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. 2023 Jun 22:14:1196055.
doi: 10.3389/fpsyt.2023.1196055. eCollection 2023.

Investigating the causal association of postpartum depression with cerebrovascular diseases and cognitive impairment: a Mendelian randomization study

Jia Li #  1 , Jinqiu Li #  1 , Lan Shen #  1 , Huan Wang  2 , Tian Zheng  1 , Ying Hui  1 , Xiaoxuan Li  3
Affiliations

Investigating the causal association of postpartum depression with cerebrovascular diseases and cognitive impairment: a Mendelian randomization study

Jia Li et al. Front Psychiatry. .

Abstract

Background: Postpartum depression (PPD) is considered the most widespread puerperium complication. The associations of major depressive disorder with certain types of cerebrovascular diseases and cognitive function have been proposed, but the potential causal effects of PPD on these phenotypes are still unknown.

Methods: A Mendelian randomization (MR) research design with various methods (e.g., inverse-variance weighted method and MR pleiotropy residual sum and outlier test) was adopted to establish a causal relationship between PPD with cerebrovascular diseases and cognitive impairment.

Results: No causal relationship between PPD with carotid intima media thickness and cerebrovascular diseases (i.e., stroke, ischemic stroke, and cerebral aneurysm) was found. However, MR analyses indicated a causal association between PPD and decreased cognitive function (P = 3.55 × 10-3), which remained significant even after multiple comparison corrections using the Bonferroni method. Sensitivity analyses using weighted median and MR-Egger methods indicated a consistent direction of the association.

Conclusion: The causal association between PPD and cognitive impairment indicates that cognitive impairment is a critical aspect of PPD and thus cannot be regarded as an epiphenomenon. Addressing cognitive impairment and lessening the symptoms associated with PPD independently play significant roles in the treatment of PPD.

Keywords: Mendelian randomization; causal association; cerebrovascular diseases; cognitive impairment; postpartum depression.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Directed acyclic graph showing the assumptions of MR analyses.
Figure 2
Figure 2
Scatter plots of MR analyses.
Figure 3
Figure 3
Leave-one-out plots of MR analyses.
See this image and copyright information in PMC

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