BACKGROUND Occupational studies have shown an association between elevated Mn exposure and depressive symptoms. Blood Mn (BMn) naturally rises during pregnancy due to mobilization from tissues, suggesting it could contribute to pregnancy and postpartum depressive symptoms. OBJECTIVES To assess the association between BMn levels during pregnancy and postpartum depression (PPD), creating opportunities for possible future interventions. METHODS We studied 561 women from the reproductive longitudinal Programming Research in Obesity, Growth, Environment, and Social Stressors (PROGRESS) cohort in Mexico City. BMn was measured at the 2nd and 3rd trimesters, as well as delivery. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD symptoms at 12-months postpartum. We used a generalized linear model assuming a Poisson distribution to assess the association between BMn levels and PPD, with adjustments for age, stress and depressive symptoms during pregnancy, education, socioeconomic status, and contemporaneous blood lead levels. RESULTS The mean ± standard deviation (SD) EPDS score at 12-months postpartum was 6.51 ± 5.65, and 17.11% of women met the criteria for possible PPD (score ≥ 13). In adjusted models, BMn during the 3rd trimester (β: 0.13, 95% CI: 0.04-0.21) and BMn levels averaged at the 2nd and 3rd trimester (β: 0.14, 95% CI: 0.02-0.26) had a positive association with EPDS scores at 12 months postpartum. BMn at the 2nd trimester (β: 0.07, 95% CI: -0.09-0.22) and delivery (β: 0.03, 95% CI: -0.04-0.10) had a non-significant positive association with EPDS scores at 12-months postpartum. Stress and depressive symptoms during pregnancy was associated with higher EPDS scores at 12-months postpartum in all of the adjusted models but were only significant when either BMn during 3rd trimester or BMn averaged across 2nd and 3rd trimester was assessed as the exposure. DISCUSSION Our results demonstrate that elevated BMn levels during pregnancy predict PPD symptoms and could be a potential pathway for intervention and prevention of PPD.

中文翻译：

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怀孕和产后抑郁期间的血锰水平：一项在墨西哥妇女中进行的队列研究。

背景技术职业研究表明锰暴露增加与抑郁症状之间存在关联。由于组织中的动员，血液中的锰（BMn）自然升高，表明它可能导致妊娠和产后抑郁症状。目的评估妊娠期间BMn水平与产后抑郁症（PPD）之间的关联，为将来可能的干预措施创造机会。方法我们从墨西哥城的肥胖，生长，环境和社会压力源（PROGRESS）队列的生殖纵向编程研究中研究了561名妇女。在妊娠的第三个和三个月以及分娩时测量BMn。爱丁堡产后抑郁量表（EPDS）用于评估产后12个月的PPD症状。我们使用广义线性模型（假设为Poisson分布）来评估BMn水平与PPD之间的关联，并对年龄，压力和怀孕期间的抑郁症状，教育程度，社会经济状况以及同期血铅水平进行调整。结果产后12个月的EPDS平均±标准差（SD）得分为6.51±5.65，有17.11％的女性达到了可能的PPD标准（得分≥13）。在调整后的模型中，孕中期的BMn（β：0.13，95％CI：0.04-0.21）和孕中期和孕中期的BMn平均水平（β：0.14，95％CI：0.02-0.26）与产后12个月的EPDS评分。孕中期的BMn（β：0.07，95％CI：-0.09-0.22）和分娩（β：0.03，95％CI：-0.04-0.10）在产后12个月与EPDS评分无显着正相关性。在所有调整后的模型中，怀孕期间的压力和抑郁症状与产后12个月的EPDS评分较高有关，但只有当妊娠中期的BMn或妊娠中期和妊娠中期的BMn均作为暴露量时才有意义。讨论我们的结果表明，怀孕期间BMn水平升高可预测PPD症状，并且可能是干预和预防PPD的潜在途径。