The role of autonomic nervous system activity in peripartum depression

A compelling body of research on the general population reported that depression is characterized by lower parasympathetic activity and a globally altered autonomic nervous system (ANS) reactivity. The relationship between HRV and depressive symptoms was also investigated in the pregnant population. However, there is an essential difference between studies on the general population and pregnant women. During pregnancy, women experience rapid and unique changes, including modifications in ANS activity that varies widely to maintain the body’s health homeostasis and adapt to the new physiological requests of the growing fetus. However, chronic dysfunctional changes in ANS during pregnancy have been investigated in relation to depressive symptoms, with mixed results. In this thesis, we investigate the role of prepartum autonomic nervous activity as an indicator of depressive symptoms during pregnancy and as a predictor of the presence of postpartum depressive symptoms. First, we validated and tested the use of a commercial PPG smartphone application to measure an HRV parameter (i.e., the root mean square of the successive difference between NN intervals, rMSSD) during pregnancy and its relationship with peripartum depression. Then, we explore the use of a questionnaire (i.e., Body Perception Questionnaire, BPQ) to assess the self-reported autonomic reactivity of organs above and below the diaphragm and the relationship between an altered. Therefore, this thesis aims to advance understanding of the relationship between autonomic system activity and depression. Indeed, despite the increasing interest in the association between sympathetic and parasympathetic indices and mental health, very few studies explored this topic in the pregnant population using a longitudinal design. Moreover, the focus on alternative ways to a traditional in-person laboratory physiological assessment for measuring autonomic activity provides researchers and clinicians with new validated tools to implement in ecological assessments or eHealth interventions.