The synergistic effects of short inter-pregnancy interval and micronutrients deficiency on third-trimester depression

Abstract

ObjectiveTo explore the effect of inter-pregnancy interval (IPI) and micronutrients on depression in the third trimester of pregnancy.Materials and methodsA total of 5,951 eligible pregnant women were included in this single-center retrospective cohort study. Variables with potential effects on third-trimester depression were collected. These variables included: maternal factors [age, pregnancy interval, body mass index (BMI), BMI change, gravidity, native place, education, smoking, and alcohol consumption], previous delivery outcomes [preterm birth, preeclampsia, intrahepatic cholestasis of pregnancy (ICP), gestational diabetes mellitus (GDM), fetal growth restriction (FGR), and delivery mode], and micronutrients in early pregnancy (folic acid, 25-hydroxy vitamin D, vitamin B12, calcium, and ferritin). Univariate and multivariate analyses were used to screen the factors affecting the occurrence of depression. Based on these factors, the nomogram model was established. At the same time, the interaction between IPI and micronutrients was verified.ResultsThe incidence of depression in the third trimester of pregnancy was 4.3%. Univariate and multivariate analysis showed that there were five independent risk factors for third-trimester depression: gravidity, previous cesarean section delivery, folic acid, and vitamin D levels in early pregnancy and IPI. According to the multivariate logistic regression analysis, the prediction model and nomogram were established. The prediction cut-offs of the corresponding factors were calculated according to the Youden index. Finally, the synergistic effect of short IPI and micronutrient deficiency was verified.ConclusionThere is a synergistic effect between short IPI and micronutrient deficiency in early pregnancy, which can aggravate the occurrence of depression in late pregnancy.

Assessing the risk of prenatal depressive symptoms in Chinese women: an integrated evaluation of serum metabolome, multivitamin supplement intake, and clinical blood indicators

“…Nomograms have been used for the reliable prediction of various aspects of depression risk factors (e.g., demographic characteristics, social factors, and biological factors) ( 62 , 63 ). However, there are limited reports on the use of nomograms in the PDS, and most reports typically focused on a single domain of risk factors ( 64 ). Therefore, we have constructed a risk prediction nomogram model for PDS by combining metabolic biomarkers, dietary factors, and clinical blood indicators.…”

Interpregnancy Interval After Healthy Live Birth and Subsequent Spontaneous Abortion

“…For example, folate depletion can impede embryonic development in midpregnancy by preventing collagen cross-linking and weakening tissue connection . It takes about 1 year for maternal folate levels to revert to standard concentrations after childbirth . Another reason is that a short IPI is detrimental to the recovery of uterine inflammation and contraction-related proteins and therefore is susceptible to uterine rupture and uteroplacental bleeding disorders, especially after cesarean delivery …”

“…16 It takes about 1 year for maternal folate levels to revert to standard concentrations after childbirth. 35 Another reason is that a short IPI is detrimental to the recovery of uterine inflammation and contraction-related proteins 36 and therefore is susceptible to uterine rupture and uteroplacental bleeding disorders, especially after cesarean delivery. 37 In some countries, SA is defined as intrauterine death at less than 20 weeks of gestation.…”