Investigating the causal association of postpartum depression with cerebrovascular diseases and cognitive impairment: a Mendelian randomization study

Abstract

BackgroundPostpartum depression (PPD) is considered the most widespread puerperium complication. The associations of major depressive disorder with certain types of cerebrovascular diseases and cognitive function have been proposed, but the potential causal effects of PPD on these phenotypes are still unknown.MethodsA Mendelian randomization (MR) research design with various methods (e.g., inverse-variance weighted method and MR pleiotropy residual sum and outlier test) was adopted to establish a causal relationship between PPD with cerebrovascular diseases and cognitive impairment.ResultsNo causal relationship between PPD with carotid intima media thickness and cerebrovascular diseases (i.e., stroke, ischemic stroke, and cerebral aneurysm) was found. However, MR analyses indicated a causal association between PPD and decreased cognitive function (P = 3.55 × 10−3), which remained significant even after multiple comparison corrections using the Bonferroni method. Sensitivity analyses using weighted median and MR-Egger methods indicated a consistent direction of the association.ConclusionThe causal association between PPD and cognitive impairment indicates that cognitive impairment is a critical aspect of PPD and thus cannot be regarded as an epiphenomenon. Addressing cognitive impairment and lessening the symptoms associated with PPD independently play significant roles in the treatment of PPD.

Association Between Major Depressive Disorder and the Development of Cerebral Small Vessel Disease: A Mendelian Randomization Study

“…For fewer than three remaining SNPs, a relaxed threshold of p < 1E-05 was used. Relaxing the statistical threshold for IVs has been employed in several MR studies in the psychiatric domain (Lee et al, 2023; Li et al, 2023; Pan et al, 2023). To exclude genetic variants with strong correlations, the clumping process was performed using the 1000 Genomes Project European reference panel (R2 < 0.001 and a window size of 10,000 kb).…”

Cognitive impairment and the associated factors among women with a history of pregnancy complications in rural southwestern Uganda

“…We excluded women who were less than two years postpartum, the very ill, and those who were known to have been diagnosed with severe mental illness. The reason for excluding women who were less than two years postpartum was to help us capture long-term cognitive effects of pregnancy complications and mitigate the effect of postpartum depression that could exist among the mothers [ 37 , 38 ]. In this study,"the very ill" referred to women who were experiencing severe acute illnesses or were admitted to the hospital for a medical condition unrelated to pregnancy complications.…”

Neurobiological and Behavioral Underpinnings of Perinatal Mood and Anxiety Disorders (PMADs): A Selective Narrative Review

“…These structural changes suggest a unique pathological mechanism in PPD, potentially linked to long-term parenting stress [14]. Li et al [39] 2023…”

“…The postpartum period is marked by complex hormonal changes influencing brain areas involved in social interaction and cognitive processing [40]. Li et al [39] utilized a Mendelian randomization approach to investigate the potential causal effects of PPD on cognitive impairment. A significant causal relationship was found between PPD and decreased cognitive function, indicating that cognitive impairment is a critical aspect of PPD.…”