Inflammatory, clinical and sociodemographic factors associated with depressive disorder during pregnancy in Brazilian women

Abstract Depressive disorder during pregnancy is common and may be influenced by clinical and immune factors. We conducted a cross-sectional exploratory study of 55 pregnant women receiving care at a public university-affiliated antenatal clinic in Brazil to examine whether inflammatory biomarkers, obstetric history and sociodemographic characteristics were associated with depressive disorder. Depressive disorder was defined using a validated Edinburgh Postnatal Depression Scale cut-off (score ≥ 13) that showed complete agreement with DSM-5-based diagnoses in this sample. Plasma levels of CXCL16, CCL27, TNF and IL-10 were measured by ELISA and compared between women with and without depressive disorder, with adjustment for multiple testing. Exploratory logistic regression models estimated the odds of depressive disorder according to obstetric and sociodemographic variables. The prevalence of depressive disorder was 27.3%. Multigravida and multiparous women showed higher odds of depressive disorder than primigravida and nulliparous women, although estimates were imprecise and should be interpreted cautiously. None of the inflammatory biomarkers differed significantly between groups after correction; for TNF, a medium mean difference was observed but did not reach statistical significance. Weak correlations between CXCL16 or CCL27 and gestational age did not remain significant after adjustment. These findings highlight the need for larger longitudinal studies to clarify how obstetric history and immune pathways relate to depressive disorder in pregnancy.