Could blood test show risk of postnatal depression?

Could blood test show risk of postnatal depression?

By Margaret Rogers

Checking for specific genetic variants could predict which women are most at risk of postnatal depression (PND) according to researchers from Warwick Medical School.  The researchers feel that their findings could lead to the development of a simple blood test which could check for the likelihood of the development of PND.

The research was presented by Professor Grammatopoulos to the Congress of Endocrinology/European Congress of Endocrinology this month.  Grammatopoulos is a professor of molecular medicine at the University of Warwick.  He says that around one in seven new mothers suffer from PND and that this usually begins at around two weeks after childbirth.

‘Current screening policies rely on the opportunistic findings of PND cases using screening tools such as Edinburgh Postnatal Depression Score (EPDS), but such tests cannot identify women at risk, ahead of them developing the condition,’ Grammatopoulos said.

For the purposes of this study, 200 pregnant women were assessed by the research team for PND using the EPDS.  They were assessed once during their first visit to the ante-natal clinic and then again two to eight weeks after giving birth.  The women who developed PND were found to be more likely to have specific genetic variants.  (Technically these are variants of the bcl1 and rs242939 single nucleotide polymorphism (SNPs) of the glucocorticoid receptor and the corticotrophin-releasing hormone receptor – 1 genes, respectively.)

These receptors control the activity of an endocrine system (the hypothalamo-pituitary adrenal (HPA) axis) that is activated in response to stress.  This part of the brain monitors many aspects of the body’s systems and is closely associated with the pituitary gland.

The study findings suggest that PND is a particular subgroup of depression.  It has a particular genetic element which suggests that some women are genetically more sensitive to environmental factors which can trigger the onset of depression.

Grammatopoulos said ‘Although we knew already that there was an association of the HPA axis with depression, ours is the first study to show a link between specific elements of this pathway and the particular case of PND.  We now intend to conduct further research on other genetic variants of the HPA axis in a larger, multi-centre study involving women from Coventry, Birmingham and London.’

He added ‘We think that we have made an important step forward in characterising the prospective risks and are therefore paving the way for timely, appropriate medical treatment for women who are likely to develop PND.’

Postnatal depression is a condition that is quite distinct from the ‘baby blues’. You can read more about this condition here. It is generally believed that PND is caused by hormonal upheaval and, until now, was not associated with the HPA axis.

Professor Grammatopoulos concluded ‘We believe that we have made a discovery with important clinical and social implications.  If we can identify women likely to suffer from PND in advance so that they can be treated appropriately and at an early stage, we will have improved the lives not just of the parents, but also of their children.’

 

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