Association between Edinburgh Postnatal Depression Scale and Serum Levels of Ketone Bodies and Vitamin D, Thyroid Function, and Iron Metabolism

Abstract

Suicide due to postpartum depression is the most common perinatal-related death and is a social concern in Japan. Nutritional deficiencies during pregnancy may contribute to postpartum depression; therefore, we investigated the relationship between postpartum depression and nutritional status during pregnancy and postpartum. We focused specifically on ketone bodies because they are known to protect brain cells. The relationship between the Edinburgh Postnatal Depression Scale (EPDS) scores and the serum levels of ketone bodies and vitamin D, thyroid function, and iron metabolism was examined. Overall, 126 pregnant women were identified for the study, and 99 were eventually included in the analysis. We defined an EPDS score of ≥9 as being positive for postpartum depression, and serum ketone levels were found to be higher in the group with an EPDS score of ≥9 during the second trimester; however, there were no other significant findings. We may be able to predict postpartum depression from a pregnant woman’s serum ketone levels in the second trimester. There was a positive correlation between the EPDS scores at 3 days and 1 month postpartum (r = 0.534, p < 0.001). EPDS scores assessed in the early postpartum period may be useful for the timely detection of postpartum depression.

Exploring Depression and Nutritional Covariates Amongst US Adults using Shapely Additive Explanations

“…The visualizations completed for the top four continuous covariates were concordant with current literature: there is strong epidemiological evidence that good diet is associated with decreased risk of depression 22 . Many authors have noted statistically significant associations between Vitamin B6, Dietary Fiber, Potassium Intake, Vitamin E, Low Fat and Low Cholesterol Diet, Copper, Caffeine, Lutein Zeaxanthin, Phosphorous, Food Folate, Folate, Vitamin K, Iron, Theobromine, Total Choline, Magnesium, Sodium, Grams of Protein, Vitamin B12, Fiber, and Zinc similarly to our study 38–43 . Since visualizations for risk factors match literature relationships, we have increased confidence that the machine learning model is able to capture the actual physiological relationships of these covariates 44–51 .…”

“…22 Many authors have noted statistically significant associations between Vitamin B6, Dietary Fiber, Potassium Intake, Vitamin E, Low Fat and Low Cholesterol Diet, Copper, Caffeine, Lutein Zeaxanthin, Phosphorous, Food Folate, Folate, Vitamin K, Iron, Theobromine, Total Choline, Magnesium, Sodium, Grams of Protein, Vitamin B12, Fiber, and Zinc similarly to our study. [38][39][40][41][42][43] Since visualizations for risk factors match literature relationships, we have increased confidence that the machine learning model is able to capture the actual physiological relationships of these covariates. [44][45][46][47][48][49][50][51] These transparent machine-learning tools allow for increased confidence that these algorithms are picking up true signal within these covariates to predict the presence of depression rather than just replicating potential biases stemming from systemic data-quality errors that are present within the data set.…”

Causal associations between vitamin D and postpartum depression: A bidirectional mendelian randomization study

“…The results reveal the absence of a causal relationship between genetically determined variations in 25(OH)D levels and the risk of PPD. While a majority of available observational studies, often employing cross-sectional or case-control designs, have reported there exists an inverse correlation between the levels of 25(OH)D and postpartum depression [ 22 , 23 ], some studies have failed to establish a significant association between 25(OH)D levels and the occurrence or development of PPD [ 24 , 25 ]. Indeed, the true nature of the relationship between PPD and 25(OH)D remains unclear due to confounding factors and potential reverse causation.…”

Thyroid Predictors of Postpartum Mood Disorders

“…Furthermore, obtaining EDPS scores earlier than six months may also provide further evidence of a possible correlation. Additionally, there are other studies that fail to associate varying peripartum TSH levels with PPD, thus raising considerable doubt regarding its use as a marker [ 28 , 29 ]. When considering clinical application, it is also important to consider the logistical difficulties of obtaining serum TSH levels during the intense process of labor.…”

“…Several studies illustrated the association between thyroid hormones and PMD. Elevated levels of TSH during labor are significantly associated with an increased risk of PPD at 6 months postpartum [ 27 ], however, other studies cast doubt on this association [ 28 , 29 ]. Low levels of total and free T4 in the third trimester were also correlated with PPD in a prospective cohort study conducted by Pedersen et al [ 26 ].…”