Inflammatory trajectories across pregnancy: Investigating novel markers of risk for postpartum depression

项目摘要 产后抑郁症（PPD）是分娩后发生的最常见的精神疾病形式， 全球近18%的妇女，并导致母亲及其子女的痛苦和功能受损。 孩子为了阐明导致PPD风险的因素，目前的项目旨在测试炎症反应的作用。 在预测产后抑郁症状中的跨妊娠标记物。具体而言，反映了最近 关于怀孕期间免疫系统复杂和不断变化的作用的理论工作，目前的项目 将利用165名孕妇的前瞻性纵向设计来检查 炎症标志物在整个妊娠期预测PPD症状和诊断在一个和两个- 产后数月。通过产前和产后期间的反复评估，考虑到 炎症标志物的潜在曲线轨迹，而不是单一的评估，并通过检查 同时，我们将克服过去的进展障碍， 反映了怀孕时交替的免疫优先级。利用之前采集的储存血浆样本 作为妊娠期间抑郁症状的父母R 01研究的一部分， （MH 109662），这项工作将描述关键抑郁症相关炎症标志物的轨迹， 在有和没有产前抑郁症状升高的妇女中，每个妊娠三个月（目标1）， 检查炎症轨迹是否前瞻性地预测抑郁症状和PPD诊断， 产后一个月和两个月（目标2）。同时，它还将探讨抑郁症相关的预测特异性。 炎症标志物（相对于Th 1和Th 2细胞因子或与其他炎症相关的炎症标志物的变化） 精神疾病），并将探讨妊娠期炎症特征是否与某些因素有差异 PPD症状（目标3）。通过这种严格的方法，我们将准备进行强有力的 产前炎症和产后抑郁症状之间的定向关联测试， 确定可作为风险生物标志物的炎症参数。在此过程中，该项目的见解将 对于推进未来的假设，以阐明精确的神经生物学级联反应，解释 炎症和产后抑郁症状之间的联系，最终目标是确定新的因素 以预防或治疗产后抑郁症为目标。

Project Summary Postpartum depression (PPD) is the most common form of psychiatric illness occurring after childbirth, affecting nearly 18% of women globally and contributing to suffering and impaired functioning in both mothers and their children. To elucidate factors that contribute to PPD risk, the current project seeks to test the role of inflammatory markers across pregnancy in the prediction of postpartum depressive symptoms. Specifically, reflecting recent theoretical work on the complex and shifting role of the immune system during pregnancy, the current project will utilize a prospective longitudinal design of 165 pregnant women to examine dynamic trajectories of inflammatory markers across pregnancy in the prediction of PPD symptoms and diagnosis at one- and two- months postpartum. Through repeated assessments across the prenatal and postpartum periods, by considering potentially curvilinear trajectories of inflammatory markers instead of single assessments, and by examining a range of immunological markers simultaneously, we will overcome past roadblocks to progress and more closely mirror the alternating immunological priorities of pregnancy. Leveraging stored plasma samples collected prior to the COVID-19 pandemic as part of a parent R01 study of depressive symptoms during pregnancy (MH109662), this work will characterize trajectories of key depression-relevant inflammatory markers across each trimester of pregnancy in women with and without elevated prenatal depressive symptoms (Aim 1) and examine whether inflammatory trajectories prospectively predict depressive symptoms and PPD diagnosis at one- and two-months postpartum (Aim 2). As well, it will probe the predictive specificity of depression-relevant inflammatory markers (versus shifts in Th1 and Th2 cytokines or inflammatory markers implicated in other psychiatric disorders) and will explore whether inflammatory profiles in pregnancy differentially relate to certain PPD symptoms (Aim 3). Through this methodologically rigorous approach, we will be poised to conduct strong tests of directional associations between prenatal inflammation and postpartum depressive symptoms and to identify inflammatory parameters that may serve as risk biomarkers. In doing so, insights from this project will be critical for advancing future hypotheses to elucidate the precise neurobiological cascades that account for links between inflammation and postpartum depressive symptoms, with the ultimate goal to identify novel factors to target in the prevention or treatment of postpartum depression.