English, Sarah (2019) Psychosocial and biological profiling of perinatal depression. PhD thesis, University of Warwick.

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Abstract

Perinatal depression (PND) has profound consequences for family life, social functioning as well as long-term cognitive development for the offspring. Current screening is ineffective, with half of all cases undetected. Understanding which factors provide the highest risk of PND will benefit screening and the targeting of treatment. PND involves interplay between individual chronic and acute disease burdens, biological and psychosocial environmental behavioural factors. The predictive potential of specific factors and their contribution to severity scores on the Edinburgh Postnatal Depression Scale (EPDS) screening tool is explored here.

This study has employed a multidisciplinary approach to combine psycho-sociodemographic factors with biomarkers from a population of women screened for antenatal (N=1579) and postpartum (N=872) depressive symptoms. Different methods of regression modelling have been explored to determine predictors of perinatal depression, which has also been compared with a machine learning approach. The heterogeneous presentation of symptoms has additionally been explored with statistical analysis.

History of anxiety or depression, young maternal age (18-24) low social status and smoking pre-pregnancy were identified as the strongest contributions to antenatal scores, whereas depressive symptoms in pregnancy and a history of depression or PND exhibited the strongest association with postpartum EPDS. Circulating concentration of IL-10 was significantly associated with antenatal EPDS, in addition to the ratio of IL-6/IL-10. The inclusion of IL-6 and IL-10 data improves prediction of antenatal scores. IL-6 and BDNF concentration were predictive of lower infant birth weights. In general the available covariates are better suited to predict EPDS scores antenatally than postpartum. Risk factor profiles for antenatal and postpartum depression appear to be largely different, supporting the theory that PND is a heterogeneous disease and that underlying pathologies are also heterogeneous.

Item Type:	Thesis or Dissertation (PhD)
Subjects:	R Medicine > RC Internal medicine R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry R Medicine > RG Gynecology and obstetrics
Library of Congress Subject Headings (LCSH):	Postpartum depression -- Diagnosis, Depression in women -- Diagnosis, Biochemical markers -- Diagnostic use
Official Date:	July 2019
Dates:	Date Event July 2019 UNSPECIFIED
Institution:	University of Warwick
Theses Department:	Warwick Medical School
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Grammatopoulos, Dimitris
Sponsors:	Warwick Medical School
Format of File:	pdf
Extent:	263 leaves : illustrations (some colour)
Language:	eng

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