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Bilirubin and postpartum depression: an observational and Mendelian randomization study
Yi Liu1,2, Zhihao Wang3, Duo Li4
1Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Frontiers in Psychiatry
|March 25, 2024
Summary
Lower serum total bilirubin levels are linked to a higher risk of postpartum depression (PPD). Further research is needed to understand the exact mechanisms behind this association in PPD.
Area of Science:
- Obstetrics and Gynecology
- Psychiatry
- Biochemistry
Background:
- Postpartum depression (PPD) is a common complication of childbirth, yet its underlying causes remain unclear.
- Serum bilirubin has been implicated as a predictor of depression, but its specific role in PPD has not been previously investigated.
Purpose of the Study:
- To investigate the association between serum bilirubin levels and the risk of developing postpartum depression (PPD).
- To explore the potential causal relationship between bilirubin and PPD using Mendelian randomization (MR).
Main Methods:
- Retrospective analysis of clinical data from 1,810 pregnant women (2017-2020).
- Logistic regression and random forest algorithms to identify PPD risk factors, including total and direct bilirubin levels.
- Two-sample Mendelian randomization (MR) analysis to assess causality, with sensitivity analyses for robustness.
Main Results:
- PPD patients exhibited significantly lower levels of total and direct serum bilirubin compared to controls.
- Elevated total bilirubin was identified as a protective factor against PPD (OR = 0.94).
- Genetically predicted total bilirubin showed an association with a decreased risk of PPD (IVW: OR = 0.86), even after adjusting for covariates.
Conclusions:
- Decreased serum total bilirubin levels are associated with an increased incidence of postpartum depression.
- The findings suggest a potential protective role of bilirubin in PPD, warranting further investigation into its mechanisms.
