| 1. |
- Bernabe, Beatriz Penalver, et al.
(författare)
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Interactions between perceived stress and microbial-host immune components : two demographically and geographically distinct pregnancy cohorts
- 2023
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Ingår i: Translational Psychiatry. - : Springer Nature. - 2158-3188. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Higher stress during pregnancy associates with negative outcomes and elevated inflammation. The gut microbiota, reflecting environment and social interactions, alongside host immune responses have the potential to better understand perceived stress and identify when stress is excessive in pregnancy. Two U.S. cohorts of 84 pregnant individuals, composed of urban women of color and suburban white women, completed the Perceived Stress Scale-10 (PSS-10) and provided fecal and blood samples at two time points. Confirmatory Factor Analysis assessed the robustness of a two-factor PSS-10 model (Emotional Distress/ED and Self-Efficacy/SE). Gut microbiota composition was measured by 16 S rRNA amplicon sequencing and the immune system activity was assessed with a panel of 21 T-cell related cytokines and chemokines. ED levels were higher in the suburban compared to the urban cohort, but levels of SE were similar. ED and SE levels were associated with distinct taxonomical signatures and the gut microbiota data improved the prediction of SE levels compared with models based on socio-demographic characteristics alone. Integration of self-reported symptoms, microbial and immune information revealed a possible mediation effect of Bacteroides uniformis between the immune system (through CXCL11) and SE. The study identified links between distinct taxonomical and immunological signatures with perceived stress. The data are congruent with a model where gut microbiome and immune factors, both impacting and reflecting factors such as close social relationships and dietary fiber, may modulate neural plasticity resulting in increased SE during pregnancy. The predictive value of these peripheral markers merit further study.
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| 2. |
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| 3. |
- Fransson, Emma, PhD, 1973-, et al.
(författare)
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Differentiated mental health patterns in pregnancy during COVID-19 first two waves in Sweden : a mixed methods study using digital phenotyping
- 2022
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Ingår i: Scientific Reports. - : Springer Nature. - 2045-2322. ; 12:1
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Tidskriftsartikel (refereegranskat)abstract
- To utilize modern tools to assess depressive and anxiety symptoms, wellbeing and life conditions in pregnant women during the first two waves of the COVID-19 pandemic in Sweden. Pregnant women (n = 1577) were recruited through the mobile application Mom2B. Symptoms of depression, anxiety and wellbeing were assessed during January 2020–February 2021. Movement data was collected using the phone’s sensor. Data on Google search volumes for “Corona” and Covid-related deaths were obtained. Qualitative analysis of free text responses regarding maternity care was performed. Two peaks were seen for depressive symptoms, corresponding to the two waves. Higher prevalence of anxiety was only noted during the first wave. A moderating effect of the two waves in the association of depression, anxiety, and well-being with Covid deaths was noted; positive associations during the first wave and attenuated or became negative during the second wave. Throughout, women reported on cancelled healthcare appointments and worry about partners not being allowed in hospital. The association of mental health outcomes with relevant covariates may vary during the different phases in a pandemic, possibly due to adaptation strategies on a personal and societal/healthcare level. Digital phenotyping can help healthcare providers and governmental bodies to in real time monitor high-risk groups during crises, and to adjust the support offered.
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| 4. |
- Kimmel, Mary C., et al.
(författare)
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Heart rate variability in late pregnancy : exploration of distinctive patterns in relation to maternal mental health
- 2021
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Ingår i: Translational Psychiatry. - : Springer Nature. - 2158-3188. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Exploration of photoplethysmography (PPG), a technique that can be translated to the clinic, has the potential to assess the autonomic nervous system (ANS) through heart rate variable (HRV) in pregnant individuals. This novel study explores the complexity of mental health of individuals in a clinical sample responding to a task in late pregnancy; finding those with several types of past or current anxiety disorders, greater trait anxiety, or greater exposure to childhood traumatic events had significantly different HRV findings from the others in the cohort. Lower high frequency (HF), a measure of parasympathetic activity, was found for women who met the criteria for the history of obsessive-compulsive disorder (OCD) (p = 0.004) compared with women who did not meet the criteria for OCD, and for women exposed to greater than five childhood traumatic events (p = 0.006) compared with those exposed to four or less childhood traumatic events. Conversely higher low frequency (LF), a measure thought to be impacted by sympathetic system effects, and the LF/HF ratio was found for those meeting criteria for a panic disorder (p = 0.006), meeting criteria for social phobia (p = 0.002), had elevated trait anxiety (p = 0.006), or exposure to greater than five childhood traumatic events (p = 0.004). This study indicates further research is needed to understand the role of PPG and in assessing ANS functioning in late pregnancy. Study of the impact of lower parasympathetic functioning and higher sympathetic functioning separately and in conjunction at baseline and in relation to tasks during late pregnancy has the potential to identify individuals that require more support and direct intervention.
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| 5. |
- Kimmel, Mary C., et al.
