Journal of South Asian Federation of Obstetrics and Gynaecology

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VOLUME 16 , ISSUE 3 ( May-June, 2024 ) > List of Articles


Nurturing the Mind from Within: Exploring the Role of Gut–Microbiota–Brain Axis in Postpartum Depression

Srinidhi Rai, Priya Alva, Sriram Naresh

Keywords : Postpartum depression, Psychology, Screening

Citation Information : Rai S, Alva P, Naresh S. Nurturing the Mind from Within: Exploring the Role of Gut–Microbiota–Brain Axis in Postpartum Depression. J South Asian Feder Obs Gynae 2024; 16 (3):285-288.

DOI: 10.5005/jp-journals-10006-2411

License: CC BY-NC 4.0

Published Online: 29-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


The pathophysiology of postpartum depression (PPD) mostly involves disruptions of the immunological system, gut microbiota, neurotransmitters, hormone production, and neuroendocrine regulation. This review explores the reciprocal exchange of signals along the gut–brain axis, with a particular emphasis on the role that gut microorganisms play in neurotransmitter synthesis, precursor generation, and the secretion of vital metabolites, thus unravelling the complex interactions of the microbiota–gut–brain axis to pave a better understanding of microbiota-mediated pathogenesis, avenues for therapeutic possibilities leveraging microbiota–gut–brain axis modulations.

