title: A pilot study evaluating genetic and environmental factors for postpartum depression.
abstract: OBJECTIVE
  To assess the influence of genetic and environmental risk factors upon postpartum depression.
  
  
  METHODS
  Case-control, prospective study.
  
  
  METHODS
  The University of California at San Francisco Obstetric and Gynecology Clinic.
  
  
  METHODS
  Mothers screened for postpartum depression six weeks after delivery with the Edinburgh Postnatal Depression Scale and recruited as cases and controls.
  
  
  METHODS
  Eligible subjects completed a series of assessments and a structured clinical interview to confirm diagnosis of depression. Deoxyribonucleic acid was obtained for genotyping of 81 single nucleotide polymorphisms in 12 genes hypothesized to be postpartum depression-related.
  
  
  RESULTS
  Twenty-four cases and 24 controls were eligible for analysis. Three single necleotide polymorphisms in the serotonin 2A receptor (HTR2A) gene were associated with postpartum depression. The strongest association at a functional promoter polymorphism (rs6311), a functional promoter single nucleotide polymorphisms (p=0.002, odds ratio 0.25, 95% confidence interval:0.10-0.63), was a finding robust to population stratification. Gene-wide association was significant for HTR2A (permuted p=0.008), but not when corrected for all 12 genes. Analysis of demographic and psychosocial risk factors identified distressed relationship, unplanned pregnancy, and a previous history of depression as significant predictive variables (p≤0.05).
  
  
  CONCLUSIONS
  This pilot data suggests deoxyribonucleic acid variations in HTR2A may be associated with postpartum depression. Psychosocial variables were also identified as risk factors. The relative influence of these variables on the manifestation of postpartum depression is yet to be determined.
authors.affiliation: Dr. El-Ibiary is from Midwestern University, College of Pharmacy-Glendale, Department of Pharmacy Practice, Glendale, Arizona, and the Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, California; Drs. Hamilton and Erdman are from the Department of Psychiatry and Institute for Human Genetics, University of California, San Francisco, San Francisco, California; Drs. Abel and Robertson are from the Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California; and Dr. Finley is from the Department of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, California.
authors.forename: Shareen Y
authors.initials: SY
authors.lastname: El-Ibiary
authors.forename: Steven P
authors.initials: SP
authors.lastname: Hamilton
authors.forename: Rebecca
authors.initials: R
authors.lastname: Abel
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Erdman
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Robertson
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Finley
keywords: HTR2A; Perinatal depression; gene-environment interaction; postpartum; serotonin