Fecal Microbiota Changes in Patients With Postpartum Depressive Disorder Original paper

What was studied?

This original research article examined fecal microbiota changes in postpartum depressive disorder (PPD), exploring whether distinct microbial signatures—specifically a postpartum depressive disorder microbiome signature—could be identified. The focus keyphrase postpartum depressive disorder microbiome fits squarely here, as the study compared the gut microbial composition of women with PPD to healthy postpartum controls using 16S rRNA sequencing. The research sought to determine microbial taxa linked with depression severity and sex hormone fluctuations, recognizing the gut–brain–hormone axis as a potential driver of PPD. Importantly, the investigators analyzed differences in microbial diversity, taxonomic composition, and microbe–clinical correlations, providing detailed genus-level findings relevant for microbiome signature databases.

Who was studied?

The study enrolled 57 postpartum women, including 28 patients with clinically diagnosed PPD and 16 healthy controls who provided fecal samples (total fecal dataset n=44). All participants were from Shenzhen, China, and were within 12 months postpartum. Diagnosis followed DSM-IV criteria, and depressive symptom severity was assessed with the Hamilton Depression Rating Scale (17-HAMD) and the Edinburgh Postnatal Depression Scale (EPDS). Exclusion criteria removed confounders such as bipolar disorder, severe mental illness, suicidal risk, pregnancy, antibiotic use, steatohepatitis, or participation in other clinical trials. Serum sex hormone levels (estradiol, progesterone, prolactin, testosterone, FSH, LH) were also measured to investigate microbiota–hormone interactions.

Most important findings

The postpartum depressive disorder microbiome displayed distinct taxonomic alterations. Alpha-diversity did not differ between groups, but beta-diversity (community structure) diverged significantly, indicating broader ecosystem instability in PPD. Firmicutes—a dominant phylum in healthy guts—was notably reduced in PPD. At the genus level, several butyrate-producing bacteria were significantly decreased in PPD, including Faecalibacterium, Phascolarctobacterium, Butyricicoccus, Megasphaera, and members of Lachnospiraceae. These taxa are central to SCFA production, anti-inflammatory signaling, epithelial integrity, and neuroactive metabolite generation. Meanwhile, pro-inflammatory or pathobiont-associated taxa were elevated, particularly Escherichia/Shigella and Enterococcus (family Enterobacteriaceae).

Key microbial associations with depression severity included:

Microbiota also displayed strong correlations with sex hormones. For example, Faecalibacterium and Lachnospiraceae were linked to estradiol, prolactin, progesterone, and testosterone, supporting a hormone–microbiome interplay that may influence PPD biology.

Key implications

This study suggests that PPD is associated with a distinct gut microbial signature characterized by reduced SCFA-producing taxa and increased inflammatory organisms. These shifts align with known pathways of gut‐driven immune activation, HPA-axis modulation, and neuroinflammatory processes implicated in depression. The identified associations between microbes, depression scores, and sex hormones highlight a tripartite interaction—microbiota, mood, and reproductive endocrinology—that could inform biomarker development. Clinically, these findings point toward the potential for microbiome-informed diagnostics, targeted probiotics, dietary SCFA enhancement strategies, and hormone–microbe therapeutic frameworks. Continued research with longitudinal designs is needed to confirm causality and refine these microbial indicators.

Citation

Zhou Y, Chen C, Yu H, Yang Z. Fecal microbiota changes in patients with postpartum depressive disorder. Front Cell Infect Microbiol. 2020;10:567268. doi:10.3389/fcimb.2020.567268