130: Selective serotonin reuptake inhibitors and vasopressin: an intersection of depression and preeclampsia

Abstract

High circulating copeptin, a marker for arginine vasopressin (AVP) secretion, is associated with human depression and preeclampsia (PreE). Higher AVP secretion has been shown to be an important etiologic agent in both PreE and depression. Data suggest a lower incidence of PreE in women with depression who are currently taking selective serotonin reuptake inhibitors (SSRIs). While the biomechanism is unknown, SSRIs may decrease copeptin/AVP levels. The objective of this study is to investigate associations among copeptin (vasopressin secretion), depression symptoms, SSRIs, and PreE during pregnancy and postpartum. Overall, we hypothesize that SSRIs may modulate preeclampsia incidence in depressed pregnant women by decreasing vasopressin secretion. In this case-control study, 233 banked clinically annotated maternal plasma samples from the Iowa Maternal Fetal Tissue Bank (IRB #200910784) were used from pregnant women with (PHQ-9 score > 10) and without (PHQ-9 score < 10) depression symptoms as measured by the Patient Health Questionnaire-9 (PHQ-9) scores. Copeptin was measured using a commercial enzyme-linked immunosorbent assay. Chi-square, t-tests, and linear regression were performed with alpha=0.05. Thirty-six percent (n=84) of women studied were at risk for depression (PHQ >10). Consistent with previous data, the mean CopeptinLog 10 in women with PreE was significantly higher in comparison to controls (2.1 ± 0.56 vs. 1.93 ± 0.48, p< 0.001). Further, mean CopeptinLog10 is lower in women with a PHQ > 10 (1.77 ± 0.60 vs. 1.94 ± 0.47, p< 0.001). Linear regression demonstrates that copeptin levels decreases for each 0.043 increase of depression symptom score (p< .033). This decrease in copeptin was associated with a higher SSRI usage in PHQ >10 group (25.9% vs. 12.2%, p=008) Further, a lower incidence of PreE was observed in this PHQ >10, higher SSRI group in comparison to the PHQ< 10 group (2.4% vs. 8.8%, p=0.05). Our findings suggest SSRIs could decrease copeptin/AVP secretion levels in pregnancy which in turn may decrease the risk of preeclampsia.