Perinatal mood and anxiety disorders affect a significant number of women, with approximately 1 in 8 experiencing symptoms that can impact their overall health, daily activities, and family life, according to the Centers for Disease Control and Prevention.
Researchers have identified a distinct set of plasma proteins that can serve as a potential biomarker for perinatal mood and anxiety disorders, according to a new study. The study, published in JAMA Network Open, noted that while traditional risk factors for these disorders, such as a history of depression and pregnancy complications like preeclampsia, are known, they are not specific or sensitive enough to inform clinical decision-making or prevention strategies for these conditions.
The study involved 52 women, including 34 with a risk for perinatal mood and anxiety disorders and 18 controls. Mental health screening was conducted at two time points – n the third trimester and again at three months post-delivery. An elevated risk of perinatal mood and anxiety disorders was identified by screening individuals with above-validated cutoffs for depression, anxiety, and/or posttraumatic stress disorder at both time points.
Plasma samples collected in the third trimester were screened using the aptamer-based SomaLogic SomaScan proteomic assay technology to evaluate the perinatal mood and anxiety disorder-associated changes in the expression of 1,305 protein analytes. From a panel of 53 significant perinatal moods and anxiety disorder-associated proteins, a unique 20-protein signature differentiated perinatal mood and anxiety disorder cases from controls in a principal component analysis.
This protein signature included NCAM1, NRCAM, and NTRK3 which converge around neuronal signalling pathways regulating axonal guidance, astrocyte differentiation, and maintenance of GABAergic neurons. The study found that participants with perinatal mood and anxiety disorders had a unique and distinct plasma protein signature that regulated a variety of neuronal signalling and proinflammatory pathways.
The researchers noted that additional validation studies with larger sample sizes are needed to determine whether some of these molecules can be used in conjunction with traditional risk factors for the early detection of perinatal mood and anxiety disorders. Perinatal mood and anxiety disorders encompass a range of mental health disorders that occur during pregnancy and up to 1 year postpartum, affecting approximately 20% of women.
The field of maternal mental health has recently begun the process of developing a diagnostic test for postpartum depression, which is surprising given the increasing prevalence of perinatal mood and anxiety disorders (PMADs). According to Postpartum Progress, self-reported postpartum depressive symptoms affected approximately 950,000 American women annually prior to the pandemic. To provide some context, this number is higher than the number of women affected by diabetes each year (approximately 800,000). If a blood test taken in the first or second trimester could identify PMAD risk, physicians could connect their patients to appropriate care promptly, which could potentially prevent the development of severe symptoms and long-term effects.
In the future, this study aims to expand its research to include a larger population and assess symptoms of perinatal mood and anxiety disorders (PMADs) at multiple points in time, instead of just during the third trimester and three months post-delivery. While the results are not conclusive and do not indicate causation, they are significant due to the high prevalence of PMADs. The study hopes to encourage further research in this area. Additionally, the study did not involve diagnosed cases of PMADs, and future research could utilize structured diagnostic interviews to provide a higher level of confidence that women meet the criteria for these disorders.
