Investigating the impact of endocrine-disrupting compounds on antepartum mental health at the Nexus of genetic insights and maternal-fetal outcomes: A prospective study

Abstract

Background

Antepartum depression arises from hormonal, environmental, and genetic factors. Endocrine-disrupting compounds (EDCs) disrupt the endocrine system, increasing vulnerability to depressive symptoms. Genetic variations, particularly in estrogen receptor (ER) pathways, are linked to peripartum depression, with EDCs exposure exacerbating these effects by further disrupting estrogen pathways. Additionally, EDCs exposure in antepartum women is associated with adverse maternal and fetal outcomes. Hence, study aims to evaluate the relationship between EDCs and genetic polymorphisms with antepartum depressive symptoms and assess the impact of EDCs and antepartum depressive symptoms on maternal and fetal outcomes.

Materials and methods

We conducted a prospective cohort study to evaluate depressive symptoms during pregnancy in 400 women between 28 and 40 weeks of gestation, utilizing the Edinburgh Postnatal Depression Scale (EPDS). Women with elevated EPDS scores and matched controls were assessed for urinary bisphenol A and methylparaben levels, along with ER1 gene polymorphism using Tetra-ARMS PCR. The cohort group was followed to document maternal-fetal outcomes, with statistical analyses performed using SPSS.

Results

Twenty-three percent of antepartum women exhibited depressive symptoms. A linear regression analysis indicated that a one-unit increase in log bisphenol A levels corresponded to a 1.1-point increase in EPDS-measured depressive symptom scores. ER1 polymorphisms (A/A and T/A genotypes) and the frequency of the A allele correlate with an increased risk of experiencing antepartum depressive symptoms. Elevated EPDS scores correlated with pregnancy-induced hypertension, anemia, hypothyroidism, and fetal distress. Notably, bisphenol A and methylparaben levels were higher in homozygous genotypes, with bisphenol A linked to maternal anemia, hypothyroidism, and fetal distress, while methylparaben was associated with maternal anemia and fetal distress.

Conclusion

Nearly a quarter of antepartum women displayed depressive symptoms, correlating with elevated endocrine disruptor levels. Higher bisphenol A and methylparaben levels were observed in individuals with mutant genotypes, indicating gene-environment interactions with antepartum depressive symptoms. The observed association of EDCs with maternal anemia, hypothyroidism, and fetal distress highlights the possible effect of EDC on maternal and fetal health.