University of Oulu

Lahti-Pulkkinen, M., Girchenko, P., Robinson, R., Lehto, S. M., Toffol, E., Heinonen, K., Reynolds, R. M., Kajantie, E., Laivuori, H., Villa, P. M., Hämäläinen, E., Lahti, J., & Räikkönen, K. (2019). Maternal depression and inflammation during pregnancy. Psychological Medicine, 50(11), 1839–1851. https://doi.org/10.1017/s0033291719001909

Maternal depression and inflammation during pregnancy

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Author: Lahti-Pulkkinen, Marius1,2,3; Girchenko, Polina1; Robinson, Rachel1;
Organizations: 1Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
2National Institute for Health and Welfare, Helsinki, Finland
3Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
4Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
5Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland
6Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki, Finland
7Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
8PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
9Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, University of Helsinki, Helsinki, Finland
10Medical and Clinical Genetics; Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, Helsinki, Finland
11Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
12Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, University of Helsinki, Helsinki, Finlandt Psychiatry, King’s College London, London, United Kingdom
13Department of Clinical Chemistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
14Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland
15Turku Institute for Advanced Studies, University of Turku, Turku, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 2.9 MB)
Persistent link: http://urn.fi/urn:nbn:fi-fe2021082343806
Language: English
Published: Cambridge University Press, 2021
Publish Date: 2020-02-23
Description:

Abstract

Background: Maternal depression during pregnancy increases the risk for adverse developmental outcomes in children. However, the underpinning biological mechanisms remain unknown. We tested whether depression was associated with levels of and change in the inflammatory state during pregnancy, if early pregnancy overweight/obesity or diabetes/hypertensive pregnancy disorders accounted for/mediated these effects, and if depression added to the inflammation that typically accompanies these conditions.

Methods: We analyzed plasma high-sensitivity C-reactive protein (hsCRP) and glycoprotein acetyls at three consecutive stages during pregnancy, derived history of depression diagnoses before pregnancy from Care Register for Healthcare (HILMO) (N = 375) and self-reports (N = 347) and depressive symptoms during pregnancy using the Center for Epidemiological Studies Depression Scale completed concurrently to blood samplings (N = 295). Data on early pregnancy body mass index (BMI) and diabetes/hypertensive pregnancy disorders came from medical records.

Results: Higher overall hsCRP levels, but not change, during pregnancy were predicted by history of depression diagnosis before pregnancy [HILMO: mean difference (MD) = 0.69 standard deviation (s.d.) units; 95% confidence interval (CI) 0.26–1.11, self-report: MD = 0.56 s.d.; 95% CI 0.17–0.94] and higher depressive symptoms during pregnancy (0.06 s.d. per s.d. increase; 95% CI 0.00–0.13). History of depression diagnosis before pregnancy also predicted higher overall glycoprotein acetyls (HILMO: MD = 0.52 s.d.; 95% CI 0.12–0.93). These associations were not explained by diabetes/hypertensive disorders, but were accounted for and mediated by early pregnancy BMI. Furthermore, in obese women, overall hsCRP levels increased as depressive symptoms during pregnancy increased (p = 0.006 for interaction).

Conclusions: Depression is associated with a proinflammatory state during pregnancy. These associations are mediated by early pregnancy BMI, and depressive symptoms during pregnancy aggravate the inflammation related to obesity.

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Series: Psychological medicine
ISSN: 0033-2917
ISSN-E: 1469-8978
ISSN-L: 0033-2917
Volume: 50
Issue: 11
Pages: 1839 - 1851
DOI: 10.1017/S0033291719001909
OADOI: https://oadoi.org/10.1017/S0033291719001909
Type of Publication: A1 Journal article – refereed
Field of Science: 3123 Gynaecology and paediatrics
3124 Neurology and psychiatry
Subjects:
Funding: The PREDO study is funded by the Academy of Finland (grant number 285324, 12848591, 1284859, 1312670, 269925), European Union's Horizon 2020 Award SC1-2016-RTD-733280 for RECAP, European Commission Dynamics of Inequality Across the Life-course: structures and processes (DIAL) No 724363 for PremLife, EVO (a special state subsidy for health science research), University of Helsinki Research Funds, the Signe and Ane Gyllenberg Foundation, Emil Aaltonen Foundation, Finnish Diabetes Research Foundation, Foundation for Cardiovascular Research, Foundation for Pediatric Research, Jane and Aatos Erkko Foundation, Novo Nordisk Foundation, Päivikki and Sakari Sohlberg Foundation, Sigrid Juselius Foundation, and Finnish Medical Foundation. The sponsors played no role in the design or conduct of this study.
Copyright information: © Cambridge University Press 2019. This article has been published in a revised form in Psychological Medicine [https://doi.org/10.1017/S0033291719001909]. This version is published under a Creative Commons CC-BY-NC-ND. No commercial re-distribution or re-use allowed. Derivative works cannot be distributed. © copyright holder.
  https://creativecommons.org/licenses/by-nc-nd/4.0/