Abstract
Perinatal depression is becoming increasingly acknowledged as its high global and national prevalence in New Zealand continues to incur a burden of disease on mothers and their babies, affecting their physical and psychological wellbeing and their overall quality of life. Factors that influence and impact the etiological development of perinatal depression are complex and can be due to a combination of biological, psychological, and environmental factors. It has been increasingly recognised that an association exists between elevated levels of systemic inflammation and the occurrence of mood disorders, suggesting that inflammation may contribute to the development and maintenance of symptoms of depression and other mood disorders. Studies confirm that during the gestation period, elevation of inflammatory cytokines and other inflammatory biomarkers, such as C-reactive protein (CRP), was observed, suggesting that inflammation may be involved in perinatal depression and that targeted treatment of inflammation could be beneficial.
The current study analysed blood samples and participant data drawn from a larger randomised controlled trial investigating the impact of a multivitamin supplementation compared to a placebo in women experiencing perinatal depression.
The sub-study aimed to determine whether the administration of a multivitamin supplementation over a 12-week period reduced inflammatory markers in perinatal women as well as their symptom severity of psychological distress. Sixty-one participants provided samples for analysis at baseline and 43 participants provided samples at the 12-week follow-up. The primary measure of CRP concentrations in the plasma samples was analysed using latex immunoassay.
This study did not demonstrate a decrease in plasma CRP concentrations for participants in the intervention group over time, nor was there a difference in CRP concentrations between the two groups at the week 12 follow up. Analyses showed a significant decrease in the various mood measures over time, but the mood scores were not significantly different between the two groups at week 12. Correlations were observed between two of the inflammatory measures (CRP and IL-6) and secondary mood measures, with analyses suggesting a positive relationship, particularly with anxiety. These findings suggest that as an inflammatory marker (CRP or IL-6) increased, scores on the secondary mood measures also increased. Future research exploring a IL-6 as the primary inflammatory measure is recommended as well as further research having a more focused investigation on anxiety in the perinatal period as the inflammatory markers were more frequently associated with anxiety measures. Further research could also look to better determine the association between inflammation and PND, through use of established anti-inflammatory agents.