title: Association of depressive symptoms with inflammatory biomarkers among pregnant African-American women.
abstract: Depression and inflammation are associated with poorer birth outcomes. African-American women have higher levels of inflammatory biomarkers, more depressive symptoms, and a disparate burden of poorer birth outcomes, but the association between depressive symptoms and inflammation within this higher-risk group is unknown. We examined this association among African-American women in the second trimester of pregnancy and additionally tested whether body mass index (BMI) mediates or moderates this relationship. We recruited 187 women from the obstetrics clinics of a large urban health system. Depression symptoms were measured with the Center for Epidemiological Studies Depression (CES-D) scale and inflammatory biomarkers (high-sensitivity C-reactive protein [hs-CRP], interleukin [IL]-6, IL-10, IL-1β, and tumor necrosis factor-α [TNF-α]) with enzyme immunoassays. Multivariate regression models were fitted to determine the association between CES-D score and each inflammatory biomarker. CES-D was not associated with hs-CRP or TNF-α. CES-D was directly associated with IL-1β (P=0.03). BMI moderated the relationship between CES-D and IL-6 (P<0.01) and IL-10 (P=0.04); in leaner women, depressive symptoms were associated with higher IL-6 and IL-10 levels, whereas in heavier women, depressive symptoms were associated with lower IL-10 levels. BMI did not mediate the relationship between CES-D and inflammation. We conclude that depressive symptoms are associated with increased inflammation among pregnant African-American women. Future studies are needed to examine if depression, mediated through inflammation, increases the risk of adverse pregnancy outcomes in African-American women.
authors.affiliation: Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI 48202, USA. acassid1@hfhs.org
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Cassidy-Bushrow
authors.forename: Rosalind M
authors.initials: RM
authors.lastname: Peters
authors.forename: Dayna A
authors.initials: DA
authors.lastname: Johnson
authors.forename: Thomas N
authors.initials: TN
authors.lastname: Templin
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003863:Depression / Q000453:epidemiology / Q000276:immunology* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism*; D053583:Interleukin-1beta / Q000378:metabolism*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000276:immunology* / Q000503:physiopathology; D014505:Urban Population; D055815:Young Adult
chemical_list: D018836:Inflammation Mediators; D053583:Interleukin-1beta; D002097:C-Reactive Protein