A scoping review of functional genomics in perinatal depression

Perinatal depression (PD) is a major public mental health problem affecting 10-20% of pregnant women. Women undergo profound biological and psychosocial adaptations during pregnancy and the postpartum period. Measures of genomic function can reveal pregnancy-associated adaptations, and may also illuminate mechanisms underlying PD, offering potential for clinically useful biomarkers. A systematic overview of functional genomic signatures of PD is currently lacking. We conducted a scoping review of the current literature on two aspects of genomic function: DNA methylation and gene expression. Literature was reviewed through May 2024. Thirty-three studies met inclusion criteria. Altered genomic function related to estrogen signaling and immune function were most consistently associated with PD. However, the reviewed studies used heterogeneous molecular profiling methods, were based on small sample sizes, largely used candidate-gene approaches, and reported mixed findings. The lack of replicated signatures underscores the need for a more comprehensive assessment of genomic function in PD.