Relationship between inflammatory biomarkers, vitamin D levels, and depressive symptoms in late pregnancy and during the postpartum period: a prospective, observational study

• Published in: Middle East current psychiatry (Cairo) Vol. 29; no. 1; pp. 1 - 9
• Main Authors: Nassr, Ola Ali, Mohammed, Mohammed Mahmood, Showman, Hind Abdulkhaliq
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2022; SpringerOpen
• Subjects: Inflammation; Inflammatory markers; Medicine; Medicine & Public Health; Poor marital relationship; Postpartum depressive symptoms; Pregnancy depressive symptoms; Psychiatry; Vitamin D level; C-reactive protein; Postpartum depressive symptoms; Vitamin D level; Pregnancy depressive symptoms; Inflammatory markers; Inflammation; Poor marital relationship; Interleukin-6
• ISSN: 2090-5416; 2090-5416
• DOI: 10.1186/s43045-022-00241-w

Background
Perinatal depression impacts maternal and fetal health, and exhibits a high rate of continuity postpartum. Not only does it impair the maternal quality of life, it also increases the risk of adverse birth and developmental problems in offspring. Vitamin D deficiency and excessive inflammation have been associated with perinatal depression. There is a scarcity of evidence regarding the biological causes of maternal depression in Iraq, therefore, the present study aims to assess perinatal depressive symptoms associations with inflammatory markers and vitamin D levels, and to investigate the interaction between vitamin D and the inflammatory markers. A prospective, observational study design was utilized to recruit healthy pregnant women from private obstetrics clinic in Baghdad, Iraq, from April to September 2021. The Edinburgh Postnatal Depression Scale (EPDS) was used to measure depressive symptoms during the third trimester and at 6 months postpartum. Serum levels of interleukin (IL)-6, C-reactive protein (CRP), and 25-hydroxy vitamin D (25-OH-D) were quantified, using a fully automated chemiluminescence immunoassay analyzer.
Results
Eighty patients were eligible for inclusion. The antenatal EPDS scores demonstrated a significant association with square root IL-6 (
B
= – 0.025,
p
= 0.040) and no association with CRP or vitamin D levels. The severity of postpartum depressive symptoms tended towards a positive association, with larger increases of CRP concentration (
p
= 0.065). In contrast, the association between marital relationship quality and CRP was statistically significant (
p
= 0.001). There was a statistically significant association between CRP and vitamin D concentration (
p
= 0.041). Antepartum EPDS significantly predicted the postpartum EPDS score (
p
= 0.000,
B
= 0.180,
R
2
for the model = 0.976, CI (0.17–0.19)).
Conclusions
The study findings show a significant association between third trimester depressive symptoms and IL-6 concentration. CRP and vitamin D levels do not correlate with perinatal depressive symptoms and a poor marital relationship significantly elevates the CRP level. In addition, vitamin D level was associated with CRP level and antepartum depressive symptoms predict postpartum EPDS score. Future studies involving a larger population and including women with pregnancy complications would provide a further insight into the role of inflammation and vitamin D deficiency in the etiology of perinatal depression.