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The effect of antenatal depression and antidepressant treatment on placental tissue: a protein-validated gene expression study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health.ORCID iD: 0000-0002-6246-7218
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Research group (Dept. of women´s and children´s health), Reproductive Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, Centre for Reproductive Biology in Uppsala (CRU).
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Medicinsk genetik och genomik.
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(English)Manuscript (preprint) (Other academic)
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-367376OAI: oai:DiVA.org:uu-367376DiVA, id: diva2:1267163
Note

Jocelien Olivier and Inger Sundström-Poromaa are shared last authors.

Available from: 2018-11-30 Created: 2018-11-30 Last updated: 2018-12-05
In thesis
1. Biological Aspects of Peripartum Depression
Open this publication in new window or tab >>Biological Aspects of Peripartum Depression
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Peripartum depression affects around 12% of women in pregnancy and postpartum, and about 2–3% of European pregnant women use antidepressants, mostly selective serotonin reuptake inhibitors (SSRIs). An increased risk of poor pregnancy outcomes has been described in women with antenatal depression and SSRI treatment during pregnancy. The biological mechanisms behind these complications are not fully understood and here we investigated several biological correlates of peripartum depression, and discriminated between the effects of antidepressant treatment and depression itself.

In Paper I, attentional biases in pregnant and postpartum women were studied by using the Emotional Stroop Task, measuring reaction times to different stimuli. The major finding was shorter reaction times in postpartum depressed women, for emotionally valenced stimuli, which can be interpreted as emotional numbing.

In Paper II, peripheral inflammatory markers were assessed by proximity extension assay technology in depressed, SSRI-treated and healthy pregnant women. Lower levels of 23 markers were found in women with antenatal depression, independent of treatment, compared with healthy controls. These findings suggest a dysregulated switch to the anti-inflammatory M2 milieu characterizing a normal third trimester.

In Paper III, normal changes in inflammatory markers across pregnancy and postpartum were assessed in healthy pregnant and postpartum women. The majority (41) of the 50 markers that differed between groups were lower postpartum. These results clearly reflect the change in the immune system in pregnancy to postpartum transition.

In Paper IV, placental gene and protein expression were investigated and nominally significant findings were noted for serotonin receptor 1A (HTR1A) and neuropeptide Y2 receptor (NPY2R), where women with untreated depression displayed higher gene expression than healthy controls. Protein expression analyses revealed higher levels of HTR1A in placentas from SSRI-treated women, compared with healthy controls and women with untreated depression. This suggests possible involvement of HTR1A in the effect of antenatal depression on the placenta.

Overall, peripartum depression is associated with altered cognitive-emotional processing, lower levels of several mostly anti-inflammatory markers, and altered placental gene and protein expression. However, we found no major differences between untreated and treated depression.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2019. p. 114
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1520
Keywords
Peripartum depression, antenatal depression, postpartum depression, antidepressant treatment, selective serotonin reuptake inhibitor, SSRI, pregnancy, postpartum, attentional bias, Emotional Stroop Task, inflammatory markers, proximity extension assay, placenta, gene expression, TaqMan low-density array, protein expression, immunohistochemistry, HTR1A, NPY2R
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-367385 (URN)978-91-513-0522-6 (ISBN)
Public defence
2019-02-01, Sal IX, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15 (Swedish)
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Available from: 2019-01-09 Created: 2018-12-05 Last updated: 2019-01-21

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Edvinsson, ÅsaHellgren, CharlotteKallak, Theodora KunovacÅkerud, HelenaSkalkidou, AlkistisLager, SusanneSundström Poromaa, Inger

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Edvinsson, ÅsaHellgren, CharlotteKallak, Theodora KunovacÅkerud, HelenaSkalkidou, AlkistisStener-Victorin, ElisabetFornes, RominaSpigset, OlavLager, SusanneOlivier, JocelienSundström Poromaa, Inger
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Reproductive HealthDepartment of Women's and Children's HealthCentre for Reproductive Biology in Uppsala (CRU)Medicinsk genetik och genomikObstetrics and Reproductive Health Research
Obstetrics, Gynecology and Reproductive Medicine

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