Comparison of two instruments to track depression symptoms during pregnancy in a sample of pregnant teenagers in Southern Brazil.

INTRODUCTION: Depression during pregnancy in adolescents is increasing significantly. However, instruments for early depression screening during prenatal care are scarce. Faced this fact, the objective of this research is to identify the best cutoff points for the Edinburgh Postnatal Depression Scale (EPDS) and Beck Depression Inventory (BDI) in a sample of pregnant adolescents. METHOD: 807 pregnant adolescents, with a mean age of 17 years, met in public antenatal services were evaluated. Two screening scales for depression were analyzed, EPDS and the BDI. These scales had their accuracy measured by AUC of their ROC curve, as well as their respective sensitivity and specificity. RESULTS: In the analysis, the best cutoff for the EPDS was≥10, in which the sensitivity was 81.1% and specificity 82.7%. For the BDI, it was with recognized the cutoff ≥11, sensitivity 86.7% and specificity 73.8%. In the analysis of the ROC AUC, values of 0.89 (CI 0.87-0.92) for the EPDS and BDI for 0.87 (CI 0.84-0.89) were identified compared to the MINI. LIMITATIONS: The sample was composed majority by middle and low income adolescent and the study was performed only with pregnant women in the second trimester. CONCLUSIONS: The results indicate that both scales have good accuracy in screening of depression in adolescent mothers. However, the EPDS scale shows higher AUC ROC and also better sensitivity and specificity values, the latter being more precise and effective for screening for depression in this population.

Serum NGF, BDNF and IL-6 levels in postpartum mothers as predictors of infant development: the influence of affective disorders.

BACKGROUND: Early adverse experiences are associated with increased risk of developing psychiatric disorders, although little is known about the neurobiological mediators involved. The mechanisms by which early environmental influences may mediate vulnerability in the development of offspring await further investigation. The present study correlated the NGF, BDNF, IL-6 and cortisol levels of mothers with postpartum affective disorders (PPAD) with infant development. METHODS: A longitudinal study was performed with 152 pregnant women and their infants. Between 60 and 120 days after delivery, women were interviewed and provided biological samples for biochemical analysis, and the infants were examined for neurobiological-motor development. RESULTS: Overall, the mothers' history of affective disorders, PPAD and anxiety disorder were associated with infant motor development. Using an adjusted linear regression analysis, PPAD (p = 0.049), maternal anxiety disorder (p = 0.043), NGF level (p = 0.034) and infant cortisol level (p = 0.013) were associated with infant motor development. Using a factorial analysis of primary components, two components were retained. The psychological factor was characterized by a positive loading of a history of affective disorder, PPAD and anxiety disorder. For the biological factor, infant cortisol adhered negatively with infant motor development, but NGF was positively associated. The psychological factor had a negative association, but the biological factor had a positive association with infant motor development. CONCLUSIONS: There are few studies that have focused on the relationship of biomarkers and infant neurodevelopment. Our study points that psychological and biological factors are associated with infant motor development, however the causal relationship between these factors is still to be defined.

Brain-derived neurotrophic factor in post-partum depressive mothers.

UNLABELLED: Postpartum depression (PPD) is the most common psychiatric complication observed in women after they give birth. Some women are particularly sensitive to hormonal changes, starting in early menarche, thus increasing their vulnerability to psychological stressing agents that are triggered by environmental and physiological factors throughout their lives. Decreased serum brain-derived neurotrophic factor (BDNF) levels have been associated to different neuropsychiatric conditions and BDNF has been considered as a candidate marker for such dysfunctions. The goal of this study was to compare the levels of BDNF between mothers who suffer from PPD and healthy control mothers as well as to searching for associations between BDNF levels and the severity of PPD. This is a case-control study including 36 mothers with PPD and 36 healthy control mothers. PPD was defined according to the Beck Depression Inventory (BDI). Serum BDNF was assayed with the sandwich ELISA method. RESULTS: Serum levels of BDNF were significantly lower in women with PPD than in control mothers (P ≤ 0.03). A significant negative correlation between BDI score and serum BDNF levels was observed (P ≤ 0.02 and r = -0.29). Our study demonstrated that low BDNF levels are associated with PPD. This result point out to the potential usage of BDNF in the screening of PPD, which could promote early treatment and, therefore, reduce the burden to the PPD women and to the health system.