BDNF基因多态性与剖宫产产妇产后抑郁的相关性分析

目的 研究脑源性神经营养因子(BDNF)基因多态性与剖宫产产妇产后抑郁(PPD)的相关性.方法 选择2014年2月-2015年2月在中南大学湘雅三医院和湖南省妇幼保健医院进行椎管内麻醉下剖宫产手术的产妇360例,记录患者的一般资料.应用爱丁堡产后抑郁量表(EPDS)分别对产妇产前1d、产后第42天的精神状态进行评估,以EPDS评分12分(总分13分)作为产后抑郁的评定界值.采用Sequenom?Mass Array SNP对BDNF基因G712A、rs56164415、rs11030100、rs11030101、rs6265位点的基因型进行测定,分析产妇一般资料、不同基因型与产后抑郁的相关性.结果 本组360例产妇产后抑郁的发生率为7.2%.Logistic回归分析显示,孕期压力大、孕期心情差、围产期单核细胞数值升高、产前抑郁情绪是剖宫产后抑郁的危险因素,而BDNF基因rs6265位点突变是剖宫产产后抑郁的保护因素(P<0.05).BDNF基因G712A、rs11030101、rs11030100、rs56164415位点突变与产后抑郁的发生无关(P>0.05),且其单倍体型与产后抑郁也无关.结论 携带BDNF rs6265CC基因型、孕期压力大、孕期心情差、围产期单核细胞数值升高以及产前抑郁情绪是产后抑郁的危险因素.

Correlations between BDNF genetic polymorphism and postpartum depression in cesarean section parturient

Objective To study the correlations between the genetic polymorphism of brain-derived neurotrophic factor (BDNF) and the postpartum depression (PPD) in cesarean section parturient. Methods Three hundred and sixty parturients, who underwent cesarean section under spinal anesthesia from Feb. 2014 to Feb. 2015 in Third Xiangya Hospital of Central South University or Hunan Maternal and Child Health Hospital, were selected as subjects. The general information of parturients was recorded and Edinburgh Postnatal Depression Scale (EPDS) was used to evaluate the depression condition of parturients at the prenatal 1 day and the 42th day postpartum, and with a cut-off point of 12/13 for identifying PPD. The genotypes of BDNF gene locus G712A, rs56164415, rs11030100, rs11030101 and rs6265 were measured by Sequenom? Mass Array SNP. Finally, the correlations of PPD to different genotypes and general information of parturients were statistically analyzed. Results The incidence of PPD among the selected subjects was 7.2%. Pregnancy mental stress, poor pregnancy mood, perinatal elevated monocyte count, prenatal depression mood and BDNF gene locus rs6265 mutation all could affect the incidence of PPD in cesarean section parturients (P<0.05). No statistically significant difference existed between BDNF gene G712A, rs11030101, rs11030100 and rs56164415 locus mutation and PPD (P>0.05), and their haploid forms were not related to PPD also. Conclusion BDNF rs6265CC genotype, pregnancy mental stress, poor pregnancy mood, perinatal elevated monocyte count and prenatal depression mood are the risk factors for postpartum depression.