Inflammatory biomarkers and perinatal depression: a systematic review
Silva-Fernandes, Anabela;
| Cold Spring Harbor Laboratory | 2023 | DOI Conde, Ana
;Marques, Margarida
;Caparros-Gonzalez, Rafael A.
;Fransson, Emma
; Mesquita, Ana Raquel Marcelino; Figueiredo, Bárbara;Skalkidou, Alkistis
Artigo de Jornal
This article is a preprint and has not been peer-reviewed [what does this mean?]. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.
Background: Approximately 10 to 20% of pregnant women worldwide experience perinatal depression (PND), a depressive episode with onset during pregnancy or after childbirth. We performed a systematic review to identify, summarize and discuss
studies on inflammatory biomarkers described in relation to PND.
Methods: Inclusion criteria defined the selection of observational studies written in
English, French, Spanish or Portuguese, that evaluate analytical levels of inflammatory
molecules (protein levels) in biological fluids in women, with a diagnosis of depression
using ICD/DSM diagnostic criteria or depressive symptoms assessed by standardized
psychometric instruments, during pregnancy and/or postpartum. Case reports,
experimental studies, reviews, qualitative analysis, meta-analysis, gray literature or
replicated data were excluded. Three electronic databases were used for search
(Pubmed, Web of Science and PsychInfo) and quality assessment of selected studies
were performed using the Newcastle-Ottawa Scale. Data extraction included study
design; number of subjects; obstetric information; tools and timepoints of depression
and inflammatory markers assessment.
Results: 56 studies where the major aim was to analyze the association between
depression and inflammatory biomarkers during pregnancy and postpartum period were
included in this systematic review. Overall, the findings of our systematic review lend
support to the hypothesis that several inflammatory markers may be associated with
peripartum depressive symptoms. The associations were somewhat different looking at
pregnancy compared to the delivery time-point and postpartum, and mainly referred to
increased levels of IL-6, IL-8, CRP and TNF-α among depressed.
Discussion: Our results revealed high heterogeneity in relation to the timing of
biological sampling for markers, as well as timing and instruments used for depression
assessment within the perinatal period for the different studies. Studies differed also in relation to use of biomarkers or depression as exposure and outcome respectively, and
whether these were addressed at the same timepoint or separate ones.
Given the high burden of PND on women, children and families, it is crucial to try to
harmonize methods used in related studies, in order to be able to pool results that could
give us insights into the pathophysiological mechanisms behind how the immune
system and PND are connected; this could have great impact on early detection,
prevention and even treatment of PND.
AS-F was supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education, through the national funds, within the scope of the Transitory Disposition of the Decree No. 57/2016, of 29th of August, amended by Law No. 57/2017 of 19 July and previously through the fellowship grant SFRH/BPD/107732/2015. This paper is part of the COST Action Riseup-PPD CA18138 and was supported by COST under COST Action Riseup-PPD CA18138 (Virtual Mobility Grant).