Abstract
Antenatal depression affects ~9–19% of pregnant women and can exert persistent adverse effects on both mother and child. There is a need for a deeper understanding of antenatal depression mechanisms and the development of tools for reliable diagnosis and early identification of women at high risk. As the use of untargeted blood metabolomics in the investigation of psychiatric and neurological diseases has increased substantially, the main objective of this study was to investigate whether untargeted gas chromatography–mass spectrometry (GC–MS) plasma metabolomics in 45 women in late pregnancy, residing in Uppsala, Sweden, could indicate metabolic differences between women with and without depressive symptoms. Furthermore, seasonal differences in the metabolic profiles were explored. When comparing the profiles of cases with controls, independently of season, no differences were observed. However, seasonal differences were observed in the metabolic profiles of control samples, suggesting a favorable cardiometabolic profile in the summer vs. winter, as indicated by lower glucose and sugar acid concentrations and lactate to pyruvate ratio, and higher abundance of arginine and phosphate. Similar differences were identified between cases and controls among summer pregnancies, indicating an association between a stressed metabolism and depressive symptoms. No depression-specific differences were apparent among depressed and non-depressed women, in the winter pregnancies; this could be attributed to an already stressed metabolism due to the winter living conditions. Our results provide new insights into the pathophysiology of antenatal depression, and warrant further investigation of the use of metabolomics in antenatal depression in larger cohorts.
Highlights
Antenatal depression, i.e., an episode of major depression during pregnancy[1], affects ~9% of pregnant women in high income countries and more than 19% in low- and middle-income countries[2]
In this study, we demonstrate the use of untargeted metabolomics in discriminating plasma metabolite profiles between pregnant women with and without depressive symptoms
In the overall analysis, comprising samples of both summer and winter childbirths, no significant differences in the metabolic profiles between cases and controls were observed
Summary
I.e., an episode of major depression during pregnancy[1], affects ~9% of pregnant women in high income countries and more than 19% in low- and middle-income countries[2]. Decreased levels of serum allopregnanolone[7], morning cortisol[8], and oxytocin[9] have been reported among depressed pregnant women. A disrupted immune response, with both decreased and increased levels of inflammatory markers has been reported among women with antenatal depression, when compared with controls[10,11,12,13]. The identified differences in the measured parameters have not led to the development of reliable diagnostic tests. It is, critical to further investigate the pathophysiology of antenatal depression and its Henriksson et al Translational Psychiatry (2019)9:204 underlying biological mechanisms, in a holistic, discoverydriven way. Using the omic analyses of the systems biology era to identify biomarkers with sufficient accuracy and sensitivity for early disease diagnosis and/or the identification of women with higher disease susceptibility, may facilitate the development of preventive measures and more targeted effective treatment
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