The role of maternal prenatal thyroid function on offspring depression: Findings from the ALSPAC cohort

Epigenetic changes caused by early life stress in the pathogenesis of depression

Major depressive disorder (MDD) is a severe psychiatric disorder with a complex and poorly understood pathogenesis. Epigenetics, a rapidly advancing field of biology, has been implicated in various psychiatric conditions, including schizophrenia, anxiety, substance addiction, and autism. Furthermore, substantial research indicates that epigenetic modifications play a crucial role in the etiology of depression. Early life stress (ELS) refers to adverse experiences occurring during prenatal development (e.g., maternal physical and mental health complications during pregnancy) and/or postnatal life (e.g., abuse, neglect, poverty, parental loss, family conflict, violence, and malnutrition). These early-life adversities can lead to epigenetic modifications, which, in turn, influence key biological processes and contribute to the pathogenesis of MDD. This review provides an overview of the regulatory mechanisms and functions of various epigenetic modifications, including non-coding RNAs, DNA methylation, and histone modifications. We then examine ELS-induced epigenetic alterations and their biological consequences, such as dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, neurogenesis, and neuroplasticity. Finally, we explore their potential implications for both the pathogenesis and treatment of MDD. We hypothesize that ELS-induced epigenetic changes may serve as biomarkers for MDD diagnosis and offer novel therapeutic targets for its treatment.

Principles, policies, and practices: Thoughts on their integration over the rise of the developmental psychopathology perspective and into the future

Developmental psychopathology has, since the late 20th century, offered an influential integrative framework for conceptualizing psychological health, distress, and dysfunction across the lifespan. Leaders in the field have periodically generated predictions about its future and have proposed ways to increase the macroparadigm's impact. In this paper, we examine, using articles sampled from each decade of the journal Development and Psychopathology's existence as a rough guide, the degree to which the themes that earlier predictions have emphasized have come to fruition and the ways in which the field might further capitalize on the strengths of this approach to advance knowledge and practice in psychology. We focus in particular on two key themes first, we explore the degree to which researchers have capitalized on the framework's capacity for principled flexibility to generate novel work that integrates neurobiological and/or social-contextual factors measured at multiple levels and offer ideas for moving this kind of work forward. Second, we discuss how extensively articles have emphasized implications for intervention or prevention and how the field might amplify the voice of developmental psychopathology in applied settings.

The incidence and risk factors of depression across six time points in the perinatal period: a prospective study in China

Introduction

Perinatal depression (PND) affects approximately 15%-20% of women. This study aimed to determine the incidence of PND and identify risk factors.

Methods

A prospective study was conducted at the Affiliated People's Hospital of Ningbo University. The Edinburgh Postnatal Depression Scale (EPDS) was used to screen for PND. Classification models were constructed using Extreme Gradient Boosting (XGBoost), Logistic Regression (LR), Random Forest (RF), and Support Vector Machine (SVM), and the optimal model was selected.

Results

Between March 2019 and August 2021, a total of 485 participants completed all valid questionnaires. Depression was observed in 75 (15.5%), 47 (9.7%), 25 (5.2%), 94 (19.4%), 85 (17.5%), and 43 (8.9%) cases during the first trimester, the second trimester, the third trimester, 1 week postpartum, 6 months postpartum, and 12 months postpartum, respectively. During the prenatal period, factors such as monthly income, employment status, marital status, and thyroid function significantly impacted depression. Additionally, factors including monthly income, employment status, marital status, parity, and unintended pregnancy were found to affect the likelihood of developing postpartum depression. XGBoost was chosen for its accuracy (0.9097) and precision (0.9005) in predicting prenatal depression, as well as for its accuracy (0.9253) and precision (0.9523) in predicting postpartum depression.

Discussion

In conclusion, the incidence of depression varies throughout the perinatal period, with different factors influencing prenatal and postpartum depression.

Relationship between Serum TSH Level and Adverse Pregnancy Outcome in Advanced Maternal Age

The purpose of this paper is to explore the relationship between serum thyroid-stimulating hormone (TSH) levels and adverse pregnancy outcomes in advanced maternal age. A total of 97 elderly parturient women who were treated in our hospital from June 2020 to March 2021 are included in this study. According to the TSH level, the parturient women are divided into three groups, including A (<0.25 μIU/ml), B (>4.00 μIU/ml), and C (0.25-4.00 μIU/ml) groups. The clinical data of all parturients are collected and sorted out. The serum levels of TSH, free triiodothyronine (FT3), and free thyroxine (FT4) are measured by chemiluminescence immunoassay. The levels of immunoglobulin (Ig) A, IgG, and IgM are determined by immunoturbidimetry. The incidence of adverse pregnancy outcomes is analyzed. The birth weight and Apgar score of newborns in the three groups are compared. The TSH level in group A is significantly lower than that in groups B and C, but the levels of FT3 and FT4 in group A are notably higher than those in groups B and C (P < 0.05). The levels of IgA, IgG, and IgM in group A are significantly higher than those in groups B and C (P < 0.05). The incidence of adverse pregnancy outcomes in group C is 2.38%, which is obviously lower than the 20.00% in group A and 17.14% in group B (P < 0.05). The birth weight and Apgar score of infants in group A and group B are significantly lower than those in group C (P < 0.05). TSH has a great influence on the pregnancy outcome in advanced maternal age, which should be paid more attention in clinic.

