Using inflammatory biomarkers in early pregnancy to predict subsequent antenatal depression.

Background: Antenatal depression (AD) is one of the most common pregnancy complications. Recent studies indicated that immune responses during pregnancy may contribute to development of AD.

Objectives: This study aimed to identify possible inflammatory biomarkers in early pregnancy to predict maternal depressive symptoms before delivery.

Methods: This case-control study was conducted within the Maternal and Infant Health (MI-Health) birth cohort (Beijing, China) and depressive symptoms were assessed by Zung Self-rating Depression Scale (SDS) in both second and third trimesters. By using immune multi-factors kits, we tested 26 inflammatory factors in the serum of 38 cases with antenatal depression symptoms in both trimesters (SDS ≥ 53) and 38 controls. Logistic regression was used to identify candidate biomarkers, and the predictive capabilities were evaluated by using Receiver Operator Characteristics (ROC) analysis.

Results: The concentrations of ln(CCL24) (p = 0.020), IL-7 (p = 0.006) and IL-10 (p = 0.014) were higher in early pregnancy among women with depressive symptoms comparing to healthy controls. The difference remained statistically significant after adjusting for maternal age, education level, gestational diabetes mellitus, pre-pregnancy BMI and gestational weeks of blood sampling (OR(ln(CCL24)) = 4.625, OR(IL-7) = 1.414, OR(IL-10) = 1.151). In ROC analysis, ln(CCL24), IL-7, and IL-10 achieved discrimination for depressive symptoms antepartum, with the values of AUC estimated at 0.75.

Limitations: The sample size is limited, and the infectious disease infection records were not collected for control.

Conclusion: Higher levels of CCL24, IL-7 and IL-10 may indicate the higher risk of antenatal depression and are potential biomarkers indicating pathogenesis of antenatal depression.