P regnancy can trigger the first episode of depression in a women or a recurrence of depression in those women with a prior history of the disorder. The prevalence of depression during pregnancy is estimated at 8% to 51%. The wide range in cited prevalence can be due to variations in the criteria used to diagnose depression and the timing and types of assessments used for evaluation of the disorder. This study evaluated the time to onset, duration, and risk factors for major and minor depression in pregnant women.The women were recruited from the Centers for Prenatal Care of the Public Health Service District in Mantova, Italy from September 2005 to August 2006. At each monthly visit, the study participants completed the Primary Care Evaluation of Mental Disorders (PRIME-MD) for screening of depressive disorders and the Hospital Anxiety and Depression Scale (HADS) for evaluation of the severity of anxious and depressive symptoms. The patients also completed a brief questionnaire for sociodemographic data. The PRIME-MD evaluates the presence of 9 depressive symptoms occurring in the previous 2 weeks. The HADS is a 14-item self-administered test that evaluates anxiety and depression in a nonpsychiatric population; it generates 2 subscale scores, that is, an anxiety and a depression score. Comparisons were made among women with minor or major depression and those without depression.Of 193 women who visited the center during the study period, 154 completed the study; their mean age was 30.8 ± 4.4 years, and the mean number of assessments completed during pregnancy was 6.2 ± 0.5. Nineteen (12.3%) and 28 (18.1%) women had major and minor depression, respectively, and 107 had no depressive symptoms. Those without depressive symptoms served as the control group. The 3 groups of women were similar in age, education, and family status although a larger number of women in the depression groups (26.3% in major depression group and 32.1% in minor depression group) were housewives compared with the controls (6.5%). Women with major depression had more frequent conflict with a husband or partner than women in the control group [odds ratio (OR), 7.8; 95% confidence interval (CI), 1.0-62.7]. No differences were found among the groups in the rates of family and job problems, presence of family support, and unwanted pregnancy. Major depression had a later onset (5.6 ± 2.8 mo vs. 2.3 ± 1.7 mo, respectively; P = 0.09) and longer duration (3.5 ± 2.2 mo and 1.6 ± 0.7 mo, respectively; P = 0.03), compared with minor depression. Among those with depression, 6 mothers with major depression and 2 with minor depression were still depressed at the final evaluation before delivery. No depressed women were treated with antidepressants or other psychotropic drugs, and only 2 women with major depression received psychologic support. Compared with nondepressed women, predictive factors at the beginning of pregnancy for the development of major depression were a history of a previous depressive episode (OR, 9.5; CI,) and conflict with a husband or...

Objective To determine the interrelationships during early pregnancy of complement-activation fragments Bb, C3a and sC5b-9, and angiogenesis-related factors placental growth factor (PiGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng), and their associations with pre-eclampsia. Design Prospective cohort study. Setting Denver complement study (June 2005–June 2008). Population A total of 668 pregnant women with singleton gestations, recruited between 10 and 15 weeks of gestation. Methods Using univariable and multivariable logistic regression analysis, concentrations of complement-activation fragments and angiogenesis-related factors were compared between 10 and 15 weeks of gestation in women who subsequently did or did not develop pre-eclampsia. Interrelationships between these variables were tested using the non-parametric Spearman rank correlation coefficient. Main outcome measure Pre-eclampsia. The association of complement-activation fragments and angiogenesis-related factors with obesity was also examined. Results The mean (±SD) levels of complement Bb in early pregnancy among women who did and did not develop pre-eclampsia were 0.84 (±0.26) µg/ml and 0.69 (±0.2) µg/ml, respectively (P = 0.001). Concentrations of PiGF were significantly (P = 0.01) lower (31 ± 12 pg/ml) in early pregnancy in the pre-eclamptic group of women, as compared with the normotensive group (39 ± 32 pg/ml). The adjusted odds ratio (AOR) of Bb and PiGF were 2.1 (CI = 1.4–3.1, P < 0.0003) and 0.2 (CI = 0.07–0.7, P = 0.01), respectively. There was no significant difference in the levels of C3a, sC5b-9, sFlt-1 and sEng in early pregnancy among women who developed pre-eclampsia, compared with women who remained normotensive during pregnancy. Higher levels of Bb (P = 0.0001) and C3a (P = 0.03), and lower levels of sFlt-1 (P = 0.0002) and sEng (P = 0.0001) were found among women with obesity, compared with non-obese controls. No meaningful relationships were found between the complement-activation fragments and the angiogenesis-related factors. Conclusions In this cohort during early pregnancy, increased concentrations of complement-activation factor Bb and lower concentrations of PiGF were associated with the development of pre-eclampsia later in pregnancy.

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This study emphasises the potential of (D-Ser(2))glucagon-exe for the treatment of obesity-related diabetes.