Published online Mar 22, 2015. doi: 10.5498/wjp.v5.i1.103
Peer-review started: July 19, 20114
First decision: October 14, 2014
Revised: November 21, 2014
Accepted: December 16, 2014
Article in press: December 17, 2014
Published online: March 22, 2015
Processing time: 249 Days and 2.5 Hours
Postpartum depression is one of the most prevalent psychopathologies. Its prevalence is estimated to be between 10% and 15%. Despite its multifactorial etiology, it is known that genetics play an important role in the genesis of this disorder. This paper reviews epidemiological evidence supporting the role of genetics in postpartum depression (PPD). The main objectives of this review are to determine which genes and polymorphisms are associated with PPD and discuss how this association may occur. In addition, this paper explores whether these genes are somehow related to or even the same as those linked to Major Depression (MD). To identify gaps in the current knowledge that require investigation, a systematic review was conducted in the electronic databases PubMed, LILACS and SciELO using the index terms “postpartum depression” and “genetics”. Literature searches for articles in peer-reviewed journals were made until April 2014. PPD was indexed 56 times with genetics. The inclusion criteria were articles in Portuguese, Spanish or English that were available by institutional means or sent by authors upon request; this search resulted in 20 papers. Genes and polymorphisms traditionally related to MD, which are those involved in the serotonin, catecholamine, brain-derived neurotrophic factor and tryptophan metabolism, have been the most studied, and some have been related to PPD. The results are conflicting and some depend on epigenetics, which makes the data incipient. Further studies are required to determine the genes that are involved in PPD and establish the nature of the relationship between these genes and PPD.
Core tip: 5HTT and 5HTTLPR were the most studied gene and polymorphism, respectively. 5HTTLPR is associated with postpartum depression (PPD) in the majority of papers, but epigenetics must be considered. TPH1 and TPH2 polymorphisms are related to peripartum depression. COMT and MAOA polymorphisms were also risk factors for PPD. Once again, only when epigenetic was analyzed, an association with BDNF polymorphism was possible. MTHFR, CYP2D6 and PER2 polymorphisms were not related to this mood disorder. Polymorphisms of oxytocin, steroids and estrogen genes were positively correlated with PPD.