Depression

Postpartum Depression Linked to Inflammation

Inflammatory factors contribute to pregnancy-related depression.

Posted Dec 10, 2019

Dr. Odelya Gertel Kraybill Expressive Trauma Integration™
Pregnancy-Related Depression
Source: Dr. Odelya Gertel Kraybill Expressive Trauma Integration™

The America Pregnancy Association suggests that 70-80% of new mothers experience negative feelings and mood changes after giving birth. These common feelings are often referred to as “baby blues” and manifest in teariness or crying with no apparent reason, a sense of restlessness, irritability, sadness, mood changes and so forth. A recent study suggests that inflammation may play a role in this.

Depression is the most common mental health condition affecting perinatal women and mothers worldwide. According to NAMI about six percent of women experience a major depressive episode during pregnancy or in the first year following delivery. 

But some studies put the figure higher. In a recent study, Sidhu et al., (2019) suggested that about 10% of pregnant women and 13% of women who have given birth, experience a mental disorder, primarily depression. Sidhu’s study of peripartum depression*, which covers the time frame before birth and one year afterward, found a prevalence of depression to be as high as 14% and negatively associated with a first pregnancy, joint family, and the working status of the mother (Sidhu et al., 2019).   

Could depression be linked to inflammation?    
There is a growing body of evidence that links inflammation to mental health symptoms in general. Inflammation has been found to trigger depressionDepression and/or bipolar disorder were found to be accompanied by immune system dysregulation and inflammation, and high levels of cytokines. Exposure to childhood adversity has been linked to the development of inflammatory conditions later in life. Stress at a young age is associated with gut inflammation that can lead to problematic mental and physical conditions.

Inflammation and pregnancy-related depression
Recent studies suggest that pregnancy-related inflammation may put perinatal women at special risk of depression. Some evidence suggests that peripartum depression is triggered by dynamic changes of the immune system during pregnancy and at delivery. Achtyes et al., (2019) investigated whether inflammation (as measured by pro-inflammatory status in plasma, together with changes in the kynurenine pathway activity) is associated with the development of severe depression and suicidal behavior post-partum

The team analyzed blood samples from a sample of 165 patients who were diagnosed with peripartum onset depression (PPD) and women who were not suffering from PPD.
They found that several inflammatory factors appear to contribute to pregnancy-related depression onset and severity. Moreover, women with lower serotonin levels were at an increased risk for suicidal behavior, even when adjusting for depression severity, psychosocial factors, age BMI, and medication

These results indicate that severe depression in the postpartum period involves dysregulation of the immune response and the kynurenine pathway, with a concomitant reduction in serotonin levels. 

The authors proposed that inflammatory cytokines and the kynurenine pathway are potential treatment targets in PPD, opening up the possibility of novel therapeutic strategies targeting peripartum depression (Achtyes et al., 2019).

These findings contribute to an expanding body of evidence important for mental health practitioners, educators, and patients. There’s a growing call to address bio-medical root causes of inflammation and how they link to mental health symptoms.

*Peripartum Depression (PD) refers to depressive episodes that take place during pregnancy or within the first 12 months after giving birth (Gaynes et al., 2005).

References

Achtyes, E., Keaton, S. A., Smart, L., Burmeister, A. R., Heilman, P. L., Krzyzanowski, S., ... & Muzik, M. (2019). Inflammation and kynurenine pathway dysregulation in post-partum women with severe and suicidal depression. Brain, behavior, and immunity.

Gaynes, B. N., Gavin, N., Meltzer-Brody, S., Lohr, K. N., Swinson, T., Gartlehner, G., ... & Miller, W. C. (2005). Perinatal depression: Prevalence, screening accuracy, and screening outcomes: Summary. In AHRQ evidence report summaries. Agency for Healthcare Research and Quality (US).

Sidhu, G. S., Sidhu, T. K., Kaur, P., Lal, D., & Sangha, N. K. (2019). Evaluation of peripartum depression in females. International Journal of Applied and Basic Medical Research, 9(4), 201.