title: Maternal depressive symptoms throughout pregnancy are associated with increased placental glucocorticoid sensitivity.
abstract: BACKGROUND
  Maternal prenatal depression predicts post-partum depression and increases risk of prematurity and low birth weight. These effects may be mediated by altered placental function. We hypothesized that placental function would be influenced by the gestational week of experiencing depressive symptoms and aimed to examine associations between maternal depressive symptoms during pregnancy and placental expression of genes involved in glucocorticoid and serotonin transfer between mother and fetus.
  
  
  METHODS
  We studied women participating in a prospective pregnancy cohort: the Prediction and Prevention of Preeclampsia (PREDO) Study, Helsinki, Finland. Maternal depressive symptoms were assessed at 2-week intervals throughout pregnancy in 56 healthy women with singleton, term pregnancies. Messenger ribonucleic acid (mRNA) levels of glucocorticoid (GR) and mineralocorticoid (MR) receptors and serotonin transporter (SLC6A4), 11β-hydroxysteroid dehydrogenase type 1 (HSD1) and 2 (HSD2) were quantified in placental biopsies.
  
  
  RESULTS
  In adjusted analyses women who reported higher depressive symptoms across the whole pregnancy had higher mRNA levels of GR [effect size 0.31 s.d. units, 95% confidence interval (CI) 0.01-0.60, p = 0.042] and MR (effect size 0.34 s.d. units, 95% CI 0.01-0.68, p = 0.047). These effects were significant for symptoms experienced in the third trimester of pregnancy for GR; findings for MR were also significant for symptoms experienced in the second trimester. GR and MR mRNA levels increased linearly by having the trimester-specific depressive symptoms scores 0, 1 or 2-3 times above the clinical cut-off for depression (p = 0.003, p = 0.049, respectively, and p = 0.004, p = 0.15 in adjusted analyses).
  
  
  CONCLUSIONS
  Our findings offer potential gestational-age-specific mechanisms linking maternal depressive symptoms during pregnancy via placental biology. Future studies will test whether these also link with adverse offspring outcomes.
authors: Endocrinology Unit,University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute,47 Little France Crescent,Edinburgh,UK.
authors: R M
authors: RM
authors: Reynolds
authors: Institute of Behavioral Sciences, University of Helsinki,00014 University of Helsinki,Helsinki,Finland.
authors: A-K
authors: AK
authors: Pesonen
authors: Endocrinology Unit,University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute,47 Little France Crescent,Edinburgh,UK.
authors: J R
authors: JR
authors: O'Reilly
authors: Institute of Behavioral Sciences, University of Helsinki,00014 University of Helsinki,Helsinki,Finland.
authors: S
authors: S
authors: Tuovinen
authors: Institute of Behavioral Sciences, University of Helsinki,00014 University of Helsinki,Helsinki,Finland.
authors: M
authors: M
authors: Lahti
authors: National Institute for Health and Welfare,00271 Helsinki,Finland.
authors: E
authors: E
authors: Kajantie
authors: Department of Obstetrics and Gynaecology,University of Helsinki and Helsinki University Central Hospital,Helsinki,Finland.
authors: P M
authors: PM
authors: Villa
authors: Haartman Institute, Medical Genetics, University of Helsinki,00014 University of Helsinki,Helsinki,Finland.
authors: H
authors: H
authors: Laivuori
authors: HUSLAB and Department of Clinical Chemistry,Helsinki University Central Hospital,00014 University of Helsinki,Helsinki,Finland.
authors: E
authors: E
authors: Hämäläinen
authors: Endocrinology Unit,University/BHF Centre for Cardiovascular Science, Queen's Medical Research Institute,47 Little France Crescent,Edinburgh,UK.
authors: J R
authors: JR
authors: Seckl
authors: Institute of Behavioral Sciences, University of Helsinki,00014 University of Helsinki,Helsinki,Finland.
authors: K
authors: K
authors: Räikkönen
mesh_terms: D042842:11-beta-Hydroxysteroid Dehydrogenases / Q000032:analysis; D000328:Adult; D003863:Depression / Q000503:physiopathology*; D005260:Female; D005387:Finland; D005938:Glucocorticoids / Q000235:genetics / Q000378:metabolism*; D006801:Humans; D016014:Linear Models; D010920:Placenta / Q000737:chemistry; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D011264:Pregnancy Trimesters; D011569:Psychiatric Status Rating Scales; D012333:RNA, Messenger / Q000032:analysis / Q000235:genetics / Q000378:metabolism*; D018161:Receptors, Mineralocorticoid / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction; D050486:Serotonin Plasma Membrane Transport Proteins / Q000032:analysis / Q000235:genetics; D055815:Young Adult
chemical_list: D005938:Glucocorticoids; D012333:RNA, Messenger; D018161:Receptors, Mineralocorticoid; C493230:SLC6A4 protein, human; D050486:Serotonin Plasma Membrane Transport Proteins; D042842:11-beta-Hydroxysteroid Dehydrogenases
keywords: Depression; glucocorticoid receptors; mineralocorticoid receptors; placenta; pregnancy