Table 2.
Summary of included articles (pregnancy).
| PREGNANCY | ||||
|---|---|---|---|---|
| First Author | Purpose/Aims | Design# | Factor Domain | Summary of significant findings (values) |
| Miyake2 (2022) (N = 1744) Japan | Examine the association between tryptophan intake and depressive symptoms during pregnancy. | Cross-sectional1 | Bh | Tryptophan intake was positively associated with being unemployed (p = 0.0001), household income (p = 0.002), education (p = 0.01), and intake levels of saturated fatty acids (p ≤ 0.0001), eicosapentaenoic acid plus docosahexaenoic acid (p ≤ 0.0001), calcium (p ≤ 0.0001), vitamin D (p ≤ 0.0001), isoflavones (p ≤ 0.0001), fish (p ≤ 0.0001) and negatively associated with having ever smoked (p = 0.0006) and cereal intake (p ≤ 0.0001). Age was negatively associated to the prevalence of depressive symptoms during pregnancy in a crude analysis (p = 0.02). |
| Compared with tryptophan intake in the lowest quartile, tryptophan intake in the highest quartile was related to a ↓ prevalence of depressive symptoms during pregnancy. The inverse exposure – response relationship was also significant in the crude analysis. | ||||
| ↑ tryptophan intake was independently negatively associated with the prevalence of depressive symptoms during pregnancy: the adjustedPRs (95% CIs) for depressive symptoms during pregnancy in all four quartiles of tryptophan intake (Crude PR (95% CI), 1.00; 0.95 (0.74–1.22); 0.87 (0.67–1.12); 0.57 (0.42–0.76), p=0.0001)); (Adjusted PR (95% CI), 1.00; 0.99 (0.76–1.28); 0.94 (0.71–1.25); 0.64 (0.44–0.93), p=0.04)). | ||||
| These results were not changed when controlling for dietary factors. | ||||
| ®Venkatesh2 (2019) (N = 462) US | 1) Determine whether antenatal depression was associated with two biomarkers of oxidative stress, 8-OHdG and 8-Isoprostane, and five biomarkers of inflammation. 2) assess whether the association between antenatal depression and SPTB was mediated by those biomarkers found to be significant in the primary aim. | Prospective2 | B | Spontaneous preterm birth (SPTB) was 2 times more frequent among those with depression compared to those without (12.4 vs. 6.3%, OR: 2.1 [95% CI: 1.10–4.04], p = 0.02) |
| Those with depression had ↑ levels of specific gravity corrected 8-isoprostane compared to those without depression (geometric mean: 299.96 pg/mL vs. 237.01 pg/mL, p = 0.001). | ||||
| Those with depression who had prenatal antidepressant exposure had ↓ levels of 8-isoprostane compared to those who had depression without antidepressant exposure (geometric mean: 362.40 pg/mL, p = 0.03); however, both groups (antidepressant exposure vs. not) had ↑ 8-isoprostane levels compared to those without prenatal depression (237.01 pg/mL, ANOVA p = 0.02). | ||||
| Prenatal depression was associated with SPTB (AOR: 2.09, 95% CI: 1.09–4.03, p = 0.02). The association between 8-isoprostane and prenatal depression with STPB were ↓ when analyzed in the same regression model, which is suggested by the authors to indicate partial mediation of 8-isoprostane on the relationship between prenatal depression and SPTB (AOR for 8-isoprostane: 3.72, 95% CI: 2.14–6.46, p < 0.001; AOR prenatal depression: 1.68, 95% CI: 0.85–3.34, p = 0.13). After bootstrapping over 1,000 iterations, it was found that 27% of the effect of prenatal depression on SPTB was explained by 8-isoprostane. | ||||
| No significant findings were noted for 8-OHdG or inflammatory markers. | ||||
| Chang (2018) (N = 33) Taiwan | Investigate if subjects with depression in pregnancy had higher levels of pro – inflammatory markers and lower levels of anti-inflammatory markers. | Case control1 | B | Compared to controls, those with prenatal depression had ↓ levels of omega-3 polyunsaturated fatty acid (3-PUFAs) (p = 0.026), EPA (p = 0.019), and DHA (p = 0.02). They also had ↑ n-6/n-3 ratios. |
| TNF-α was the only inflammatory marker found to be significantly ↑ for those with prenatal depression versus those without (p = 0.016). | ||||
| No correlation between depression severity PUFAs and inflammatory markers were found. Depression duration was negatively correlated with total n-3 PUFAs, EPA and DHA (r = −0.415, −0.395, −0.392, p = < 0.05). Current depression was positively correlated with n-6/n-3 ratio and TNF-α (r = 0.458, 0.443, p < 0.01). | ||||
| ®Finy2 (2018) (N = 214) US | Examine the association between childhood abuse, low socioeconomic status (SES) and inflammatory markers during pregnancy | Cross-sectional1 | B, S | Childhood abuse history was positively associated with CRP and IL-6. Current SES and CRP and IL-6 were negatively associated (p’s < 0.01). |
