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- Axfors, Cathrine
(författare)
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Anxious personality traits in pregnant women : Associations with postpartum depression, delivery complications and health care use
- 2018
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Anxious personality traits, including those encompassed by negative emotionality (neuroticism) and the tendency to worry about close relationships (attachment anxiety) during pregnancy were the focus of this thesis. The overall aim was to examine perinatal correlates of these characteris-tics in terms of psychiatric and obstetric health as well as antenatal care (ANC).Papers I-II were part of a large population-based project on pregnant women in Uppsala in 2009-2012 (n=2160). Papers III-IV adjoined participants from several projects in 2005-2011, on oral contraceptive use, infertility, induced abortion, premenstrual mood disorder, and perina-tal depression (n=2819). The participants reported on the Swedish universities Scales of Per-sonality for neuroticism (papers II-IV) and the Attachment Style Questionnaire (ASQ) for attachment anxiety (papers I-II). The participants also answered the Edinburgh Postnatal De-pression Scale on depressive symptoms (paper II). In paper III, information on obstetric com-plications for primiparous women with singleton pregnancies (n=1969) was extracted from Swedish national health registers. In paper IV, ANC use was derived from medical records of obstetric low-risk women residing in Uppsala (n=1052).The ASQ had similar psychometric properties in pregnant women (n=1631) as in previous reports (paper I). In non-depressed pregnant women (n=1431), the combination of neuroticism and attachment anxiety was the best risk indicator of postpartum depressive symptoms (paper II). Whereas high neuroticism was not related to obstetric complications (paper III), it was associated with higher use of ANC (paper IV).Summarized, this thesis illustrates how anxious personality traits may predispose for post-partum depression and higher use of ANC in the absence of obstetric complications. Future development of these findings should be to evaluate individual and societal benefits of a greater emphasis on psychological support in ANC.
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| 2. |
- Bränn, Emma, 1988-
(författare)
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Biomarkers for Peripartum Depression : Focusing on aspects of the immune system and the metabolome
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Peripartum depression is a common, multifactorial, and potentially devastating disease among new mothers. A biological marker for peripartum depression would facilitate early detection, better understanding of the pathophysiology, and identification of targets for treatment. Evidence is growing for a potential role of the immune system in depression outside the peripartum period. Major adaptations of the immune system occur during pregnancy, justifying the search for immunological markers for peripartum depression. The immune system is very complex and dynamic during pregnancy, complicating the study of associations with depression. The metabolome is also affected by pregnancy and is linked to the immune system via, e.g., the microbiota. Hence, metabolomic profiling could increase the understanding of peripartum depression. This thesis aimed to explore inflammatory markers and metabolic profiles in the peripartum period, in order to discover possible biomarkers, and to increase the understanding of the pathophysiology of peripartum depression.All studies were conducted within the Biology, Affect, Stress, Imaging, and Cognition (BASIC) study. The Edinburgh Postnatal Depression Scale and the Mini International Neuropsychiatric Interview were used to assess depressive symptoms. Multiplex Proximity Extension assays were used to analyze inflammatory markers in pregnancy and postpartum. Luminex Bio-Plex Pro Human Cytokine Assays were used to analyze cytokine levels across the peripartum period, and gas chromatography-mass spectrometry metabolomics were used for metabolic profiling. No marker was discriminative enough to be used on its own as a biomarker for peripartum depression. However, several inflammatory markers (such as STAM-BP, TRANCE, HGF, IL-18, FGF-23, and CXCL1) were identified as possible candidates for more advanced diagnostic algorithms. The results further pointed towards the importance of adaptation of the immune system during pregnancy and postpartum, where levels of cytokines such as VEGF-A might have an important role in antenatal and postpartum depression. The results even highlight the importance of examination timing. Lastly, the metabolic profiling suggested different subgroups of women with postpartum depressive symptoms, supporting theories of peripartum depression being a heterogeneous disease in need of subgroup definition.
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| 3. |
- Henriksson, Hanna E., 1988-
(författare)
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Seasonal aspects of peripartum depressive symptoms
- 2019
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Every year, a large proportion of pregnant and newly delivered women develop peripartum depression, a condition that may cause long-term suffering for the entire family. Although there is a lack of consensus, some studies propose an association between season and the risk of developing depression during pregnancy and the postpartum period. Furthermore, the immune system, which undergoes numerous structural changes during pregnancy, has been suggested to exhibit seasonal variations. In addition, discrepancies in metabolic profiles have been reported between women with and without depression after childbirth. This thesis aimed to investigate seasonal aspects of peripartum depressive symptoms (PPDS) and biological markers during the peripartum period. The data mainly derived from the prospective population-based Biology, Affect, Stress, Imaging, and Cognition (BASIC) study, but data were also included from the longitudinal population-based Uppsala-Athens (UPPSAT) study. The presence of depressive symptoms was primarily assessed using the Edinburgh Postnatal Depression Scale (EPDS). There were no consistent associations between season, meteorological parameters, air pollen count, and PPDS. Moreover, a number of inflammatory markers were identified as having seasonal variations among samples from pregnant women. On the contrary, only one marker had a seasonal pattern during the early postpartum period. Furthermore, metabolic profiles were not discriminatory between pregnant women with and without depressive symptoms. However, when divided into summer and winter childbirths, discrepancies were identified in metabolic profiles between summer cases and controls, as well as between summer and winter controls. In summary, the studies included in this thesis suggest that season, specifically, is not associated with PPDS. However, season may have a moderating effect on the association between depressive symptoms and the metabolic profile of pregnant women. In addition, the seasonal variations appears more prominent among inflammatory markers during late pregnancy, compared with the early postpartum period. These findings suggest that women need equal attention in clinical care regardless of the season during which they give birth. Future studies on biological aspects of PPDS and immune-associated conditions are encouraged to also assess seasonality.
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| 4. |
- Öberg, Mariella, 1970-
(författare)
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Exposed to Violence
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Violence against women is a crime against human rights and a major global public health issue affecting the lives of millions of girls and women worldwide. Exposure to violence poses a threat to health, both in the short and the long term. To minimize the devastating consequences of violence it is central to identify girls and women who have been exposed and to find possible risk factors that may serve as targets for prevention efforts.The main aims of this thesis were to study the prevalence of sexual, physical and psychological violence among women in Sweden and to explore possible associations to violence and polyvictimization during childhood as well as sociodemographic factors.In a family planning unit, 1226 women seeking either termination of pregnancy or contraceptive counseling were recruited to answer questions about different types of violence. Of the women seeking termination of pregnancy, 29% reported experiences of intimate partner violence, compared to 22% of women seeking contraceptive counseling. Of all the women attending a family planning unit, 27% reported lifetime experiences of sexual violence.A survey containing questions about lifetime experiences of sexual, physical and/or psychological violence was sent to a national sample of 10 000 women and 10 000 men. Lifetime experiences of at least one type of severe violence were reported by over 50% of both women and men. Sexual violence was more than three times more common among women compared to men.Rape/attempted rape in adulthood was more common among women who were single, had college-level education and those who had been unemployed or had received social welfare payments.Exposure to sexual, physical and psychological violence in childhood was highly associated with rape/attempted rape in adulthood among the women respondents.Conclusion: Lifetime experiences of violence are common among women in Sweden. Multiple exposure to violence during childhood is the most potent risk factor for exposure to sexual violence in adulthood. The findings underscore the importance of detecting individuals who have been exposed in order to offer help, and may contribute to the development of effective prevention programs, especially among children and adolescents.
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