The Effect Of Inflammatory Cytokines And Social Support And Their Interactions On Postpartum Depression

Objective To explore the relationship between prenatal depression and postpartum depression(PPD),and to analyze the effects of inflammatory cytokines and social support and their interactions on PPD,so as to provide a reference for the prevention and treatment of PPD.Methods1.Correlation between prenatal depression and postpartum depression:Self rating depression scale(SDS)and Edinburgh postnatal depression scale(EPDS)was used to investigated the prenatal and postpartum depression status in 200pregnant women from the Yinchuan Maternal and Child Health Hospital and the Zhongwei Traditional Chinese Medicine Hospital between September and November 2016.The SDS scale and the EPDS scale at 3 days postpartum were completed by the mother.The state of depression was assessed by telephone follow-up on the 42nd day after delivery.2.The effect of inflammatory cytokines and social support and their interactions on PPD:Blood samples were collected from 176 expectant mothers,and Enzyme-Linked ImmunoSorbent Assay(ELISA)was used to determine serum inflammatory factors[Tumor necrosis factor-α,(TNFα),interleukin-1β(IL-1β),Interleukin-6(IL-6)]content.The depression group were included in the EPDS score≥13 points after 3 days postpartum and 42 days postpartum,and the control group were the EPDS score<13 points.The Social Support Rating Scale(SSRS)was used to investigate the status of maternal social support,and the maternal should fill it out.Results1.Correlation between prenatal depression and postpartum depression:The prevalence rate of prenatal depression in 200 women was 20.0%,the prevalence rate of 3 days postpartum depression was 26.0%,and the prevalence rate of 42days postpartum depression was 15.5%,all of which were mainly mild depression.The prevalence rate of 3 days postpartum depression with prenatal depression in female were higher than that in female without prenatal depression(χ~2=9.381,P=0.002).So were female that 42 days postpartum depression with prenatal depression(χ~2=11.923,P=0.001).Pearson correlation analysis showed that SDS score was positively correlated with EPDS score at 3days postpartum(r=0.382,P<0.01)and 42 days postpartum(r=0.281,P<0.01).Generalized estimating equation analysis also showed that prenatal depression was positively correlated with depression at 3 days postpartum(r=0.219)and 42 days postpartum(r=0.251).Unconditional logistic regression analysis showed that prenatal depression was a risk factor for depression at 3 days postpartum(P=0.012,OR=2.664).And that prenatal depression(P=0.001,OR=4.059)was a risk factors for depression at 42 days postpartum.2.The effect of inflammatory cytokines and social support and their interactions on PPD:The IL-1βlevel(107.95±52.06)pg/mL in the depression group at 3 days postpartum was higher than that in the control group(69.97±33.19)pg/mL,and the difference was statistically significant(t’=-4.819,P<0.001).The TNFαlevel(176.79±109.85)pg/mL in the depression group at 3 days postpartum was also higher than the control group(104.04±56.20)pg/mL,and the difference was statistically significant(t’=-4.530,P<0.001).The level of IL-1β(125.22±51.37)pg/mL in the depression group at 42 days postpartum was higher than that in the control group(72.41±36.07)pg/mL,the difference was statistically significant(t’=-5.326,P<0.001).The level of TNFαcontent(214.92±99.81)pg/mL in the depression group at 42 days postpartum was also higher than the control group(106.00±63.81)pg/mL,the difference was statistically significant(t’=-5.728,P<0.001).The IL-1βlevel(174.40±15.06)pg/mL in the moderate to severe depression group at 3 days postpartum was higher than that in the mild depression group(103.88±50.76)pg/mL,and the difference was statistically significant(t’=-6.229,P=0.001).Unconditional logistic regression analysis showed that IL-1β(P<0.001,OR=1.022)and TNFα(P<0.001,OR=1.013)were risk factors for depression at 3 days after delivery.Parental support(P=0.015,OR=0.355)and friend support(P=0.024,OR=0.590)are protective factors for depression at 3 days postpartum.And that IL-1β(P<0.001,OR=1.025)and TNFα(P<0.001,OR=1.014)are risk factors for depression at 42 days postpartum.Parental support(P=0.042,OR=0.410)is a protective factor for depression at 42 days postpartum.Interaction model analysis showed that the interaction between IL-1βand social support had an impact on PPD.And that the interaction between TNFαand social support also had an effect on PPD.Conclusion1.Prenatal depression is positively associated with postpartum depression,and prenatal depression increases the risk of PPD.2.IL-1βand TNFαare risk factors for PPD.3.Parental support and friend support are protective factors for depression at3 days postpartum;parental support is protective factor for depression at 42 days postpartum.4.The presence of IL-1βwith low husband support,low parental support,and low friend support can increase the risk of PPD.The presence of serum TNFαwith low husband support also increases the risk of PPD.