| Depressive symptoms were positively correlated with IL-6 (r = 0.23, p < 0.01). | ||||
| ®Miller2 (2018) (N=170) US | To evaluate the association between psychotropic medication and maternal serum inflammatory biomarkers in women with antenatal depressive symptoms (ADS) in the mid-trimester. | Cross-sectional1 | B | Those with untreated depression were more likely to be from a racial/ethnic minority group, to have a ↓ household income, to be publicly insured, have a ↓ educational level, and ↓ likely to be married. Further, they were ↑ likely to be employed than those with depression non-responsive to treatment but were ↓ likely to be employed than those with depression responsive to treatment. |
| There were no differences noted in serum levels of IFNy, IL13, IL6, IL8, or CRP, but TNF-α differed across the groups. Post-hoc analyses indicated those non-responsive to treatment (p = 0.02) and untreated depression (p = 0.01) had ↓ TNF-α compared to those responsive to treatment. No differences noted between untreated depression and those non-responsive to treatment (p = 0.76). | ||||
| When controlling for race/ethnicity, income, and marital status, a linear regression demonstrated both those with depression who were non-responsive to treatment and those who had untreated depression had ↑ TNF-α compared to those responsive to treatment (β = 0.27, 95% CI: 0.02–0.52 and β = 0.23, 95% CI 0.02–0.44). | ||||
| ®Ross (2017) (N = 90) US | Examine the association between pregnant women’s close relationships and cytokine profiles in the third trimester. | Prospective2 | B, S | Correlations between cytokines varied within each trimester and ranged from r = 0.660 – r = −0.469 with a mean r = 0.322 indicating a good proportion of variance in each cytokine is unique. |
| Romantic partner (RP) relationships with positive features (i.e., support/closeness) were associated with ↓ levels of inflammatory cytokines; RP relationships low in both positive and negative features (indifferent) were associated with cytokine profiles indicating ↑ inflammation. | ||||
| Positive RP relationship was negatively associated with IL6:IL10 ratio. Further, when positive RP features were ↑ and there were ↓ RP negative features, the estimated IL6:IL10 ratios were lowest indicating a potential buffering or protective effect of positive RP relationships. | ||||
| Positive and negative RP relationships were associated with IL10 levels (b(SE) = 0.031 (0.009), p = 0.001; b(SE) = 0.017 (0.007), p = 0.017). | ||||
| Positive and negative RP relationships were associated with IFNy levels (b(SE) = 0.131 (0.041), p = 0.002; b(SE) = 0.095 (0.032), p = 0.004) | ||||
| Neither positive and negative RP relationships were associated with IL13, IL8, IL6, and TNF-α levels. | ||||
| ↑ positive RP relationship was associated with ↓ depressed mood (r = −0.35, p = 0.001) and perceived stress (r = −0.41, p < 0.001) whereas ↑ negative RP relationship was associated with ↑ depressed mood (r = 0.51, p < 0.001), perceived stress (r = 0.53, p < 0.001), and pregnancy distress (r = 0.29, = 0.005). | ||||
| ®Christian (2009) (N = 60) US | Examine associations among perceived stress, current depressive symptoms, and serum inflammatory markers among pregnant women from primarily lower socioeconomic backgrounds. | Cross-sectional1 | B, Bh | When controlling for pre-pregnancy BMI, ↑ depression scores were associated with ↑ levels of IL-6 (β = .23, t(2, 55) = 1.98, p = 0.05). |
| ↑ depression scores were marginally associated with ↑ TNF-α levels (β = 0.24, t(2, 58), p = 0.06). | ||||
| Depressive symptoms were positively correlated with perceived stress (r = 0.050, p < 0.01). | ||||
| Those classified as unhappy about their pregnancies had ↑ depressive symptoms compared to those who were happy about their pregnancy (mean CES-D = 22, SD = 10; mean CES-D = 16, SD = 10, p = 0.04). | ||||
| Those reporting ↓ social support had ↑ depressive symptoms (p < 0.05), and those with ↑ frequent hostile and insensitive social interactions also had ↑ depressive symptoms (p < 0.01). | ||||
| After controlling for social support, hostile and insensitive social interactions remained associated with depressive symptoms (β = 0.17, r(1, 59) = 1.25, p = 0.21). | ||||
Author2 = secondary analysis; Design# = Design + Number of timepoints investigated; Domain of factors investigated in relation to depression: B = Biological, Bh = Behavioral, E = Environmental, S = Social; Values (when provided) = statistical values respective to analysis; Factors investigated in relation to depression bold; Timeframe and/or groups investigated underlined.
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Study reported race/ethnicity