title: Psychiatric symptoms and proinflammatory cytokines in pregnancy.
abstract: OBJECTIVE
  Clinical studies suggest that psychiatric symptoms, particularly depression, anxiety, and trauma, may be associated with inflammation, as indexed by proinflammatory cytokines. Such a link may be especially significant in pregnancy and may shed additional light on the etiology of perinatal mood disorders.
  
  
  METHODS
  We prospectively observed 145 women selected from a community obstetric clinic serving a primarily low-income, high-psychosocial risk population. Women without evidence of medical high-risk pregnancies were screened (including psychiatric and trauma histories) and then assessed in detail (e.g., mood symptoms) at approximately 18 and 32 weeks' gestation. Blood was drawn to measure key proinflammatory markers, interleukin 6 and tumor necrosis factor α (TNF-α). Data on pregnancy and obstetric outcome were derived from medical records.
  
  
  RESULTS
  There was considerable stability of cytokine levels within individuals and a significant mean increase across pregnancy observed for interleukin 6 (p < .001) and TNF-α (p < .001). History of trauma was associated with significantly elevated TNF-α levels (F(1,135) = 4.43, p < .05), controlling for psychosocial and obstetric covariates. In contrast, elevated measures of depression and anxiety were unrelated to proinflammatory cytokines (p > .1). Exploratory analyses indicated that neither psychiatric symptoms nor proinflammatory cytokines predicted birth weight, gestational age, or obstetric complications.
  
  
  CONCLUSIONS
  These findings suggest that antecedent trauma may be associated with persistently elevated TNF-α levels during pregnancy. The evidence that a generalized proinflammatory state was associated with symptoms of depression or anxiety in pregnant women was not found.
authors.affiliation: Departments of Psychiatry, University of Rochester Medical Center, 300 Crittenden Blvd, Rochester, NY 14642-8409, USA. emma_robertsonblackmore@urmc.rochester.edu
authors.forename: Emma Robertson
authors.initials: ER
authors.lastname: Blackmore
authors.forename: Jan A
authors.initials: JA
authors.lastname: Moynihan
authors.forename: David R
authors.initials: DR
authors.lastname: Rubinow
authors.forename: Eva K
authors.initials: EK
authors.lastname: Pressman
authors.forename: Michelle
authors.initials: M
authors.lastname: Gilchrist
authors.forename: Thomas G
authors.initials: TG
authors.lastname: O'Connor
mesh_terms: D000328:Adult; D001007:Anxiety / Q000097:blood / Q000175:diagnosis / Q000523:psychology; D016207:Cytokines / Q000097:blood*; D003863:Depression / Q000097:blood / Q000473:pathology / Q000523:psychology; D005260:Female; D006801:Humans; D007118:Immunoassay; D015850:Interleukin-6 / Q000097:blood; D054525:Minority Health; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000473:pathology* / Q000523:psychology*; D011262:Pregnancy Trimester, Second / Q000097:blood / Q000523:psychology; D011263:Pregnancy Trimester, Third / Q000097:blood / Q000523:psychology; D012306:Risk; D040921:Stress Disorders, Traumatic / Q000097:blood / Q000175:diagnosis / Q000523:psychology; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D016207:Cytokines; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha