RESUMEN
Low vitamin D levels have been implicated in postpartum depressive disorders (PPD). Our study aimed to demonstrate the association of Vitamin D Binding Protein (VDBP) genetic variants rs7041 and rs4588 with susceptibility to PPD and to investigate their possible relationship with serum vitamin D and VDBP levels in Indian women with PPD. A cross-sectional study involved 330 cases and 330 controls. Depressive symptoms were assessed using Edinburg Postnatal Depression Scale. Genotyping of SNPs was done by Taqman 5'allelic discrimination assay. Estimation of serum 25 hydroxyvitamin D [25(OH) D] and VDBP levels were done by ELISA. Serum total, free and bioavailable 25(OH) D levels were significantly lower in cases compared to controls, with similar levels of VDBP between the two groups. The study results showed that the VDBP rs4588 variant genotype AA was significantly associated with lower circulating levels of total 25(OH) D in cases. Also, the VDBP rs7041 variant TT genotype demonstrated significantly lower levels of total, free and bioavailable 25(OH) D levels in controls. However, VDBP rs7041 and rs4588 variants were not associated with PPD susceptibility. Also, VDBP haplotypes showed no association with PPD susceptibility. Our results demonstrated that VDBP polymorphisms rs4588 and rs7041 and their haplotypes are not associated with PPD susceptibility in the South Indian population. However, vitamin D levels were found to be influenced by the risk genotypes of VDBP SNPs rs4588 and rs7041.
Asunto(s)
Depresión Posparto , Proteína de Unión a Vitamina D , Estudios Transversales , Depresión Posparto/genética , Femenino , Genotipo , Humanos , Polimorfismo de Nucleótido Simple , Vitamina D , Proteína de Unión a Vitamina D/genéticaRESUMEN
BACKGROUND: Low vitamin D levels have been implicated in postpartum depressive disorders. However, studies on bioavailable vitamin D levels in postpartum depression are limited. Our study aimed to assess the serum concentrations of total, free and bioavailable 25-hydroxyvitamin D (25(OH)D) levels in women with postpartum depressive symptoms (PPD) and the association between 25(OH)D levels and PPD at 6 week post-delivery. METHODS: In this cross-sectional study, a total of 330 cases and 330 age and BMI matched controls were recruited from the tertiary care hospital in South India. Women with depressive symptoms were assessed using the validated Edinburg Postnatal Depression Scale (EPDS) and cut-off score ≥10 was used. Serum 25(OH)D and VDBP levels were measured using commercially available ELISA kits. RESULTS: Serum total, free and bioavailable 25(OH)D levels were significantly lower in postpartum depressive women compared to non-depressive women (p <0.001, p = 0.01). A significant negative correlation was observed between 25(OH)D, free 25(OH)D and bioavailable 25(OH)D with EPDS score in total study subjects (p <0.001, r = -0.19; p <0.001, r = -0.14 and p <0.001, r = -0.14). Multivariate linear regression analysis further confirmed a significant association between serum total, free and bioavailable 25(OH)D levels and EPDS score (p <0.001∗). CONCLUSIONS: Our study demonstrated that lower serum total, free and bioavailable 25(OH)D levels were associated with postpartum depressive symptoms. Hypovitaminosis D after delivery may be a risk factor for postpartum depression.
Asunto(s)
Depresión Posparto/etiología , Proteína de Unión a Vitamina D/sangre , Vitamina D/análogos & derivados , Vitamina D/sangre , Adulto , Estudios de Casos y Controles , Estudios Transversales , Depresión Posparto/sangre , Depresión Posparto/epidemiología , Femenino , Humanos , India/epidemiología , Pruebas de Detección del Suero Materno , Periodo Posparto/sangre , Periodo Posparto/psicología , Embarazo , Factores de Riesgo , Vitamina D/metabolismo , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/epidemiología , Proteína de Unión a Vitamina D/metabolismo , Adulto JovenRESUMEN
Postpartum depression (PPD) is a psychiatric complication of childbirth affecting 10-20% of new mothers and has negative impact on both mother and infant. Serum lipid levels have been related to depressive disorders, but very limited literatures are available regarding the lipid levels in women with postpartum depression. The present study is aimed to examine the association of serum lipids with the development of postpartum depressive symptoms. This is a cross sectional study conducted at a tertiary care hospital in South India. Women who came for postpartum check-up at 6th week post-delivery were screened for PPD (September 2014-October 2015). Women with depressive symptoms were assessed using EPDS (Edinburgh Postnatal Depression Scale). The study involved 186 cases and 250 controls matched for age and BMI. Serum levels of lipid parameters were estimated through spectrophotometry and the atherogenic indices were calculated in all the subjects. Low serum levels of Total Cholesterol (TC) and High Density Lipoprotein cholesterol (HDL-c) were significantly low in PPD women with severe depressive symptoms. The study recorded a significant negative correlation between HDL-c and the EPDS score in PPD women (r = -0.140, p = 0.05). Interestingly, the study also observed a significant negative correlation between Body Mass Index (BMI) and EPDS scores in case group (r = -0.146, p = 0.047), whereas a positive correlation between the same in controls (r = 0.187, p = 0.004). Our study demonstrated that low levels of serum HDL-c is correlated with the development of severe depressive symptoms in postpartum women. Study highlights the role of lipids in the development of postpartum depressive symptoms.
Asunto(s)
HDL-Colesterol/sangre , Depresión Posparto/sangre , Adulto , Estudios de Casos y Controles , HDL-Colesterol/deficiencia , Estudios Transversales , Depresión Posparto/etiología , Depresión Posparto/psicología , Femenino , Humanos , Hipolipoproteinemias/sangre , Hipolipoproteinemias/complicaciones , Hipolipoproteinemias/psicología , India , Embarazo , Escalas de Valoración Psiquiátrica , Factores de Riesgo , Adulto JovenRESUMEN
BACKGROUND: Post-partum depression (PPD) is the common adverse outcome of child bearing which affects the wellbeing of both mother and newborn and has long-term effects. Hence, reliable potential biological tests for early detection of PPD are essential. Follicle stimulating hormone (FSH) and luteinizing hormone (LH) were associated with depressive disorders and the present study estimated the levels of serum FSH, LH in postpartum depression and explored them as predictive biomarkers in the development of PPD. METHODS: In this nested case control study done at a tertiary care hospital in South India, 450 postpartum women were screened at 6th week post-delivery for PPD. Socio-demographic and clinical data were recorded and depressive symptoms were assessed using Edinburgh Postnatal Depression Scale (EPDS). Out of 450 subjects screened, 100 women with depressive symptoms were categorized as cases and 100 controls were selected from the remaining subjects matching for age and BMI with cases. Serum levels of FSH and LH were measured using direct competitive immunoassay by chemiluminescene technology. RESULTS: Serum LH/FSH ratio was found to be significantly (p=0.02) low in PPD women when compared to normal postpartum subjects. We also found a significant negative correlation between LH/FSH ratio and EPDS scores. Based on the receiver operating characteristic curve, the optimal cut-off value for serum of LH/FSH levels in predicting postpartum depression was estimated to be 0.22mlU/mL with an AUC of 0.598 (95%CI, 0.291-0.859). CONCLUSION: Our study demonstrated that low LH/FSH ratio after delivery was associated with increased risk for the development of PPD. Low LH/FSH ratio at six-week post delivery can be used as a robust biochemical predictor of post-partum depression.
Asunto(s)
Depresión Posparto/sangre , Depresión Posparto/diagnóstico , Hormona Folículo Estimulante/sangre , Hormona Luteinizante/sangre , Adulto , Biomarcadores/sangre , Estudios de Casos y Controles , Depresión Posparto/psicología , Femenino , Humanos , India/epidemiología , Recién Nacido , Madres/psicología , Periodo Posparto/sangre , Periodo Posparto/psicología , Valor Predictivo de las Pruebas , Adulto JovenRESUMEN
BACKGROUND: Violence against women is an emerging problem worldwide and more so in India. Considering its adverse effects on women's health, assessing the burden of violence in the community will help in planning services for the victims. OBJECTIVES: To determine the prevalence of domestic violence and to identify factors associated with domestic violence among married women in reproductive age group in rural Puducherry. MATERIALS AND METHODS: A community-based cross-sectional study was carried out in a rural area of Puducherry, South India. Married women in reproductive age group were interviewed using structured pretested questionnaire. Domestic violence was assessed using 12 questions that were used in National Family Health Survey-3. Adjusted odds ratios (AORs) were calculated using multivariate logistic regression to identify factors associated with violence. RESULTS: Of 310 study participants, 56.7% of them reported some form of domestic violence, 51.3% reported psychological violence, 40% reported physical violence, and 13.5% reported sexual violence. A statistically significant association was found between illiteracy of women and domestic violence (AOR: 4.3, 95% confidence interval: 1.1-15.7 P: 0.03). The other factors such as love marriage and nonregistration of marriage were significantly associated with violence. CONCLUSION: The prevalence of domestic violence was found to be high in this rural setting. Multisectoral response such as improving literacy, creating awareness regarding legal aid and screening the victims of violence at primary health centers, should be initiated to mitigate this public health issue.