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  1. Pearlstein T, Howard M, Salisbury A, et al. Postpartum depression. Am J Obstet Gynecol 2009;200(4):357–364. DOI: 10.1016/j.ajog.2008.11.033.
  2. Lanjewar S, Nimkar S, Jungari S. Depressed motherhood: Prevalence and covariates of maternal postpartum depression among urban mothers in India. Asian J Psychiatr 2021;57(102567):1–6. DOI: 10.1016/j.ajp.2021.102567.
  3. Ghosh A, Goswami S. Evaluation of post-partum depression in a tertiary hospital. J Obstet Gynaecol India 2011;61(5):528–530. DOI: 10.1007/s13224-011-0077-9.
  4. Zhang S, Lu B, Wang G. The role of gut microbiota in the pathogenesis and treatment of postpartum depression. Ann Gen Psychiatry 2023;22(36):1–13. DOI: 10.1186/s12991-023-00469-8.
  5. Cameron EE, Sedov ID, Tomfohr-Madsen LM. Prevalence of paternal depression in pregnancy and the postpartum: An updated meta-analysis. J Afect Disord 2016;206:189–203. DOI: 10.1016/j.jad.2016.07.044.
  6. Rai S, Sreelatha S, Devang N, et al. The microbiota–gut–brain axis and diabetic cognitive impairment: A memorable journey. Clinical Diabetology 2023;12(4):261–271. DOI: 10.5603/DK.a2023.0025.
  7. Diamant M, Blaak EE, de Vos WM. Do nutrient-gut-microbiota interactions play a role in human obesity, insulin resistance and type 2 diabetes? Obes Rev 2011;12(4):272–281. DOI: 10.1111/j.1467-789X.2010.00797.x.
  8. Cryan JF, Dinan TG. Mind-altering microorganisms: The impact of the gut microbiota on brain and behaviour. Nat Rev Neurosci 2012;13(10):701–712. DOI: 10.1038/nrn3346.
  9. Dinan TG, Cryan JF. Melancholic microbes: A link between gut microbiota and depression? Neurogastroenterol Motil 2013;25(9): 713–719. DOI: 10.1111/nmo.12198.
  10. Cryan JF, Dinan TG. Microbiota and neuroimmune signalling— Metchnikoff to microglia. Nat Rev Gastroenterol Amp; Hepatol 2015;12(9),494–496. DOI: 10.1038/nrgastro.2015.127.
  11. Desbonnet L, Clarke G, Shanahan F, et al. Microbiota is essential for social development in the mouse. Mol Psychiatry 2014;19(2):146–148. DOI: 10.1038/mp.2013.65.
  12. Liu L, Huh JR, Shah K. Microbiota and gut brain axis. Implications for new therapeutic design in the CNS. eBiomedicine 2022;77:1–11. DOI: 10.1016/j.ebiom.2022.103908.
  13. Cheung SG, Goldenthal AR, Uhlemann AC, et al. Systematic review of gut microbiota and major depression. Front Psychiatry 2019;10(34): 1–17. DOI: 10.3389/fpsyt.2019.00034.
  14. Dalile B, Van Oudenhove L, Vervliet B, et al. The role of short-chain fatty acids in microbiota-gut-brain communication. Nat Rev Gastroenterol Hepatol 2019;16(8):461–478. DOI: 10.1038/s41575-019-0157-3.
  15. Bercik P, Verdu EF, Foster JA, et al. Chronic gastrointestinal inflammation induces anxiety-like behavior and alters central nervous system biochemistry in mice. Gastroenterology 2010;139(6): 2102–2112. DOI: 10.1053/j.gastro.2010.06.063.
  16. O'Sullivan E, Barrett E, Grenham S, et al. BDNF expression in the hippocampus of maternally separated rats: Does bifidobacterium breve 6330 alter BDNF levels? Benef Microbes 2011;2(3):199–207. DOI: 10.3920/BM2011.0015.
  17. Zhou Y, Chen C, Yu H, et al. Fecal microbiota changes in patients with postpartum depressive disorder. Front Cell Infect Microbiol 2020;10:567268. DOI: 10.3389/fcimb.2020.567268.
  18. Zhao R, Zhou Y, Shi H, et al. Effect of gestational diabetes on postpartum depression-like behavior in rats and its mechanism. Nutrients 2022;14(6):1229. DOI: 10.3390/nu14061229.
  19. Aoyagi SS, Tsuchiya KJ. Does maternal postpartum depression affect children's developmental outcomes? J Obstet Gynaecol Res 2019;45(9):1809–1820. DOI: 10.1111/jog.14064.
  20. Brett M, Baxendale S. Motherhood and memory: A review. Psychoneuroendocrinol 2001;26(4):339–362. DOI: 10.1016/s0306-4530(01)00003-8.
  21. Rupanagunta GP, Nandave M, Rawat D, et al. Postpartum depression: Aetiology, pathogenesis and the role of nutrients and dietary supplements in prevention and management. Saudi Pharm J 2023;31(7):1274–1293. DOI: 10.1016/j.jsps.2023.05.008.
  22. Baker JM, Al-Nakkash L, Herbst-Kralovetz MM. Estrogen-gut microbiome axis: Physiological and clinical implications. Maturitas 2017;103:45–53. DOI: 10.1016/j.maturitas.2017.06.025.
  23. Mayer SE, Lopez-Duran NL, Sen S, et al. Chronic stress, hair cortisol and depression: A prospective and longitudinal study of medical internship. Psychoneuroendocrinology 2018;92:57–65. DOI: 10.1016/j.psyneuen.2018.03.020.
  24. Daut RA, Fonken LK. Circadian regulation of depression: A role for serotonin. Front Neuroendocrinol 2019;54:1–37. DOI: 10.1016/j.yfrne.2019.04.003.
