Postpartum depression: A systematic review of the genetics involved

Abstract

Postpartum depression is one of the most prevalent psychopathologies. Its prevalence is estimated to be between 10% and 15%. Despite its multifactorial etiology, it is known that genetics play an important role in the genesis of this disorder. This paper reviews epidemiological evidence supporting the role of genetics in postpartum depression (PPD). The main objectives of this review are to determine which genes and polymorphisms are associated with PPD and discuss how this association may occur. In addition, this paper explores whether these genes are somehow related to or even the same as those linked to Major Depression (MD). To identify gaps in the current knowledge that require investigation, a systematic review was conducted in the electronic databases PubMed, LILACS and SciELO using the index terms "postpartum depression" and "genetics". Literature searches for articles in peer-reviewed journals were made until April 2014. PPD was indexed 56 times with genetics. The inclusion criteria were articles in Portuguese, Spanish or English that were available by institutional means or sent by authors upon request; this search resulted in 20 papers. Genes and polymorphisms traditionally related to MD, which are those involved in the serotonin, catecholamine, brain-derived neurotrophic factor and tryptophan metabolism, have been the most studied, and some have been related to PPD. The results are conflicting and some depend on epigenetics, which makes the data incipient. Further studies are required to determine the genes that are involved in PPD and establish the nature of the relationship between these genes and PPD.

The Neurobiology of Postpartum Anxiety and Depression

“…The most common treatment for maternal affective disorders during the peripartum period is the selective serotonin reuptake inhibitor medications (SSRIs) [105][106][107]. This is despite the fact that postpartum anxiety and depression are associated with altered functioning of many neurotransmitter systems such as GABA, norepinephrine, serotonin, glutamate [35, 71,108,109], steroid and peptide hormones, and genetic variants of these and other systems (for review [110]). SSRI medication use by pregnant and postpartum women in industrialized countries (including, but not limited to, Canada, USA, Australia, Iceland, Denmark, Sweden, UK, Italy, The Netherlands, and France) are on the rise [105-107, 111, 112], with higher rates in Australia and the USA (5-13%) compared to Canada and Western Europe (2-7%) [106,113].…”

Genetic and neuroendocrine regulation of the postpartum brain

“…The state of maternity includes an increased risk for depression, termed postpartum depression (PPD) (Miller, 2002; Couto et al, 2015). One view of the elevated risk for depression is that with a number of genes normally altered in producing the postpartum brain, if a subset are dysregulated or not changed from baseline appropriately, then this could lead to increased risk for PPD.…”

Distinct Genetic Profiles in Postpartum Depression With Different Trajectory of Illness

“…Meanwhile, evidence suggests that genetic factors play an important role in the development of PPD [11,12]. Indeed, the heritability of PPD is estimated to be as high as 50% [13], which is much higher than that of major depressive disorder.…”