Lower Serum Zinc and Higher CRP Strongly Predict Prenatal Depression and Physio-somatic Symptoms, Which All Together Predict Postnatal Depressive Symptoms

Abstract

Pregnancy and delivery are associated with activation of immune-inflammatory pathways which may prime parturients to develop postnatal depression. There are, however, few data on the associations between immune-inflammatory pathways and prenatal depression and physio-somatic symptoms. This study examined the associations between serum zinc, C-reactive protein (CRP), and haptoglobin at the end of term and prenatal physio-somatic symptoms (fatigue, back pain, muscle pain, dyspepsia, obstipation) and prenatal and postnatal depressive and anxiety symptoms as measured using the Edinburgh Postnatal Depression Scale (EPDS), Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HAMD), and Spielberger's State Anxiety Inventory (STAI). Zinc and haptoglobin were significantly lower and CRP increased at the end of term as compared with non-pregnant women. Prenatal depression was predicted by lower zinc and lifetime history of depression, anxiety, and premenstrual tension syndrome (PMS). The latter histories were also significantly and inversely related to lower zinc. The severity of prenatal EDPS, HAMD, BDI, STAI, and physio-somatic symptoms was predicted by fatigue in the first and second trimesters, a positive life history of depression, anxiety, and PMS, and lower zinc and higher CRP. Postnatal depressive symptoms are predicted by prenatal depression, physio-somatic symptoms, zinc and CRP. Prenatal depressive and physio-somatic symptoms have an immune-inflammatory pathophysiology, while postnatal depressive symptoms are highly predicted by prenatal immune activation, prenatal depression, and a lifetime history of depression and PMS. Previous episodes of depression, anxiety disorders, and PMS may prime pregnant females to develop prenatal and postnatal depressive symptoms via activated immune pathways.

Profiles and characteristics of clinical subtypes of perinatal depressive symptoms: A latent class analysis

“…Several studies have noted that it is difficult to determine the mechanisms underlying perinatal psychiatric illness (Di Florio & Meltzer-Brody, 2015;Jones, Cantwell, & Psychiatrists, 2010). However, other studies have suggested that prenatal depression and physio-somatic symptoms have an immune-inflammatory pathophysiology (Roomruangwong, Kanchanatawan, Sirivichayakul, Mahieu, et al, 2017). For instance serum zinc is negatively associated with prenatal depression and physio-somatic symptoms, whereas C-reactive protein (CRP) is positively associated.…”

Anxiety Disorders: Sex Differences in Serotonin and Tryptophan Metabolism

“…In addition, in women, body image satisfaction, which is associated with depressive and anxiety features, is strongly associated with activation of the TRYCAT pathway and especially with an index of quinolinic availability to the brain [99]. At the end of term pregnancy, TRYCAT pathway activity appears to be regulated by a complex network comprising inflammatory signals, nitrosative stress, bacterial translocation and regulatory autoimmune responses, pathways that are all associated with anxiety and depressive symptoms [93,100,101,102]. Overall, these studies indicate that aberrations in the TRYCAT pathway in pregnant females and parturients may be associated with increased anxiety and that sex, the menstrual cycle and PMS may have a profound effect on the TRYCAT pathway.…”

Activated neuro-oxidative and neuro-nitrosative pathways at the end of term are associated with inflammation and physio-somatic and depression symptoms, while predicting outcome characteristics in mother and baby

“…There is now evidence that perinatal depression and anxiety symptoms are predicted by immune activation and inflammatory responses, including lowered tryptophan availability and endogenous compounds with anti-inflammatory and antioxidant properties (Maes et al, 1992(Maes et al, , 2000(Maes et al, , 2001, e.g. CC16 (Maes et al, 1999), T3 popyunsaturated fatty acids (PUFAs) (De Vriese et al, 2003) and zinc, increased inflammatory cytokines and CRP levels Maes, 2014, 2016;Leff-Gelman et al, 2016;Roomruangwong et al, 2016aRoomruangwong et al, , 2016c. Recently, we published that an increased hematocrit (Hct), but not mean corpuscular volume (MCV), at the end of term may predict postnatal depressive symptoms (Roomruangwong et al, 2016b).…”