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      Maternal prenatal depression is associated with decreased placental expression of the imprinted gene PEG3

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          Abstract

          Background

          Maternal prenatal stress during pregnancy is associated with fetal growth restriction and adverse neurodevelopmental outcomes, which may be mediated by impaired placental function. Imprinted genes control fetal growth, placental development, adult behaviour (including maternal behaviour) and placental lactogen production. This study examined whether maternal prenatal depression was associated with aberrant placental expression of the imprinted genes paternally expressed gene 3 ( PEG3), paternally expressed gene 10 ( PEG10), pleckstrin homology-like domain family a member 2 ( PHLDA2) and cyclin-dependent kinase inhibitor 1C ( CDKN1C), and resulting impaired placental human placental lactogen ( hPL) expression.

          Method

          A diagnosis of depression during pregnancy was recorded from Manchester cohort participants’ medical notes ( n = 75). Queen Charlotte's ( n = 40) and My Baby and Me study (MBAM) ( n = 81) cohort participants completed the Edinburgh Postnatal Depression Scale self-rating psychometric questionnaire. Villous trophoblast tissue samples were analysed for gene expression.

          Results

          In a pilot study, diagnosed depression during pregnancy was associated with a significant reduction in placental PEG3 expression (41%, p = 0.02). In two further independent cohorts, the Queen Charlotte's and MBAM cohorts, placental PEG3 expression was also inversely associated with maternal depression scores, an association that was significant in male but not female placentas. Finally, hPL expression was significantly decreased in women with clinically diagnosed depression (44%, p < 0.05) and in those with high depression scores (31% and 21%, respectively).

          Conclusions

          This study provides the first evidence that maternal prenatal depression is associated with changes in the placental expression of PEG3, co-incident with decreased expression of hPL. This aberrant placental gene expression could provide a possible mechanistic explanation for the co-occurrence of maternal depression, fetal growth restriction, impaired maternal behaviour and poorer offspring outcomes.

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          Most cited references48

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          Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

          The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
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            Growth and function of the normal human placenta.

            The placenta is the highly specialised organ of pregnancy that supports the normal growth and development of the fetus. Growth and function of the placenta are precisely regulated and coordinated to ensure the exchange of nutrients and waste products between the maternal and fetal circulatory systems operates at maximal efficiency. The main functional units of the placenta are the chorionic villi within which fetal blood is separated by only three or four cell layers (placental membrane) from maternal blood in the surrounding intervillous space. After implantation, trophoblast cells proliferate and differentiate along two pathways described as villous and extravillous. Non-migratory, villous cytotrophoblast cells fuse to form the multinucleated syncytiotrophoblast, which forms the outer epithelial layer of the chorionic villi. It is at the terminal branches of the chorionic villi that the majority of fetal/maternal exchange occurs. Extravillous trophoblast cells migrate into the decidua and remodel uterine arteries. This facilitates blood flow to the placenta via dilated, compliant vessels, unresponsive to maternal vasomotor control. The placenta acts to provide oxygen and nutrients to the fetus, whilst removing carbon dioxide and other waste products. It metabolises a number of substances and can release metabolic products into maternal and/or fetal circulations. The placenta can help to protect the fetus against certain xenobiotic molecules, infections and maternal diseases. In addition, it releases hormones into both the maternal and fetal circulations to affect pregnancy, metabolism, fetal growth, parturition and other functions. Many placental functional changes occur that accommodate the increasing metabolic demands of the developing fetus throughout gestation.
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              Validation of the Edinburgh Postnatal Depression Scale (EPDS) in non-postnatal women.

              J. Cox (1996)
              This paper reports the validation of the EPDS against a Research Diagnostic Criteria diagnosis of Major and Minor depression. The EPDS was administered to non-postnatal women with older children (mean age of youngest child 3 years 9 months) and to postnatal women (baby aged 6 months). All who scored 9 or above and one third of low scorers were interviewed, using Goldberg's Clinical Interview Schedule. The study confirmed good user acceptability of the EPDS when administered as a postal questionnaire (92% response rate). The EPDS was found to have satisfactory sensitivity (79%) and specificity (85%). Our findings suggest that the EPDS take a place alongside other screening scales for depression in Community samples. It is proposed that when used in these settings it is referred to as the Edinburgh Depression Scale.
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                Author and article information

                Journal
                Psychol Med
                Psychol Med
                PSM
                Psychological Medicine
                Cambridge University Press (Cambridge, UK )
                0033-2917
                1469-8978
                October 2016
                15 August 2016
                : 46
                : 14
                : 2999-3011
                Affiliations
                [1 ]Cardiff School of Biosciences, Cardiff University , Cardiff CF10 3AX, UK
                [2 ]Centre for Mental Health , Imperial College, Hammersmith Campus, London W12 0NN, UK
                [3 ]Douglas Mental Health University Institute , 6875 La Salle Boulevard, Verdun, Quebec H4H 1R3, Canada
                [4 ]Maternal and Fetal Health Research Centre, University of Manchester , Manchester, UK
                [5 ]Institute of Reproductive and Developmental Biology , Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, UK
                Author notes
                [* ]Address for correspondence: R. M. John, Cardiff School of Biosciences, Cardiff University , Cardiff CF10 3AX, UK. (Email: JohnRM@ 123456cardiff.ac.uk )
                Article
                S0033291716001598 00159
                10.1017/S0033291716001598
                5080674
                27523184
                25f863ba-926e-4a86-8478-808b29f54302
                © Cambridge University Press 2016

                This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 22 September 2015
                : 10 June 2016
                : 16 June 2016
                Page count
                Figures: 4, Tables: 1, References: 69, Pages: 13
                Categories
                Original Articles

                Clinical Psychology & Psychiatry
                human placental lactogen,peg3,prenatal depression
                Clinical Psychology & Psychiatry
                human placental lactogen, peg3, prenatal depression

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