Maternal peripartum antibiotic exposure and the risk of postpartum depression

Murphy, Jordan; Paul, Sudeshna; Dunlop, Anne L.; Corwin, Elizabeth J.

doi:10.1002/nur.21881

Cited by 20 publications

(11 citation statements)

References 33 publications

(53 reference statements)

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“…Critically, the functional potential of different bacteria is increasingly understood [29,30], meaning that identification of key taxa that are differentially abundant in people with mental disorders and that influence these commonly dysregulated systems is an imperative. Such identification may afford opportunities for both understanding aetiology and identifying clinically useful biomarkers, as well as new targeted treatment strategies, including dietary changes [31][32][33][34][35], antibiotics [36][37][38][39][40][41][42], probiotic supplements [43][44][45][46][47][48][49] and even faecal microbial transplants [50][51][52].…”

Section: Introductionmentioning

confidence: 99%

A systematic review of gut microbiota composition in observational studies of major depressive disorder, bipolar disorder and schizophrenia

et al. 2022

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The emerging understanding of gut microbiota as ‘metabolic machinery’ influencing many aspects of physiology has gained substantial attention in the field of psychiatry. This is largely due to the many overlapping pathophysiological mechanisms associated with both the potential functionality of the gut microbiota and the biological mechanisms thought to be underpinning mental disorders. In this systematic review, we synthesised the current literature investigating differences in gut microbiota composition in people with the major psychiatric disorders, major depressive disorder (MDD), bipolar disorder (BD) and schizophrenia (SZ), compared to ‘healthy’ controls. We also explored gut microbiota composition across disorders in an attempt to elucidate potential commonalities in the microbial signatures associated with these mental disorders. Following the PRISMA guidelines, databases were searched from inception through to December 2021. We identified 44 studies (including a total of 2510 psychiatric cases and 2407 controls) that met inclusion criteria, of which 24 investigated gut microbiota composition in MDD, seven investigated gut microbiota composition in BD, and 15 investigated gut microbiota composition in SZ. Our syntheses provide no strong evidence for a difference in the number or distribution (α-diversity) of bacteria in those with a mental disorder compared to controls. However, studies were relatively consistent in reporting differences in overall community composition (β-diversity) in people with and without mental disorders. Our syntheses also identified specific bacterial taxa commonly associated with mental disorders, including lower levels of bacterial genera that produce short-chain fatty acids (e.g. butyrate), higher levels of lactic acid-producing bacteria, and higher levels of bacteria associated with glutamate and GABA metabolism. We also observed substantial heterogeneity across studies with regards to methodologies and reporting. Further prospective and experimental research using new tools and robust guidelines hold promise for improving our understanding of the role of the gut microbiota in mental and brain health and the development of interventions based on modification of gut microbiota.

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Section: Introductionmentioning

confidence: 99%

A systematic review of gut microbiota composition in observational studies of major depressive disorder, bipolar disorder and schizophrenia

et al. 2022

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“…Strengths and limitations of the study One of the main strengths of this study is the scope and comprehensiveness of the data collected. There has been one prior study exploring the effect of antibiotic exposure on the risk of developing depressive symptoms in this population; however, it was small (n = 120), very limited in the variables collected and only considered antibiotics used during and within 14 days of delivery, despite reporting on their potential effect on mental health up to 6 months postpartum [74]. In contrast, our study is designed to be statistically powered to comprehensively investigate the potential association between antibiotic use during pregnancy, delivery, and up to 12 months postpartum and the development of depression, taking into account a large range of relevant variables.…”

Section: Discussionmentioning

confidence: 99%

Maternal antibiotic exposure and the risk of developing antenatal or postpartum depression: The Maternal Experience Study protocol

