Persistent pain after cesarean delivery has an incidence as high as 23 percent, while perinatal depression has an incidence of 15 percent nationwide. The economic burden is about $635 billion in the United States alone, not to mention the emotional and social burden that persistent pain and depression can have on the mother, infant and social support network.
Recently, neuroinflammation has emerged as an important mediator of persistent pain with the release of inflammatory cytokines, such as TNF-α, IL-1β, and IL-18 in the central nervous system (CNS) implicated in central sensitization. Furthermore, there is significant overlap in the inflammatory mediators associated with depression and those involved in the pathogenesis of persistent pain, suggesting that neuroinflammation may be a common etiological process. The studies associating neuroinflammation with the development of persistent pain and/or perinatal depression in parturients are limited. Most studies measure plasma cytokine profiles and it is unclear if plasma reflects the CNS neuroinflammation underlying persistent pain and perinatal depression. The objective of Dr. Mary Yurashevich’s study is to identify biomarkers associated with persistent pain and perinatal depression. The central hypothesis is that the peripartum neuroinflammatory cytokine profile is significantly different among women who develop persistent pain and/or perinatal depression, compared to those who do not develop these conditions.
The 2020 DIG will assist Yurashevich to further pursue studies examining the role of biomarkers in predicting persistent pain and peripartum depression in cesarean delivery, which accounts for roughly one-third of the four million annual births in the United States.