Mild Depressive Symptoms Are Associated with Elevated C-Reactive Protein and Proinflammatory Cytokine Levels During Early to Midgestation: A Prospective Pilot Study

Background: We examined depressive symptoms, C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) levels during early to-midgestation. Methods: We measured depressive symptoms on the Patient Health Questionnaire-9 (PHQ-9), and serum CRP, IL-6, and TNF-alpha levels twice in 27 pregnant women. Results: After adjustment, depressive symptoms prospectively (beta = 0.42, p < 0.05 at 16-20 weeks of gestation) and concurrently (beta = 0.54, p < 0.01 at 7-10 weeks of gestation) predicted elevated CRP [F (2, 14) = 9.20, p = 0.003, R-2 = 0.57 and F (3, 15) = 9.08, p = 0.001, R-2 = 0.64, respectively]. There were similar patterns of results for TNF-alpha (beta = 0.72, p < 0.01) and IL-6 levels (beta = 0.39, p < 0.05) at 7-10 weeks of gestation [F (2,19) = 8.84, p = 0.002, R-2 = 0.48]. Furthermore, the association between depressive symptoms at 7-10 weeks of gestation and increased IL-6 levels at 16-20 weeks of gestation approached statistical significance. We confirmed the findings with the Wilcoxon signed rank test (IL-6: Z = 2.44, p = 0.015; TNF-alpha: Z = 1.94, p = 0.05; CRP: approached statistical significance). Conclusions: These pilot data suggest that depressive symptoms may be associated with inflammatory markers during early to-midgestation.