(författare)
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Metabolite trajectories across the perinatal period and mental health : A preliminary study of tryptophan-related metabolites, bile acids and microbial composition
- 2022
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Ingår i: Behavioural Brain Research. - : Elsevier. - 0166-4328 .- 1872-7549. ; 418
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Tidskriftsartikel (refereegranskat)abstract
- Depression and anxiety during pregnancy and postpartum are common, but affected women differ in timing, trajectories, and extent of symptoms. The objective of this pilot, feasibility study is to analyze trajectories of serotonin and tryptophan-related metabolites, bile acid metabolites, and microbial composition, in relation to psychiatric history and current symptoms across the perinatal period. Serum and fecal samples were collected from 30 women at three times points in the perinatal period and assayed with LC-MS/MS and 16S sequencing respectively. We defined mean trajectories for each metabolite, clustered individuals by metabolite trajectories, tested associations between metabolites, and examined metabolite levels in relation to microbial composition. Findings of note include: (1) changes in kynurenine and the ratio of kynurenic acid to kynurenine from second trimester to third trimester were strongly associated with baseline primary and secondary bile acids. (2) Secondary bile acid UDCA and its conjugated forms were associated with lower bacterial diversity and levels of Lachnospiraceae, a taxa known to produce Short Chain Fatty Acids. (3) History of anxiety was associated with UDCA levels, but history of major depression was not associated with any of the bile acids. (4) There was a trend towards lower dietary fiber for those with history of anxiety or depression. Overall, our results reveal substantial temporal variation in tryptophan-related metabolites and in bile acid metabolites over the perinatal period, with marked inter-individual variability. Trajectories of TRP -related metabolites, primary and secondary bile acids, and the absence or presence of microbes that produce Short Chain Fatty Acids (SCFAs) considered in concert have the potential to differentiate individuals based on perinatal adaptations that may impact mental and overall health.
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| 6. |
- Kimmel, Mary C.
(författare)
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Pregnancy—A Critical Time for Mental Health : Interrogating Psychiatry with Microbiota-Gut-Brain Axis and Autonomic Nervous System Biomarkers
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Perinatal mood and anxiety disorders (PMADs) are common and impact the parent and child beyond the perinatal period of pregnancy and postpartum. The aim of this thesis was to study biomarkers that might reflect perinatal mental health. This work focused on multiple methods of mental health characterization and the autonomic nervous system as reflected by heart rate variability (HRV), the immune system, and the gut microbiome.Three observational longitudinal cohorts of pregnant individuals from three geographic regions were studied: 1) the Biology, Affect, Stress, Imaging and Cognition (BASIC) and the follow-up study U-BIRTH from Uppsala University Hospital; 2) the University of Illinois at Chicago (UIC) MoMent cohort; and 3) the University of North Carolina at Chapel Hill (UNC) cohort.The first paper assessed HRV before and after a mental task and in relation to psychiatric diagnoses, exposure to trauma, and self-report of mental distress. The second paper studied the Perceived Stress Scale (PSS-10) in relation to microbial composition and T-cell related cytokines and chemokines. The third paper studied the Edinburgh Postnatal Depression Scale (EPDS) in relation to whole genome sequencing and Gut Brain Modules for functioning. The fourth paper assessed trajectories of infant temperament in relation to depression and anxiety from the EPDS.The PSS-10 and the EPDS factored differently in the cohorts. HRV patterns differed based on anxiety disorder type, greater trait anxiety, and greater exposure to childhood traumatic eventsut microbiome data improved the prediction of PSS-10 self-efficacy; and self-efficacy was associated with a bacteria type more beneficial in the presence of dietary fiber that also associated with an immune factor important in immune tolerance. Greatest variation in microbial community functioning was due to cortisol degradation and synthesis of inositol, menaquinone, and the short chain fatty acid (SCFA) acetate. nxiety in pregnancy was associated with children who had higher levels of sensitivity and greater negative affectivity that increased over early life.These four papers highlight: 1) the course of mental health in pregnancy is critical to the development of parent and child; 2) the characterization of perinatal mental health requires a mix of methods that recognize there may be differences in the use of the methods based on the population; and 3) biomarkers of perinatal mental health need to reflect dynamic systems, and the components may not be as important as the patterns and interactions.
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| 7. |
- Sörensen, Ferdinand, et al.
(författare)
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Interactions of Perinatal Depression versus Anxiety and Infants' Early Temperament Trajectories
- 2024
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Ingår i: Child Development. - : John Wiley & Sons. - 0009-3920 .- 1467-8624. ; 95:3, s. 721-733
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Tidskriftsartikel (refereegranskat)abstract
- This study examines the interplay between maternal depression/anxiety and infant temperament's developmental trajectory in 1687 Swedish-speaking mother–infant dyads from Uppsala County (2009–2019), Sweden. The sample includes a high proportion of university-educated individuals and a low share of foreign-born participants. Maternal depressive and anxiety symptoms were assessed using the Edinburgh Postnatal Depression Scale during gestational weeks 17 and 32 and postpartum at week 6. Multinomial regression explored associations between maternal variables and infant temperament trajectories at 6 weeks, 12 months, and 18 months. Prenatal anxiety is associated with the high-rising infant difficult temperament trajectory, while prenatal depression/anhedonia is associated with the stable-medium trajectory, attenuated postpartum. Associations between infant temperament and maternal mood depended on timing (pre/postpartum) and symptom type (depression/anhedonia vs. anxiety).
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