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

项目摘要 产后抑郁症(PPD)是产后最常见的精神疾病，影响 全球近18%的妇女造成母亲和母亲的痛苦和功能受损 孩子们。为了阐明导致产后抑郁风险的因素，目前的项目试图测试炎症的作用。 孕期标志物在预测产后抑郁症状中的作用。具体来说，反映了最近 目前的项目是关于怀孕期间免疫系统复杂和变化的作用的理论工作 将利用对165名孕妇的前瞻性纵向设计来检查 妊娠期炎性标志物在预测PPD症状和诊断中的作用 产后几个月。通过对产前和产后的反复评估，通过考虑 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 一系列免疫标志物的同时，我们将克服过去取得进展的障碍，并更加紧密地 反映孕期免疫优先顺序的交替变化。利用之前收集的存储的血浆样本 作为父母R01对妊娠期抑郁症状研究的一部分，新冠肺炎大流行 (MH109662)，这项工作将表征与抑郁症相关的关键炎症标志物的轨迹 妊娠每三个月有和没有产前抑郁症状升高的妇女(目标1)和 检查炎症轨迹是否可预测抑郁症状和PPD的诊断 产后一个月和两个月(目标2)。此外，它还将探索与抑郁症相关的预测特异性 炎性标志物(与Th1和Th2细胞因子或炎性标志物在其他 精神障碍)，并将探索妊娠期间的炎症特征是否与某些 产后抑郁症状(目标3)。通过这种在方法上严格的方法，我们将准备好进行强有力的 产前炎症与产后抑郁症状的方向性相关性检验 确定可能作为风险生物标志物的炎症参数。在这样做的过程中，来自该项目的见解将 对于推进未来的假设至关重要，以阐明解释以下问题的精确神经生物学级联 炎症和产后抑郁症状之间的联系，最终目的是确定新的因素 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.