title: Postpartum depression symptoms: a case-control study on monoaminergic functional polymorphisms and environmental stressors.
abstract: OBJECTIVE
  Postpartum depression (PPD) is an under diagnosed and under treated mood disorder, with negative impact on both the mother and the infant's health. The aim of this study is to examine whether genetic variations in the monoaminergic neurotransmitter system, together with environmental stressors, contribute to the development of PPD symptoms.
  
  
  METHODS
  This nested case-control study included 275 women from a population-based cohort of delivering women in Sweden. A questionnaire containing the Edinburgh Postnatal Depression Scale was collected at 6 weeks and 6 months postpartum. Three functional polymorphisms were genotyped, catechol-O-methyltransferase (COMT)-Val158Met, monoamine oxidase A (MAOA)-upstream variable number tandem repeat (uVNTR) and serotonin transporter linked polymorphic region (5HTT-LPR). Stressful life events, maternity stressors and previous psychiatric contact were considered as potential risk factors.
  
  
  RESULTS
  COMT-Val158Met was significantly associated with PPD symptoms at 6 weeks, but not at 6 months postpartum. A significant gene-gene interaction effect was present between COMT-Val158Met and MAOA-uVNTR. In a gene-environment multivariate model, COMT-Val158Met, psychiatric contact and maternity stressors were significantly associated with PPD symptoms. Among those with history of psychiatric problems, the COMT-Val158Met and 5HTT-LPR risk variants were associated with PPD symptoms, whereas in the absence of previous psychiatric contact only maternity stressors were related to PPD symptoms.
  
  
  CONCLUSIONS
  The interaction effect between monoaminergic genes and environmental stressors is likely to contribute to vulnerability for PPD. The different patterns of association according to history of psychiatric problems, if replicated, might be helpful in screening strategies.
authors.affiliation: Department of Neuroscience, Uppsala University Hospital, Uppsala, Sweden. erika.comasco@neuro.uu.se
authors.forename: Erika
authors.initials: E
authors.lastname: Comasco
authors.forename: Sara M
authors.initials: SM
authors.lastname: Sylvén
authors.forename: Fotios C
authors.initials: FC
authors.lastname: Papadopoulos
authors.forename: Inger
authors.initials: I
authors.lastname: Sundström-Poromaa
authors.forename: Lars
authors.initials: L
authors.lastname: Oreland
authors.forename: Alkistis
authors.initials: A
authors.lastname: Skalkidou
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002394:Catechol O-Methyltransferase / Q000235:genetics*; D016009:Chi-Square Distribution; D019052:Depression, Postpartum / Q000201:enzymology / Q000235:genetics* / Q000523:psychology; D004777:Environment; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D018598:Minisatellite Repeats / Q000235:genetics; D008957:Models, Genetic; D008995:Monoamine Oxidase / Q000235:genetics*; D015999:Multivariate Analysis; D011110:Polymorphism, Genetic; D050486:Serotonin Plasma Membrane Transport Proteins / Q000235:genetics*; D013312:Stress, Physiological / Q000235:genetics*; D055815:Young Adult
chemical_list: C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins; D008995:Monoamine Oxidase; D002394:Catechol O-Methyltransferase