Pouranayatihosseinabad,

Taylor,

Hawrelak

et al. 2023

Preprint

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Background Limited epidemiological evidence suggests a link between antibiotic use and the development of depression. This study seeks to investigate this association in-depth, using a cohort of pregnant individuals. The primary aim is to explore any association between antibiotic use during pregnancy, delivery, and within 12 months postpartum, and the development of antenatal and/or postpartum depression. Methods A national prospective, observational, longitudinal cohort study has been designed to examine the relationship between the use of antibiotics during pregnancy and the development of antenatal depression up to the third trimester (32-42 weeks), as well as the use of antibiotics during pregnancy and within 12 months postpartum and the development of depression during the postpartum period. The development of depression is considered as either a diagnosis by a medical doctor and/or a scoring 13 or higher on the Edinburgh Postnatal Depression Scale. Data will be collected using online surveys, during the third trimester, and at 6 weeks, 6 months, and 12 months postpartum. These surveys include a wide range of variables previously identified as being associated with antenatal and postpartum depression (such as level of social support, history of depression, and intimate partner abuse), as well as antibiotic and probiotic use. The impact of the COVID-19 pandemic on both participants’ pregnancy experience and their mental health will also be explored. Recruitment began in August 2021, using a combination of online paid and unpaid advertisements, as well as distribution of the study flyer in relevant clinics and public spaces. It is anticipated that data collection will be completed in early 2024. Discussion This study will provide a much-needed update on the prevalence of depression during pregnancy and postpartum, and its associated factors. It will also, for the first time, comprehensively explore the potential association between antibiotic use during pregnancy and up to 12 months postpartum and the development of depression. Additionally, it will provide a better understanding of the mental health impacts of the COVID-19 pandemic on pregnant individuals in Australia.

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“…One of the main strengths of this study is the scope and comprehensiveness of the data collected. There has been one prior study exploring the effect of antibiotic exposure on the risk of developing depressive symptoms in this population; however, it was small (n = 120), very limited in the variables collected, and only considered antibiotics used during and within 14 days of delivery, despite reporting on their potential effect on mental health up to 6 months postpartum [76]. In contrast, our study is designed to be statistically powered to comprehensively investigate the potential association between antibiotic use during pregnancy, delivery, and up to 12 months postpartum and the development of depressive symptoms, taking into account a large range of relevant variables.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Maternal Antibiotic Exposure and the Risk of Developing Antenatal or Postpartum Depressive Symptoms: The Maternal Experience Study Protocol

Pouranayatihosseinabad,

Taylor,

Hawrelak

et al. 2023

MPs

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Limited epidemiological evidence suggests a link between antibiotic use and developing depression. This study seeks to investigate this association in depth, using a cohort of pregnant individuals. The primary aim is to explore any association between the use of antibiotics during pregnancy and the development of antenatal depressive symptoms up to the third trimester, as well as the use of antibiotics during pregnancy and within 12 months postpartum and the development of postpartum depressive symptoms. A national prospective, observational, longitudinal cohort study has been designed to examine these relationships. A sample size of 1500 pregnant individuals has been sought for this study, assuming 10 potential predictor variables (including antibiotic use) in the final multiple logistic regression model and allowing for a 30% drop-out rate. The development of depressive symptoms is considered either a diagnosis by a medical doctor and/or a scoring 13 or higher on the Edinburgh Postnatal Depression Scale. Data will be collected during the third trimester and at 6 weeks, 6 months, and 12 months postpartum. These surveys include variables previously identified as associated with antenatal and postpartum depression (e.g., level of social support, experience of intimate partner abuse, and obstetric complications), as well as antibiotic and probiotic use. This study will provide an update on the prevalence of the symptoms of depression during pregnancy and postpartum and its associated risk factors. It will also, for the first time, comprehensively explore the potential association between antibiotic use during pregnancy and up to 12 months postpartum and the development of depressive symptoms.

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Maternal peripartum antibiotic exposure and the risk of postpartum depression

Cited by 20 publications

References 33 publications

A systematic review of gut microbiota composition in observational studies of major depressive disorder, bipolar disorder and schizophrenia

A systematic review of gut microbiota composition in observational studies of major depressive disorder, bipolar disorder and schizophrenia

Maternal antibiotic exposure and the risk of developing antenatal or postpartum depression: The Maternal Experience Study protocol

Maternal Antibiotic Exposure and the Risk of Developing Antenatal or Postpartum Depressive Symptoms: The Maternal Experience Study Protocol

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