Depression during pregnancy and postpartum is recognized to be among the most common complications of childbearing: 7.5% of women have a new episode of major depressive disorder (MOD) during pregnancy and 6.5% have an episode within the first 3 months postpartum (1 ). No valid, feasible, objective biological diagnostic tests for MOD exist to date. An objective, laboratory-based tool could increase the diagnostic accuracy of MOD and is particularly appealing to non-psychiatrists, such as obstetrical professionals, who are generally not trained to diagnose and treat MOD. In the proposed project we plan to assess the ability of our recently developed panel of blood transcriptomic biomarkers (2,3) to follow the course of the illness in women with depression, clinical and subsyndromal, during pregnancy and postpartum from asymptomatic to symptomatic state. This panel of biomarkers consists of 15 messenger RNA (mRNA) transcripts that have been identified to differentiate subjects with no disorder from MOD patients of varying age and gender with high accuracy. The ASHER Registry has blood samples collected for measuring RNA from women, during and after pregnancy, with and without clinical diagnosis of MOD. Extensive biopsychosocial and clinical assessments and blood draws were done at the same time by the Asher Center team. The existing blood samples will be analyzed for the 15 mRNA transcript markers by lab personnel blind to the diagnostic state of the women. The statistical analyses will test the hypotheses that changes in blood marker levels from an asymptomatic state to clinical depression will parallel clinical diagnosis in pregnant or postpartum women. Specifically, we hypothesize that differences in marker levels from asymptomatic state to clinical depression or to subsyndromal depression within the same individual will reflect the clinical state of the individual, and that differences in blood marker levels will distinguish syndromal subjects from subjects with no current symptoms and subsyndromal subjects from subjects with no current symptoms. The notion that MOD in the perinatal period shares transcriptional characteristics with adolescents and adults is based on the observation that our transcriptomic panel successfully differentiated nondepressed controls from subjects with MOD independent of age, gender, race and medication or contraceptive use. Therefore, we submit that our biomarker panel will perform similarly in perinatal women.
|Effective start/end date
|9/1/16 → 8/31/18
- Northwestern Memorial Hospital (Agmt09/01/16)
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