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

整个怀孕期间的炎症轨迹：研究产后抑郁症风险的新标志物

• 批准号: 10217881
• 负责人: Elysia Poggi Davis
• 金额: $ 24.14万
• 依托单位: UNIVERSITY OF DENVER (COLORADO SEMINARY)
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-05-20 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10217881
• 关键词: Address; Adverse effects; Affect; Anti-Inflammatory Agents; Area; Automobile Driving; Behavior; Biological Assay; Biological Markers; Biological Process; Blood specimen; COVID-19 pandemic; Child; Childbirth; Cognition; Complex; Development; Diagnosis; Early identification; Etiology; Fetal Development; Fetus; Foundations; Future; Goals; Immune; Immune system; Immunologic Markers; Immunological Models; Immunologics; Impairment; Individual Differences; Inflammation; Inflammatory; Investigation; Knowledge; Link; Longitudinal Studies; Maintenance; Mental Depression; Mental disorders; Methodology; Modeling; Mothers; Neurobiology; Parents; Persons; Plasma; Postpartum Depression; Postpartum Period; Pregnancy; Pregnancy Trimesters; Pregnant Women; Prevention; Process; Public Health; Research; Risk; Risk Factors; Risk Marker; Role; Sampling; Signal Transduction; Specificity; Symptoms; Testing; Therapeutic Intervention; Time; Woman; Work; antepartum depression; clinical biomarkers; cytokine; depressive symptoms; experience; immunoregulation; inflammatory marker; insight; intergenerational; longitudinal design; maternal caregiving; maternal depression; mood symptom; novel; novel marker; perinatal period; postnatal; prenatal; prevent; prospective; suicidal risk

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.

项目概要 产后抑郁症（PPD）是产后最常见的精神疾病，影响 全球近 18% 的妇女遭受痛苦并导致母亲及其母亲的功能受损 孩子们。为了阐明导致 PPD 风险的因素，当前项目试图测试炎症的作用 整个怀孕期间的标记物可预测产后抑郁症状。具体来说，反映了最近 关于怀孕期间免疫系统复杂且不断变化的作用的理论工作，当前项目 将利用 165 名孕妇的前瞻性纵向设计来检查孕妇的动态轨迹 整个怀孕期间的炎症标志物在预测 PPD 症状和一、二胎诊断中的作用 产后几个月。通过产前和产后的反复评估，考虑 炎症标记物的潜在曲线轨迹而不是单一评估，并通过检查 同时，我们将克服过去的障碍，更加紧密地取得进展 反映了妊娠期交替的免疫优先顺序。利用之前收集的储存血浆样本 作为孕期抑郁症状家长 R01 研究的一部分，应对 COVID-19 大流行 （MH109662），这项工作将描述与抑郁症相关的关键炎症标志物的轨迹 有或没有升高的产前抑郁症状的女性怀孕的每个三个月（目标 1）和 检查炎症轨迹是否能够前瞻性地预测抑郁症状和 PPD 诊断 产后一两个月（目标 2）。此外，它将探讨抑郁症相关疾病的预测特异性 炎症标志物（与 Th1 和 Th2 细胞因子或其他相关炎症标志物的变化相比） 精神疾病）并将探讨妊娠期炎症特征是否与某些疾病存在差异相关 PPD 症状（目标 3）。通过这种方法论上严格的方法，我们将准备好进行强有力的 测试产前炎症和产后抑郁症状之间的方向关联 识别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至关重要 炎症与产后抑郁症状之间的联系，最终目标是识别新因素 以预防或治疗产后抑郁症为目标。