The cytokine profile of women with severe anxiety and depression during pregnancy

Abstract

Background Controversial findings regarding the association between pro-inflammatory cytokines and depression have been reported in pregnant subjects. Scarce data about anxiety and its relationships with cytokines are available in pregnant women. To understand the association between anxiety and cytokines during pregnancy, we conducted the present study in women with or without depression. Methods Women exhibiting severe depression (SD) and severe anxiety (SA) during the 3rd trimester of pregnancy ( n = 139) and control subjects exhibiting neither depression nor anxiety ( n = 40) were assessed through the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). Serum cytokines were measured by a multiplex bead-based assay. Correlation tests were used to analyze the data and comparisons between groups were performed. A general linear model of analysis of variance was constructed using the group as a dependent variable, interleukin concentrations as independent variables, and HDRS/HARS scores and gestational weeks as covariables. Results The highest levels of Th1- (IL-6, TNF-α, IL-2, IFN-γ), Th17- (IL-17A, IL-22), and Th2- (IL-9, IL-10, and IL-13) related cytokines were observed in women with SD + SA. The SA group showed higher concentrations of Th1- (IL-6, TNF-α, IL-2, IFN-γ) and Th2- (IL-4, and IL-10) related cytokines than the controls. Positive correlations were found between HDRS and IL-2, IL-6, and TNF-α in the SA group ( p < 0.03), and between HDRS and Th1- (IL-2, IL-6, TNF-α), Th2- (IL-9, IL-10, IL-13) and Th17- (IL-17A) cytokines ( p < 0.05) in the SD + SA group. After controlling the correlation analysis by gestational weeks, the correlations that remained significant were: HDRS and IL-2, IL-6, IL-9, and IL-17A in the SD + SA group ( p < 0.03). HARS scores correlated with IL-17A in the SA group and with IL-17A, IL-17F, and IL-2 in the SD + SA group ( p < 0.02). The linear model of analysis of variance showed that HDRS and HARS scores influenced cytokine concentrations; only IL-6 and TNF-α could be explained by the group. Conclusions We found that the cytokine profiles differ when comparing pregnant subjects exhibiting SA with comorbid SD against those showing only SA without depression.

Cortisol and DHEA-S levels in pregnant women with severe anxiety

“…In line with this, recent studies from our group showed that pregnant women exhibiting high levels of anxiety symptoms and severe depression in the third trimester of pregnancy displayed an increase of different subsets of Th1, Th2, Th17 and Treg-related immune biomarkers [72]. However, in the present study we showed that a similar related population displaying only severe anxiety, but not depression, showed a significant increase in CORT/DHEA-S index when compared to non-anxious pregnant women.…”

Comorbid Anxiety and Depression among Pregnant Pakistani Women: Higher Rates, Different Vulnerability Characteristics, and the Role of Perceived Stress

“…Mental health during pregnancy (e.g., stress, anxiety, pregnancy-related anxiety, and depression) can influence birth outcomes [ 1 ] including preterm birth [ 2 , 3 ] and low birth weight [ 3 ]. Limited studies examining the role of comorbid anxiety and depression in this literature indicate comorbid anxiety and depression may further increase the risk of preterm birth or low birth weight [ 4 , 5 ]. Studies examining immune system pathways to preterm birth demonstrate the plausibility, as a correlation exists between cytokines such as interleukin-6 and interluken-12 and depression, anxiety and perceived stress measured in the second [ 6 ] or third [ 4 ] trimester.…”

“…Limited studies examining the role of comorbid anxiety and depression in this literature indicate comorbid anxiety and depression may further increase the risk of preterm birth or low birth weight [ 4 , 5 ]. Studies examining immune system pathways to preterm birth demonstrate the plausibility, as a correlation exists between cytokines such as interleukin-6 and interluken-12 and depression, anxiety and perceived stress measured in the second [ 6 ] or third [ 4 ] trimester. Furthermore, cytokine levels were higher in women with comorbid anxiety and depression when compared to women with anxiety only [ 4 ].…”

“…Studies examining immune system pathways to preterm birth demonstrate the plausibility, as a correlation exists between cytokines such as interleukin-6 and interluken-12 and depression, anxiety and perceived stress measured in the second [ 6 ] or third [ 4 ] trimester. Furthermore, cytokine levels were higher in women with comorbid anxiety and depression when compared to women with anxiety only [ 4 ]. Finally, increases in cytokines were related to level of depression, and in women with severe anxiety, dysregulation in immune system networks triggered or worsened depressive symptoms [ 4 ].…”

“…Furthermore, cytokine levels were higher in women with comorbid anxiety and depression when compared to women with anxiety only [ 4 ]. Finally, increases in cytokines were related to level of depression, and in women with severe anxiety, dysregulation in immune system networks triggered or worsened depressive symptoms [ 4 ].…”