Antenatal depression, psychotropic medication use, and inflammation among pregnant women

Emily S. Miller*, William A. Grobman, Jennifer Culhane, Emma Adam, Claudia Buss, Sonja Entringer, Gregory Miller, Pathik D. Wadhwa, Lauren Keenan-Devlin, Ann Borders

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


To evaluate the association between psychotropic medication and inflammatory biomarkers in women with antenatal depressive symptoms (ADS). In this cross-sectional secondary analysis of a prospective multicenter observational study, 723 pregnant women underwent a depression screen using the Center for Epidemiologic Studies Depression Scale (CES-D) between 12 and 21 weeks gestation. Self-reported use of medications for depression and/or anxiety was corroborated with the medical record to document exposure to pharmacotherapy. Serum was collected and inflammatory biomarkers (IFNγ, IL13, IL6, IL8, TNFα, CRP) were measured concomitantly.Women were included if they fell into one of three categories: ADS responsive to treatment (CESD < 16 with medication), ADS not responsive to medication (CES-D > 23 despite medication), and untreated ADS (CES-D > 23 with no medication). Levels of inflammatory biomarkers were compared among groups and multivariable regressions performed. Of the 85 women studied, 16 (19%) had ADS responsive to treatment, 12 (14%) had ADS not responsive to medication, and 57 (67%) had untreated ADS. TNFα concentrations significantly differed (P = 0.016) across the cohorts. Post hoc bivariate analyses demonstrated that women with ADS responsive to treatment had lower serum TNFα than non-responders (p = 0.02) and women with untreated ADS (p = 0.01). There were no differences in IFNγ, IL13, IL6, IL8, or CRP among the groups. Regressions demonstrated that, compared to women with ADS responsive to treatment, non-responders or women with untreated ADS had higher TNFα levels (β = 0.27, 95% CI 0.02-0.52 and β = 0.23, 95% CI 0.02-0.44, respectively). Pregnant women on pharmacotherapy who respond to treatment for ADS have lower TNFa compared to women not responsive to medication or women with untreated ADS. These data suggest the possibility that either the therapeutic response in the context of pharmacotherapy is accompanied by modulation of the immune system or that pre-existing higher levels of TNFα may be associated with a poorer response to traditional pharmacotherapy.

Original languageEnglish (US)
Pages (from-to)785-790
Number of pages6
JournalArchives of Women's Mental Health
Issue number6
StatePublished - Jan 1 2018


  • Antenatal depression
  • Anti-depressants
  • Inflammation
  • Perinatal depression
  • Selective serotonin reuptake inhibitors

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Obstetrics and Gynecology


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