Potential CSF biomarkers of postpartum depression following delivery via caesarian section
Potential CSF biomarkers of postpartum depression following delivery via caesarian section
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DOI：
10.1016/j.jad.2023.09.021
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发表时间：
2023-09-21
影响因子：
6.6
通讯作者：
Liu，Zhiqiang
中科院分区：
文献类型：
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作者：
Sheng，Zhihao;Liu，Qidong;Liu，Zhiqiang
研究背景产后抑郁症（Postpartum depression，PPD）是一种严重而常见的精神疾病，是分娩后的抑郁发作.虽然存在许多用于抑郁发作的筛查工具，例如，根据爱丁堡产后抑郁量表（EPDS），没有客观的生物学指标来预测PPD。尽管进行了几项研究以鉴定PPD中的生物标志物，但对直接与大脑接触的脑脊液（CSF）的探索有限。因此，需要新的潜在的生物标志物的CSF预测PPD，以便针对具体的预防interventions.MethodsSeventy-five产妇接受剖腹产分娩入组CSF收集在分娩。在不符合排除标准的28例受试者中，产后6周EPDS评分<5分的健康产妇和产后6周EPDS评分≥ 13分的PPD患者各10例。结果脑脊液中癸酸、十二烷酸、花生酸、二十二烷酸与PPD症状呈显著负相关，L-色氨酸与PPD症状呈显著正相关。结论本研究创新性地通过产时母体脑脊液代谢组学研究了PPD发病前的潜在预测生物标志物，为PPD的预测和诊断提供了一种更为客观的方法，从而帮助识别高危产妇，以便早期启动二级预防，以减少全球PPD负担。
BackgroundPostpartum depression (PPD), the depressive episodes following delivery, is a serious and frequent psychiatric disorder. While numerous screening tools existed for depressive episodes, e.g., the Edinburgh Postnatal Depression Scale (EPDS), there are no objective biological measures for predicting PPD. Despite several studies done to identify biomarkers in PPD, there has been limited exploration into cerebrospinal fluid (CSF) which directly interfaces with the brain. Consequently, novel potential biomarkers of CSF are required to predict PPD, so as to target specific preventive interventions.MethodsSeventy-five parturients undergoing caesarean delivery were enrolled for CSF collection at delivery. Of the twenty-eight subjects who didn't meet any exclusion criteria, the number of the healthy parturients whose score of EPDS 6-weeks postpartum (6-wpp) < 5 and PPD patients whose EPDS 6-wpp ≥ 13 was ten respectively. Gas chromatography–mass spectrometry (GC–MS) analysis of CSF was used for metabolomic assessments.ResultsWe found that capric acid, dodecanoic acid, arachidic acid and behenic acid in CSF were significantly negatively correlated with PPD symptoms, meanwhile L-tryptophan had an obvious positive correlation. Moreover, these five biomarkers can be used as effective predictive biomarkers for PPD.LimitationsThe main limitations are the inclusion of only parturients who underwent caesarean sections and a small sample size.ConclusionsThis study innovatively investigated potential predictive biomarkers of PPD before the onset through intrapartum maternal CSF metabolomics, which offered a more objective approach to predict and diagnose PPD, leading to help identify high-risk parturients for early initiation of secondary prevention to reduce global PPD burden.