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eSymposia | The Microbiome: From Mother to Child


Associations between Prenatal Vaginal Microbiota and Symptoms of Depression or Anxiety: Pregnancy and Postpartum


Jan 18, 2021 12:00am ‐ Jan 18, 2021 12:00am

Description

Associations between Prenatal Vaginal Microbiota and Symptoms of Depression or Anxiety: Pregnancy and Postpartum Abstract Body: Introduction: Depression and anxiety affect between 13-20% of women in the prenatal and postpartum period. Depression and anxiety around and during pregnancy have negative sequalae on the mother, child, and family. Changes in the vaginal microbiome with stress during pregnancy have been observed previously, as one study found an association between chronic maternal stress and increased rates of bacterial vaginosis (BV), which increases the risk for preterm labor. Associations between chronic stress and having a major depressive episode have also been observed. The present study aims to elucidate associations between the prenatal vaginal microbiome and maternal mental health factors such as anxiety and depression in either the prenatal or postpartum period. Methods: Women were recruited during their first prenatal visit. Self-reported diagnoses of anxiety and depression, scores on the Edinburgh Postpartum Depression Scale (EPDS), and self-reported anti-depressant and anti-anxiolytic use were collected at three time points: the first prenatal visit (P1), in the third trimester (P2), and one month postpartum (PP). Vaginal swabs for microbiota analysis were collected in the third trimester (n= 40). The DNA from vaginal swabs was extracted, and PCR amplification was performed on the V4 region of the 16S rRNA gene. Sequence reads were processed in mothur. Alpha (Chao1, Shannon, Inverse Simpson) and beta diversity (Bray-Curtis, Sorensen) were calculated in R with the vegan package. The associations between the total EPDS and anxiety as assessed via question 4 on the EPDS (P1, PP), self-report of depression (P1, PP) and/or anxiety diagnoses (PP), anti-depressant and/or anti-anxiolytic medication (P1, P2, PP) and the vaginal bacterial alpha and beta diversity measures were tested using either Wilcoxon, Spearman, or PERMANOVA tests. Results: Women were between the ages of 19-40, most were college graduates, 76% were married. A higher score on the prenatal EPDS was associated with a less diverse and less even vaginal microbiota as well as lower levels of Bifidobacteriaceae in the vaginal community. The use of antidepressants in the third trimester of pregnancy was associated with lower diversity and evenness of the vaginal microbiota as well as lower levels of Bifidobacteriaceae in the vaginal community. Higher maternal anxiety in the prenatal period, as assessed via question 4 on the EPDS, was associated with less richness, evenness, and diversity of the vaginal microbiota. The community structure and composition of the vaginal microbiota differed based on level of scoring on the EPDS Anxiety question in the prenatal period with higher scores associated with lower levels of Lachnospiraceae, Bifidobacteriaceae, Prevotella, Bateroides, Sneathia, and higher levels of Lactobacillus in the vaginal microbiota. Conclusion: Maternal depression or anxiety during and around the pregnancy period are associated with differences in the vaginal microbiota. However, larger sample sizes will be needed to fully elucidate these relationships. Authors and Affiliations: Anfal Marafie1,2, Kameron Y. Sugino1, Nigel Paneth3,4, Rebecca Knickmeyer4,5, Kim McKee6, Sarah S. Comstock1 1Department of Food Science and Human Nutrition, Michigan State University, East Lansing, Michigan 2College of Human Medicine, Michigan State University, East Lansing, Michigan 3Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan. 4 Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan. 5Institute for Quantitative Health Science and Engineering, Michigan State University, East Lansing, Michigan. 6 Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan

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