Maternal depression and inflammation during pregnancy

Abstract

BackgroundMaternal depression during pregnancy increases the risk for adverse developmental outcomes in children. However, the underpinning biological mechanisms remain unknown. We tested whether depression was associated with levels of and change in the inflammatory state during pregnancy, if early pregnancy overweight/obesity or diabetes/hypertensive pregnancy disorders accounted for/mediated these effects, and if depression added to the inflammation that typically accompanies these conditions.MethodsWe analyzed plasma high-sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls at three consecutive stages during pregnancy, derived history of depression diagnoses before pregnancy from Care Register for Healthcare (HILMO) (N = 375) and self-reports (N = 347) and depressive symptoms during pregnancy using the Center for Epidemiological Studies Depression Scale completed concurrently to blood samplings (N = 295). Data on early pregnancy body mass index (BMI) and diabetes/hypertensive pregnancy disorders came from medical records.ResultsHigher overall hsCRP levels, but not change, during pregnancy were predicted by history of depression diagnosis before pregnancy [HILMO: mean difference (MD) = 0.69 standard deviation (s.d.) units; 95% confidence interval (CI) 0.26–1.11, self-report: MD = 0.56 s.d.; 95% CI 0.17–0.94] and higher depressive symptoms during pregnancy (0.06 s.d. per s.d. increase; 95% CI 0.00–0.13). History of depression diagnosis before pregnancy also predicted higher overall glycoprotein acetyls (HILMO: MD = 0.52 s.d.; 95% CI 0.12–0.93). These associations were not explained by diabetes/hypertensive disorders, but were accounted for and mediated by early pregnancy BMI. Furthermore, in obese women, overall hsCRP levels increased as depressive symptoms during pregnancy increased (p = 0.006 for interaction).ConclusionsDepression is associated with a proinflammatory state during pregnancy. These associations are mediated by early pregnancy BMI, and depressive symptoms during pregnancy aggravate the inflammation related to obesity.

Persistently High Levels of Maternal Antenatal Inflammation Are Associated With and Mediate the Effect of Prenatal Environmental Adversities on Neurodevelopmental Delay in the Offspring

“…It represents a composite signal of changes in multiple circulating glycoproteins and is suggestive of a prolonged low-grade inflammatory state (39). Both hsCRP and glycoprotein have been linked with overweight/obesity, chronic hypertension, preeclampsia, gestational diabetes and depression during pregnancy (44).…”

Lahti-Pulkkinen et al. respond to the letter to the editor: Maternal depression and inflammation during pregnancy by Fujitake and Chen

“…Namely, in our study sample, higher hsCRP and glycoprotein acetyl levels were not only associated with early pregnancy overweight and obesity and depression, but also with preeclampsia, chronic hypertension and gestational diabetes in current pregnancy. These results have been described in the Results section of the article text and in the Supplementary Table S4 of our article (Lahti-Pulkkinen et al, 2019). Furthermore, previously unpublished analyses in our study sample showed that maternal higher mean hsCRP and glycoprotein levels across pregnancy were associated also with significantly higher maximum levels of systolic [Pearson r(355) = 0.26, p < 0.001; for hsCRP and r(327) = 0.14, p = 0.01 for glycoprotein] and diastolic [r(355) = 0.31, p < 0.001 and r(327) = 0.20, for hsCRP and glycoprotein acetyls, respectively] blood pressure during pregnancy.…”

“…First, we thank Fujitake and Chen (2019) for their interest in our research and the letter to the editor on our recent article Maternal Depression and Inflammation during Pregnancy published in Psychological Medicine , where we showed in the Prediction and Prevention of Pre-eclampsia and Intrauterine Growth Restriction (PREDO) – pregnancy cohort, that diagnosis of depression before pregnancy and depressive symptoms during pregnancy was associated with higher levels of inflammatory biomarkers hsCRP and glycoprotein acetyls across pregnancy among 379 women (Lahti-Pulkkinen et al, 2019).…”

Prenatal programming of child neurocognitive abilities and maternal mental health

“…The biological mechanisms underlying the possible effects of maternal prenatal mental health on offspring neurocognitive development may include genetic and epigenetic changes in the structure and functioning of the placenta, in the activity of the glucocorticoid regulation of the hypothalamusepituitaryeadrenal axis regulating the stress response, and in the functioning of the inflammatory system. Studies in PREDO showed that maternal depression and/or anxiety during pregnancy were associated with increased levels of proinflammatory biomarkers high-sensitive C-reactive protein and glycoprotein throughout pregnancy [35], with morphological changes in the placenta [36], with changes in placental mRNA expression of genes regulating glucocorticoid functioning [37], and with lower epigenetic gestational age [38] and altered polyepigenetic scores of glucocorticoid-responsive genes [39] of the newborn. The increased maternal proinflammatory biomarker levels during pregnancy also predicted increased neurodevelopmental delay risk in the offspring and mediated the effects of prenatal adversity on child neurodevelopmental delay [40].…”