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Maternal depression and inflammation during pregnancy

Published online by Cambridge University Press:  23 August 2019

Marius Lahti-Pulkkinen Open the ORCID record for Marius Lahti-Pulkkinen [Opens in a new window] ,
Polina Girchenko ,
Rachel Robinson ,
Soili M. Lehto ,
Elena Toffol ,
Kati Heinonen ,
Rebecca M. Reynolds ,
Eero Kajantie ,
Hannele Laivuori  and
Pia M. Villa
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Marius Lahti-Pulkkinen*
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland National Institute for Health and Welfare, Helsinki, Finland Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
Polina Girchenko
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Rachel Robinson
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Soili M. Lehto
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland Department of Psychiatry, Kuopio University Hospital, Kuopio, Finland Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Elena Toffol
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland National Institute for Health and Welfare, Helsinki, Finland
Kati Heinonen
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Rebecca M. Reynolds
Affiliation:
Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
Eero Kajantie
Affiliation:
National Institute for Health and Welfare, Helsinki, Finland Children's Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland PEDEGO Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, OuluFinland
Hannele Laivuori
Affiliation:
Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, University of Helsinki, Helsinki, Finland Medical and Clinical Genetics; Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science, Helsinki, Finland Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland
Pia M. Villa
Affiliation:
Obstetrics and Gynaecology, University of Helsinki and Helsinki University Hospital, University of Helsinki, Helsinki, Finland
Esa Hämäläinen
Affiliation:
Department of Clinical Chemistry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
Jari Lahti
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, Finland Turku Institute for Advanced Studies, University of Turku, Turku, Finland
Katri Räikkönen
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
*
Author for correspondence: Marius Lahti-Pulkkinen, E-mail: marius.lahti-pulkkinen@helsinki.fi
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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.

Keywords

Antenataldepressiondepressive disorderdepressive symptomsfetal programmingglycoproteinhsCRPinflammation
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 11 , August 2020 , pp. 1839 - 1851
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Copyright
Copyright © Cambridge University Press 2019

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Footnotes

*

Dr Lahti-Pulkkinen and Dr Girchenko had equal contribution and are the joined first authors.

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