Journal Article Annotations
2024, 1st Quarter


Annotations by Zachary Harvanek, MD, PhD.
April, 2024

  1. Placental accelerated aging in antenatal depression.


Placental accelerated aging in antenatal depression.
Haleema Saeed, Jing Wu, Markos Tesfaye, Katherine L Grantz, Fasil Tekola-Ayele


The finding:
In an prospective observational study of pregnant women (n = 301), women with depressive symptoms (defined as Edinburgh Postpartum Depression Scale > 10) in the second trimester had biologically older placentas as measured by a placental epigenetic clock. This finding was specific to the second trimester, and was not driven by preeclampsia, eclampsia, or gestational diabetes. In sub-group analyses, this association was specific to male fetuses, although the trend was in a similar direction for female fetuses.

Strength and weaknesses:
Strengths of this study include a prospective design, the use of multiple methods to date pregnancies (LMP and ultrasound), and multiple sensitivity analyses including accounting for cell composition as well as obstetric-related illnesses which could be related to placental health. Weakness of this study include a relatively low sample size and no correction for multiple comparisons. There were also relatively strict exclusion criteria (women with pre-existing anxiety or depression requiring medications were excluded), which may limit the generalizability of the study.

These findings suggest that depression during pregnancy is associated with placental changes that may increase the risk for complications. Notably, 1 week of placental age acceleration has been associated with a 2-fold increase in odds for low birthweight, and in this study depressive symptoms were associated with 0.4 weeks of age acceleration. It remains unclear what effect, if any, treatment of depressive symptoms would have on these placental changes.