Depressão periparto e autoimunidade: o papel dos autoanticorpos antiocitocina

Abstract

Peripartum depression affects 10% of women during pregnancy and postpartum and is associated with morbidity for the mother and offspring, including impairment in maternal care and emotional and cognitive consequences in children. Several neurobiological changes have been associated to peripartum depression, including dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and low oxytocin levels. The anti-oxytocin antibodies have natural occurrence and have been linked to major depression. Objective: This study evaluated oxytocin antibodies in pregnancy and postpartum in relation to peripartum depression. Methods: The sample was composed by a cut of 73 women who presented peripartum depression and 59 women without depression randomly selected as controls from a cohort of pregnant women from obstetrics clinic of Federal University of Minas Gerais. Depression was defined by the MINI-Plus in the second and third trimester of pregnancy and postpartum. Depressive symptoms were assessed by the Edinburgh Postpartum Depression Scale, Beck Depression Inventory and Hamilton Depression Scale. The titles of free IgM and IgG anti-oxytocin antibodies were mesured in plasma by ELISA technique in the second trimester and postpartum. Results: Free IgM and IgG oxytocin antibodies are lower in postpartum in relation to pregnancy levels, but differences between peripartum depression and controls are not significant. Higher levels of free IgG oxytocin antibodies are associated with cesarean delivery. Free IgG oxytocin antibodies are also associated with peripartum and antenatal depression in regular risk pregnancies and correlate positively with depression scores. Conclusion: The association between anti-oxytocin antibodies and perinatal depression remains inconclusive, but the hypothesis that oxytocin antibodies may modulate the oxytocin functions in the brain, influencing peripartum depression occurrence, and peripherally, influencing uterine contractions and relating to cesarean delivery, should be further explored.