Risk Factors, Prognosis, Influence on the Offspring, and Genetic Architecture of Perinatal Depression Classified Based on the Depressive Symptom Trajectory

Author:

Ohseto Hisashi1ORCID,Takahashi Ippei1,Narita Akira12,Obara Taku123,Ishikuro Mami12,Kobayashi Natsuko3,Kikuchi Saya3,Li Xue1,Noda Aoi123,Murakami Keiko12,Tamiya Gen124,Sugawara Junichi1235,Tomita Hiroaki1236,Kuriyama Shinichi126ORCID

Affiliation:

1. Graduate School of Medicine, Tohoku University, Sendai 980-8575, Japan

2. Tohoku Medical Megabank Organization, Tohoku University, Sendai 980-8573, Japan

3. Tohoku University Hospital, Tohoku University, Sendai 980-8574, Japan

4. RIKEN Center for Advanced Intelligence Project, Tokyo 103-0027, Japan

5. Suzuki Memorial Hospital, Iwanuma 989-2427, Japan

6. International Research Institute of Disaster Science, Tohoku University, Sendai 980-8572, Japan

Abstract

This study is aimed at revealing the risk factors, prognosis, influence on offspring, and genetic architecture of perinatal depression (PD) classified based on the depressive symptom trajectory. Pregnant women with no history of major depressive disorder (MDD) were recruited and followed up with their offspring from 1 to 5 years postpartum. Using four self-report questionnaires in the perinatal period, PD was classified into four subtypes: pregnancy, early postpartum, late postpartum, and chronic PD. Risk factors, depressive symptom trajectory from 1 to 5 years postpartum, and child behavior problems were compared among the four PD subtypes. Genome-wide association studies (GWASs) were conducted for each subtype. The relationships between the PD subtypes and polygenic risk scores (PRS) for MDD, a psychiatric disorder, and premenstrual syndrome (PMS), a hormonal disorder, were examined. Among 12,338 participants, 1,145 (9.3%) developed pregnancy PD, 856 (6.9%) developed early postpartum PD, 382 (3.1%) developed late postpartum PD, and 1,048 (8.5%) developed chronic PD. Depressive symptoms decreased to 61.0%–73.3% in the 5 years postpartum. The relationship between risk factors and PD varied based on the PD subtype. Additionally, chronic PD increased the risk of child behavior problems by 2- to 3-fold. The GWASs uncovered five significant variants in different loci depending on PD subtypes, suggesting a subtype-specific genetic architecture. The PRS for MDD was related to pregnancy, early postpartum, and chronic PD, while that for PMS was related to late postpartum PD. It was concluded that PD is heterogeneous depending on the depressive symptom trajectory. Thus, specific prevention and treatment strategies are needed.

Funder

Ministry of Education, Culture, Sports, Science and Technology

Publisher

Hindawi Limited

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