSION: Mothers in the dissatisfied group, experienced higher depression scores at 12-weeks postpartum while they had shown higher serum Adiponectin levels at the first 24 h after delivery.

Levels of n-3 and n-6 Fatty Acids in Maternal Erythrocytes during Pregnancy and in Human Milk and Its Association with Perinatal Mental Health.

Omega-3 long-chain polyunsaturated fatty acid (n-3 FA) status may be associated with mood disorders. Here, we evaluated the potential association between antenatal depression/anxiety and n-3/n-6 FA in (a) maternal erythrocytes and (b) human milk. In addition, we explored associations between n-3/n-6 FA in erythrocytes and in human milk and postpartum depression, while controlling for antenatal depression. Twenty-seven pregnant women diagnosed with a current major depressive disorder (MDD; n = 9), anxiety disorder (AD; n = 10) or a mixed anxiety-depression disorder (MADD; n = 8), and 40 healthy controls were included. n-3/n-6 FA were determined in maternal erythrocytes in gestational week 32 and in human milk in postpartum week 1. In the first week postpartum, the Edinburgh-Postnatal-Depression-Questionnaire was used to assess postpartum depression. Results show that women with M(A)DD had significantly lower erythrocyte levels of total n-3 FA, EPA, DHA and DGLA, and significantly higher n-6 DPA, and n-6:n-3, AA:EPA and n-6 DPA:DHA ratios compared to healthy controls. No significant associations between antenatal depression or anxiety and n-3/n-6 FA in human milk were found. After controlling for antenatal mental health, n-3/n-6 FA in maternal erythrocytes or in human milk were not significantly associated with postpartum depression. In conclusion, antenatal depression, alone or with an anxiety disorder, was associated with lower n-3 FA levels and higher n-6:n-3 FA ratios in maternal erythrocytes during gestation. This study provides some insights into the associations between n-3/n-6 FA levels during pregnancy and lactation and perinatal mental health.