Adverse life events, psychiatric history, and biological predictors of postpartum depression in an ethnically diverse sample of postpartum women.
Adverse life events, psychiatric history, and biological predictors of postpartum depression in an ethnically diverse sample of postpartum women.
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DOI：
10.1017/s0033291717002641
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发表时间：
2018-05
影响因子：
6.9
通讯作者：
Meltzer-Brody S
中科院分区：
文献类型：
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作者：
Guintivano J;Sullivan PF;Stuebe AM;Penders T;Thorp J;Rubinow DR;Meltzer-Brody S
种族、精神病史和不良生活事件都与产后抑郁症（PPD）独立相关。然而，这些在黑人和拉丁裔妇女中共同发挥的作用仍然没有得到充分的研究。因此，我们进行了PPD的病例对照研究，包括症状和生物标志物的综合评估，同时检查遗传血统的影响。我们从北卡罗来纳州的产科诊所招募了产后6周的样本（549例，968例对照）。使用MINI-plus测定PPD状态。从病历中提取精神病史。参与者被管理的自我报告工具，以评估抑郁症（爱丁堡产后抑郁量表）和不良生活事件。测定雌二醇、孕酮、脑源性神经营养因子（BDNF）、催产素和别孕烷酮的水平。基因型数据的主成分被用来估计遗传祖先和逻辑回归被用来确定PPD的预测因子。该人群种族多样（68%黑人，13%拉丁裔，18%欧洲人）。遗传祖先不是PPD的预测因子。通过重性抑郁症史（p = 4.01E-14）、终生焦虑症诊断（p = 1.25E-34）和不良生活事件（p = 6.06E-06）预测病例状态。两组之间的任何激素或神经类固醇均无显著差异。在少数民族和低收入妇女中，精神病史和多次暴露于不良生活事件是PPD的重要预测因素。遗传血统和激素水平不能预测病例状态。遗传易感性的增加与危险因素的结合可以预测PPD的发生，而遗传祖先似乎没有预测性。
Race, psychiatric history, and adverse life events have all been independently associated with postpartum depression (PPD). However, the role these play together in Black and Latina women remains inadequately studied. Therefore, we performed a case-control study of PPD, including comprehensive assessments of symptoms and biomarkers, while examining the effects of genetic ancestry. We recruited our sample (549 cases, 968 controls) at six weeks postpartum from obstetrical clinics in North Carolina. PPD status was determined using the MINI-plus. Psychiatric history was extracted from medical records. Participants were administered self-report instruments to assess depression (Edinburgh Postnatal Depression Scale) and adverse life events. Levels of estradiol, progesterone, brain-derived neurotrophic factor (BDNF), oxytocin, and allopregnanalone were assayed. Principal components from genotype data were used to estimate genetic ancestry and logistic regression was used to identify predictors of PPD. This population was racially diverse (68% Black, 13% Latina, 18% European). Genetic ancestry was not a predictor of PPD. Case status was predicted by a history of major depression (p = 4.01E-14), lifetime anxiety disorder diagnosis (p = 1.25E-34), and adverse life events (p = 6.06E-06). There were no significant differences between groups in any hormones or neurosteroids. Psychiatric history and multiple exposures to adverse life events were significant predictors of PPD in a population of minority and low-income women. Genetic ancestry and hormone levels were not predictive of case status. Increased genetic vulnerability in conjunction with risk factors may predict the onset of PPD, whereas genetic ancestry does not appear predictive.
影响因子：
3.5
作者：
通讯作者：
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