Highlighting the Mechanistic Relationship Between Perinatal Depression and Preeclampsia: A Scoping Review

Abstract

Background: Although there is scientific literature supporting an association between depression and preeclampsia (PE), little is known about the underlying mechanistic pathways that may explain these observed associations. Thus, this study aimed to outline the relationship between depression and PE, and to highlight the underlying cardiovascular and metabolic risk factors that are common to both. Methods: A scoping review of the literature was conducted in Medline, Scopus, and Web of Science. Results: From 706 articles initially identified, 23 articles met the inclusion criteria and were included in this review. Although some studies reported a positive association between PE and postpartum depressive symptoms, challenges comparing different methodologies, measurement instruments and when measurements were administered, and patient populations do not permit a decisive conclusion. In addition, very few studies addressed potential underlying mechanisms that may be contributing to observed associations; thus, a secondary search was conducted to identify cardiovascular and metabolic risk factors that are common to both depression and PE. Conclusion: The cardiovascular and metabolic risk factors ( i.e., increased inflammation and oxidative stress and decreased vascular and endothelial function) common to both depression and PE suggest that these factors may contribute as underlying mechanisms in both conditions. These similarities underscore the importance to better understand these mechanisms so preventative and therapeutic strategies could be developed to improve maternal health.

Increased Risk of Gestational Hypertension by Periconceptional Exposure to Ambient Air Pollution and Effect Modification by Prenatal Depression

“…33 This may also explain why we see s significant effect of all pollutants on GH among those with prenatal depression that can also increase chronic inflammation. 34 To the best of our knowledge, our study is the first to report that prenatal depression heightened the vulnerability of air pollution on GH. Whereas little is known about the biological mechanism of how prenatal depression magnifies the effect of air pollution on GH, several biologically plausible pathways warrant further investigation.…”

“…It is worth noting that the independent association of prenatal depression with GH/preeclampsia was not significant in our study, and previous studies on such an association remain inconclusive. 34 Nevertheless, our findings suggest that early screening and providing timely treatment for prenatal depression could protect pregnant individuals against an increased risk of pregnancy complications, such as GH, from environmental insults.…”

“…Specifically, depression has been shown to affect cardiovascular health through increased arterial stiffness, endothelial dysfunction, and chronic inflammation. 34 These changes are shared pathways by which air pollution exposure may induce GH, as discussed above. Our finding that all 4 air pollutants had overlapping susceptible exposure windows among pregnant individuals with prenatal depression further supports a possible disruption on the cardiovascular system by prenatal depression.…”

“…33 This may also explain why we see s significant effect of all pollutants on GH among those with prenatal depression that can also increase chronic inflammation. 34…”

Healthy Lifestyle Beliefs Scale: Psychometric properties in Portuguese pregnant women

“…In addition, pregnancy is a period of transition that influences a woman's psychosocial well‐being (Meleis, 2010), often leading to anxiety and depression (Bedaso et al, 2021). These emotional disorders increase the incidence of pre‐eclampsia (Yuan et al, 2022), premature birth, low birth weight, and dystocia (Dadi et al, 2020; Grigoriadis et al, 2019). Depression during pregnancy raises the risk of severe postpartum depression and difficulties in breastfeeding (Grigoriadis et al, 2019; Rollè et al, 2020).…”