Mild Depressive Symptoms Are Associated with Elevated C-Reactive Protein and Proinflammatory Cytokine Levels During Early to Midgestation: A Prospective Pilot Study

Abstract

Background:

We examined depressive symptoms, C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels during early to-midgestation.

Methods:

We measured depressive symptoms on the Patient Health Questionnaire-9 (PHQ-9), and serum CRP, IL-6, and TNF-α levels twice in 27 pregnant women.

Results:

After adjustment, depressive symptoms prospectively (β=0.42, p<0.05 at 16–20 weeks of gestation) and concurrently (β=0.54, p<0.01 at 7–10 weeks of gestation) predicted elevated CRP [F (2, 14)=9.20, p=0.003, R²=0.57 and F (3, 15)=9.08, p=0.001, R²=0.64, respectively]. There were similar patterns of results for TNF-α (β=0.72, p<0.01) and IL-6 levels (β=0.39, p<0.05) at 7–10 weeks of gestation [F (2,19)=8.84, p=0.002, R²=0.48]. Furthermore, the association between depressive symptoms at 7–10 weeks of gestation and increased IL-6 levels at 16–20 weeks of gestation approached statistical significance. We confirmed the findings with the Wilcoxon signed rank test (IL-6: Z=2.44, p=0.015; TNF-α: Z=1.94, p=0.05; CRP: approached statistical significance).

Conclusions:

These pilot data suggest that depressive symptoms may be associated with inflammatory markers during early to-midgestation.