Women with perinatal mood, anxiety disorders have specific altered proteins

Key takeaways:

• A 20-protein signature differentiated perinatal mood and anxiety disorder cases from controls.
• Women without preeclampsia had increased expression of proteins regulating leucocyte migration, inflammation and immune function.

Women who developed mood or anxiety disorders associated with pregnancy and childbirth had a specific and unique plasma protein signature regulating various neuronal signaling and proinflammatory pathways, researchers reported.

“The critical first step in prevention of any disease is knowing if you are at risk,” Eynav E. Accortt, PhD, director of the Reproductive Psychology Program and clinical psychologist in the department of obstetrics and gynecology, division of maternal fetal medicine at Cedars-Sinai Medical Center, Los Angeles, said in a related press release. “The process of discovering a diagnostic test for perinatal mood and anxiety disorders, through biomarker research like this, is our holy grail.”

For a study published in the American Journal of Obstetrics and Gynecology, Accortt and colleagues analyzed data from 52 women who had mental health screening conducted in the third trimester of pregnancy and at 3 months after delivery. Elevated perinatal mood and anxiety disorder risk was identified through screening with cutoffs for depression at both time points.

Researchers collected plasma samples in the third trimester and screened them using the aptamer-based SomaLogic SomaScan proteomic assay technology to assess mood and anxiety disorder-associated changes in the expression of 1,305 protein analytes.

Among the participants, 65% had a risk for perinatal mood and anxiety disorders (mean age, 37.2 years). This group was more likely to be multiparous compared with participants without increased mental health risks (86.7% vs. 44.4%).

From a panel of 53 significant perinatal mood and anxiety disorder-associated proteins, researchers identified a unique 20-protein signature differentiating perinatal mood and anxiety disorder cases (P < .05). This signature included NCAM1, NRCAM and NTRK3 that all join neuronal signaling pathways that regulate axonal guidance, astrocyte differentiation and GABAergic neuron maintenance.

When analysis included only women without preeclampsia, researchers observed a 30-protein signature differentiating perinatal mood and anxiety disorder cases (P < .001). Among women without preeclampsia, researchers noted an increased expression of proteins including CXCL11, CXCL6, MIC-B and B2MG, which all regulate leucocyte migration, inflammation and immune function.

According to Accortt, if there were an early blood test, like that available for gestational diabetes, women could know whether they are at higher risk and consider treatment options earlier.

“In addition to the financial costs of mood disorders associated with pregnancy and childbirth, including reduced economic productivity and more preterm births, children and the family structure can be deeply affected,” Sarah Kilpatrick, MD, PhD, chair of the department of obstetrics and gynecology at Cedars-Sinai Medical Center, said in the release. “We need research-based diagnostics developed so we can help women find a pathway to wellness and be able to emerge out of the shadow of debilitating mood disorders that harm their health and the health of their families.”

Reference:

• Protein biomarkers identified in women who developed perinatal depression and anxiety. www.cedars-sinai.org/newsroom/protein-biomarkers-identified-in-women-who-developed-perinatal-depression-and-anxiety/. Published Feb. 23, 2023. Accessed Feb 24, 2023.