The association between COVID-19 pandemic and maternal isolated hypothyroxinemia in first and second trimesters

BACKGROUND

The outbreak of COVID-19 epidemic has induced entire cities in China placed under 'mass quarantine'. The majority of pregnant women have to be confined at home may be more vulnerable to stressors. In our study, we aimed to explore the effects of the epidemic on maternal thyroid function, so as to provide evidence for prevention and intervention of sustained maternal and offspring's health impairment produced by thyroid dysfunction.

METHODS

The subjects were selected from an ongoing prospective cohort study. we included the pregnant women who receive a thyroid function test during the COVID-19 epidemic and those receiving the test during the corresponding lunar period of 2019. A total of 7148 pregnant women with complete information were included in the final analysis. Multivariate linear and logistic regression models were used for analyzing the association of COVID-19 pandemic with FT4 levels and isolated hypothyroxinemia.

RESULTS

We found a decreased maternal FT4 level during the period of the COVID-19 pandemic in first and second trimesters (β = -0. 131, 95%CI = -0.257,-0.006，p = 0.040) and in first trimester (β = -0. 0.176, 95%CI = -0.326,-0.026，p = 0.022) when adjusting for 25 (OH) vitamin D, vitamin B12, folate and ferritin and gestational days, maternal socio-demographic characteristics and health conditions. The status of pandemic increased the risks of isolated hypothyroxinemia in first and second trimesters (OR = 1.547, 95%CI = 1.251,1.913, p < 0.001) and first trimester (OR = 1.651, 95%CI = 1.289,2.114, p < 0.001) when adjusting for the covariates. However, these associations disappeared in the women with positive TPOAb (p > 0.05). Additionally, we found associations between daily reported new case of COVID-19 and maternal FT4 for single-day lag1, lag3 and multi-day lag01 and lag04 when adjusting for the covariates (each p < 0.05).

CONCLUSIONS

Mass confinement as a primary community control strategy may have a significant cost to public health resources. Access to health service systems and adequate medical resources should be improved for pregnant women during the COVID-19 pandemic.

Maternal Thyroid Dysfunction During Pregnancy and the Risk of Adverse Outcomes in the Offspring: A Systematic Review and Meta-Analysis

CONTEXT

Previous studies suggested a potential link of maternal thyroid dysfunction with adverse neurocognitive outcomes and impaired development of internal organs in offspring.

OBJECTIVE

To review the association between maternal thyroid dysfunction and the risk of adverse outcomes in offspring.

DATA SOURCES

PubMed, EMBASE, and Cochrane Library.

STUDY SELECTIONS

Eligible studies reported the association between maternal thyroid hormone function and the risk of adverse outcomes in their children.

DATA EXTRACTION

Reviewers extracted data on study characteristics and results independently.

DATA SYNTHESIS

Estimates were pooled and reported as odds ratio (OR) with 95% confidence interval (CI). I2 tests were applied to assess the heterogeneity across studies.

RESULTS

We identified 29 eligible articles and found an association between maternal hyperthyroidism and attention deficit hyperactivity disorder (ADHD) (OR: 1.18, 95% CI: 1.04-1.34, I2 = 0%) and epilepsy (OR: 1.19, 95% CI: 1.08-1.31, I2 = 0%) in offspring; as well as an association of maternal hypothyroidism with increased risk of ADHD (OR: 1.14, 95% CI: 1.03-1.26, I2 = 25%), autism spectrum disorder (OR: 1.41, 95% CI: 1.05-1.90, I2 = 63%), and epilepsy (OR: 1.21, 95% CI: 1.06-1.39, I2 = 0%) in offspring.

CONCLUSION

Routine measurement and timely treatment on thyroid function should be considered for pregnant women.

Systemic endocrinopathies (thyroid conditions and diabetes): impact on postnatal life of the offspring

Fetal programming may influence childhood and adult life, determining the risk of specific diseases. During earlier stages of pregnancy, the transfer of maternal thyroid hormones to the fetus is vital for adequate neurologic development. The presence of severe maternal thyroid dysfunction, particularly severe iodine deficiency, is devastating, leading to irreversible neurologic sequelae. Moreover, mild maternal thyroid conditions, such as a mild-to-moderate iodine deficiency, may also lead to milder neurologic and behavioral conditions later during the life of the offspring. Maternal dysglycemia due to pregestational or gestational diabetes mellitus is another common situation in which fetal development encounters a hostile environment. Hyperglycemia in utero may trigger metabolic conditions in the offspring, including abnormalities of glucose tolerance and weight excess. Physicians assisting pregnant women have to be aware about these conditions, because they may go unnoticed if not properly screened. Because an early diagnosis and appropriate management may prevent most of the possible negative consequences for the progeny, the prevention, early diagnosis, and proper management of these endocrine conditions should be offered to all women undergoing pregnancy. Here, we comprehensively review the current evidence about the effects of maternal thyroid dysfunction and maternal dysglycemia on the cognitive function and carbohydrate metabolism in the offspring, two prevalent conditions of utmost importance for the child's health and development.