南方医科大学学报

南方医科大学学报 ›› 2019, Vol. 39 ›› Issue (01): 57-.doi: 10.12122/j.issn.1673-4254.2019.01.09

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产后抑郁与去甲肾上腺素代谢酶基因多态性的关联及危险因素分析

马嘉慧，黄振东，汪赛赢，郑珊珊，段开明   

  • 出版日期:2019-01-20 发布日期:2019-01-20

Postpartum depression: association with genetic polymorphisms of noradrenaline metabolic enzymes and the risk factors

  • Online:2019-01-20 Published:2019-01-20

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摘要： 目的探究剖宫产产后抑郁发病与去甲肾上腺素代谢酶基因多态性的关联以及其相关危险因素。方法招募591例行择 期剖宫产的中国产妇，以爱丁堡产后抑郁评分（EPDS）9/10分为产后抑郁评估截点；并对所有无产前抑郁产妇的儿茶酚氧甲基 转移酶基因5个位点（rs2020917, rs737865等）和单胺氧化酶A基因1个位点（rs6323)进行基因型检测。采用SPSS18.0 分析各 单核苷酸多态性与剖宫产产后抑郁的相关性，分析所有单核苷酸多态性、连锁不平衡、单倍型等在产后抑郁发病中的作用，并对 所有相关危险因素行logistic 回归分析以及基因与环境的交互作用分析。结果产后抑郁发生率为18.1%；单因素分析显示 COMT 多态性rs2020917 基因、COMT 多态性rs737865 基因与产后抑郁发病率相关（P<0.05）；COMT基因型rs2020917 和 rs737865具有共线性，logistic分析显示COMT基因多态性rs2020917TT基因型和rs737865GG基因型、孕期压力大、家庭暴力 是产后抑郁的危险因素（P<0.05），以上两种基因多态性与环境因素不存在显著的交互作用。结论携带COMT 多态性 rs2020917TT基因型、COMT多态性rs737865GG基因型，孕期压力大、家庭暴力是产后抑郁的危险因素。

Abstract: Objective To investigate the association of genetic polymorphisms of norepinephrine metabolizing enzymes with postpartum depression and analyze the risk factors for postpartum depression in women following cesarean section. Methods A total of 591 Chinese woman of Han Nationality undergoing caesarean section were enrolled in this study. The diagnosis of postpartum depression was established for an Edinburgh Postnatal Depression Scale (EPDS) score ≥9. For all the women without antepartum depression, the genotypes of catechol-O-methyltransferase (COMT; at 5 sites including rs2020917 and rs737865) and monoamine oxidase A (rs6323) were determined using Sequenom® Mass Array single nucleotide polymorphism (SNP) analysis. We analyzed the contribution of the genetic factors (SNPs, linkage disequilibrium and haplotype) to postpartum depression and performed logistic regression analysis to identify all the potential risk factors for postpartum depression and define the interactions between the genetic and environmental factors. Results The incidence of postpartum depression was 18.1% in this cohort. Univariate analysis suggested that COMT polymorphism at rs2020917 (TT genotype) and rs737865 (GG genotype) were significantly correlated with the occurrence of postpartum depression (P<0.05). Logistic regression analysis showed that COMT polymorphism at rs2020917 (TT genotype) and rs737865 (GG genotype), severe stress during pregnancy, and domestic violence were the risk factors for postpartum depression (P<0.05); no obvious interaction was found between the genetic polymorphisms and the environmental factors in the occurrence of postpartum depression. Conclusion The rs2020917TT and rs737865GG genotypes of COMT, stress in pregnancy, and domestic violence are the risk factors for postpartum depression.