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Adverse life events, psychiatric history, and biological predictors of postpartum depression in an ethnically diverse sample of postpartum women

Published online by Cambridge University Press:  27 September 2017

J. Guintivano ,
P. F. Sullivan ,
A. M. Stuebe ,
T. Penders ,
J. Thorp ,
D. R. Rubinow  and
S. Meltzer-Brody
J. Guintivano*
Affiliation:
Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
P. F. Sullivan
Affiliation:
Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA Department of Genetics, University of North Carolina, Chapel Hill, NC, USA Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
A. M. Stuebe
Affiliation:
Department of Obstetrics and Gynecology, University of North Carolina, NC, USA Department of Maternal and Child Health, Gillings School of Global Public Health, NC, USA
T. Penders
Affiliation:
Department of Psychiatry and Behavioral Medicine, East Carolina University, NC, USA
J. Thorp
Affiliation:
Department of Obstetrics and Gynecology, University of North Carolina, NC, USA
D. R. Rubinow
Affiliation:
Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
S. Meltzer-Brody
Affiliation:
Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
*
Author for correspondence: J. Guintivano, E-mail: guinti@email.unc.edu
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Abstract

Background

Race, psychiatric history, and adverse life events have all been independently associated with postpartum depression (PPD). However, the role these play together in Black and Latina women remains inadequately studied. Therefore, we performed a case–control study of PPD, including comprehensive assessments of symptoms and biomarkers, while examining the effects of genetic ancestry.

Methods

We recruited our sample (549 cases, 968 controls) at 6 weeks postpartum from obstetrical clinics in North Carolina. PPD status was determined using the MINI-plus. Psychiatric history was extracted from medical records. Participants were administered self-report instruments to assess depression (Edinburgh Postnatal Depression Scale) and adverse life events. Levels of estradiol, progesterone, brain-derived neurotrophic factor, oxytocin, and allopregnanalone were assayed. Principal components from genotype data were used to estimate genetic ancestry and logistic regression was used to identify predictors of PPD.

Results

This population was racially diverse (68% Black, 13% Latina, 18% European). Genetic ancestry was not a predictor of PPD. Case status was predicted by a history of major depression (p = 4.01E-14), lifetime anxiety disorder diagnosis (p = 1.25E-34), and adverse life events (p = 6.06E-06). There were no significant differences between groups in any hormones or neurosteroids.

Conclusions

Psychiatric history and multiple exposures to adverse life events were significant predictors of PPD in a population of minority and low-income women. Genetic ancestry and hormone levels were not predictive of case status. Increased genetic vulnerability in conjunction with risk factors may predict the onset of PPD, whereas genetic ancestry does not appear predictive.

Keywords

Adverse life eventsgenetic ancestrypostpartum depressionpsychiatric history.
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 7 , May 2018 , pp. 1190 - 1200
Copyright
Copyright © Cambridge University Press 2017 

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