  25. Yano JM, Yu K, Donaldson GP, et al. Indigenous bacteria from the gut microbiota regulate host serotonin biosynthesis. Cell 2015;161(2):264–276. DOI: 10.1016/j.cell.2015.02.047
  26. Geng S, Cheng S, Li Y, et al. Faecal microbiota transplantation reduces susceptibility to epithelial injury and modulates tryptophan metabolism of the microbial community in a Piglet model. J Crohns Colitis 2018;12(11):1359–1374. DOI: 10.1093/ecco-jcc/jjy103.
  27. Dinan TG, Cryan JF. Regulation of the stress response by the gut microbiota: Implications for psychoneuroendocrinology. Psychoneuroendocrinology 2012;37(9):1369–1378. DOI: 10.1016/j.psyneuen.2012.03.007.
  28. Dinan TG, Cryan JF. Microbes, immunity, and behavior: Psychoneuroimmunology meets the microbiome. Neuropsychopharmacology 2017;42(1):178–192. DOI: 10.1038/npp.2016.103.
  29. Christiansen CB, Gabe MBN, Svendsen B, et al. The impact of short-chain fatty acids on GLP-1 and PYY secretion from the isolated perfused rat colon. Am J Physiol Gastrointest Liver Physiol 2018;315(1):G53–G65. DOI: 10.1152/ajpgi.00346.2017.
  30. Nankova BB, Agarwal R, MacFabe DF, et al. Enteric bacterial metabolites propionic and butyric acid modulate gene expression, including CREB-dependent catecholaminergic neurotransmission, in PC12 cells–possible relevance to autism spectrum disorders. PLoS ONE 2014;9(8):1–16. DOI: 10.1371/journal.pone.0103740.
  31. Pascale A, Marchesi N, Marelli C, et al. Microbiota and metabolic diseases. Endocrine 2018;61:357–371. DOI: 10.1007/s12020-018-1605-5.
  32. Koh A, De Vadder F, Kovatcheva-Datchary P, et al. From dietary fiber to host physiology: Short-chain fatty acids as key bacterial metabolites. Cell 2016;165(6):1332–1345. DOI: 10.1016/j.cell.2016.05.041.
  33. Steckert AV, Comim CM, Igna DM, et al. Effects of sodium butyrate on aversive memory in rats submitted to sepsis. Neurosci Lett 2015;595:134–138. DOI: 10.1016/j.neulet.2015.04.019.
  34. Yamawaki Y, Yoshioka N, Nozaki K, et al. Sodium butyrate abolishes lipopolysaccharide-induced depression-like behaviors and hippocampal microglial activation in mice. Brain Res 2018;1680:13–38. DOI: 10.1016/j.brainres.2017.12.004.
  35. Wei Y, Melas PA, Wegener G, et al. Antidepressant-like effect of sodium butyrate is associated with an increase in TET1 and in 5-hydroxymethylation levels in the Bdnf gene. Int J Neuropsychopharmacol 2014;18(2):pyu032. DOI: 10.1093/ijnp/pyu032.
  36. Hashimoto K, Bruno D, Nierenberg J, et al. Abnormality in glutamine-glutamate cycle in the cerebrospinal fluid of cognitively intact elderly individuals with major depressive disorder: A 3-year follow-up study. Transl Psychiatry 2016;6(3):e744. DOI: 10.1038/tp.2016.8.
  37. Pu J, Liu Y, Zhang H, et al. An integrated meta-analysis of peripheral blood metabolites and biological functions in major depressive disorder. Mol Psychiatry 2021;26(8):4265–4276. DOI: 10.1038/s41380-020-0645-4.
  38. Domin H, Szewczyk B, Woźniak M, et al. Antidepressant-like effect of the mGluR5 antagonist MTEP in an astroglial degeneration model of depression. Behav Brain Res 2014;273:23–33. DOI: 10.1016/j.bbr.2014.07.019.
  39. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987;150:782–786. DOI: 10.1192/bjp.150.6.782.
  40. Walton GD, Ross LE, Stewart DE, et al. Decisional conflict among women considering antidepressant medication use in pregnancy. Arch Womens Ment Health 2014;17(6):493–501. DOI: 10.1007/s00737-014-0448-1.
  41. Leucht S, Hierl S, Kissling W, et al. Putting the efficacy of psychiatric and general medicine medication into perspective: Review of meta-analyses. Br J Psychiatry 2012;200(2):97–106. DOI: 10.1192/bjp.bp.111.096594.
  42. Cammarota G, Ianiro G, Bibbò S, et al. Gut microbiota modulation: Probiotics, antibiotics or fecal microbiota transplantation? Intern Emerg Med 2014;9(4):365–373. DOI: 10.1007/s11739-014- 1069-4.
  43. Liu X, Cao S, Zhang X. Modulation of gut–microbiota–brain axis by probiotics, prebiotics, and diet. J Agric Food Chem 2015;63(36): 7885–7895. DOI: 10.1021/acs.jafc.5b02404.
  44. Sandhu KV, Sherwin E, Schellekens H, et al. Feeding the microbiota-gut-brain axis: Diet, microbiome, and neuropsy chiatry. Transl Res 2017;179:223–244. DOI: 10.1016/j.trsl.2016.10.002.
  45. Garg R, Chauhan V, Agrawal P, et al. Polycystic ovary syndrome till date and possibilities in coming years. J South Asian Feder Obs Gynae 2024; 16(2):169–173. DOI: 10.5005/jp-journals-10006-2371.
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