期刊
PSYCHOLOGICAL MEDICINE
卷 50, 期 11, 页码 1839-1851出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291719001909
关键词
Antenatal; depression; depressive disorder; depressive symptoms; fetal programming; glycoprotein; hsCRP; inflammation
资金
- Academy of Finland [285324, 12848591, 1284859, 1312670, 269925]
- European Union [SC1-2016-RTD-733280]
- University of Helsinki Research Funds
- Signe and Ane Gyllenberg Foundation
- Emil Aaltonen Foundation
- Finnish Diabetes Research Foundation
- Foundation for Cardiovascular Research
- Foundation for Pediatric Research
- Jane and Aatos Erkko Foundation
- Novo Nordisk Foundation
- Paivikki and Sakari Sohlberg Foundation
- Sigrid Juselius Foundation
- Finnish Medical Foundation
- European Commission Dynamics of Inequality Across the Life-course: structures and processes (DIAL) [724363]
- EVO
- Academy of Finland (AKA) [285324, 285324, 269925, 269925] Funding Source: Academy of Finland (AKA)
Background Maternal 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. Methods We 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. Results Higher 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 = 0.56s.d.; 95% CI 0.17-0.94] and higher depressive symptoms during pregnancy (0.06s.d.pers.d.increase; 95% CI 0.00-0.13). History of depression diagnosis before pregnancy also predicted higher overall glycoprotein acetyls (HILMO: MD = 0.52s.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). Conclusions Depression 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.
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