Blood Test for Postpartum Disorders: Identifying Epigenetic Biomarkers

CONFERENCE REPORTER
Jennifer L. Payne, MD, created a blood test that is predictive of postpartum depression (PPD) about 13 or 14 years ago, and this test is based on epigenetic biomarkers, allowing investigators to take blood in the third trimester and predict with about 80% accuracy who is at elevated risk for developing postpartum depression in 3 months.¹

Two genetic loci, HP1BP3 and TTC9B, were modified by estrogen exposure in the rodent model and were also prospectively predictive of PPD in antenatal blood in pregnant women who later developed PPD.

“I think epigenetic changes are likely part of the path of physiology of depressive illness,” said Payne.

However, an epigenome-wide association study (EWAS) that assessed whether epigenetic changes were predictive of psychiatric symptoms or recurrence of psychiatric illness outside of the postpartum time period, found that the previously identified epigenetic biomarkers were not associated with postpartum psychosis. This indicates that PPD and postpartum psychosis have distinct underlying biological mechanisms.

Investigators also identified multiple (912) epigenetic changes that were statistically associated with depressive symptoms, but did not identify any epigenetic changes that were statistically associated with either manic or psychotic symptoms. They also found epigenetic changes that were associated with future psychiatric relapse outside of the postpartum time period, with a limited follow-up period of up to 4 years.

At the American Society of Clinical Psychopharmacology (ASCP) Annual Meeting in Miami, FL, Payne elaborated on this test and its implications for the future of psychiatry in her presentation, “Epigenetic Biomarkers in Postpartum Depression and Postpartum Psychosis.”² Development of blood tests that are predictive of a future mental illness or future course of psychiatric illness could move psychiatry from a reactive approach to a preventative one, shared Payne.

Dr Payne is vice chair of research, professor of psychiatry and neurobehavioral sciences, and director of the Reproductive Psychiatry Research Program at the University of Virginia in Charlottesville.

References

1. Osborne LM, Etyemez S, Pinna G, et al. Neuroactive steroid biosynthesis during pregnancy predicts future postpartum depression: a role for the 3α and/or 3β-HSD neurosteroidogenic enzymes? Neuropsychopharmacology. 2025;50:904-912.

2. Payne J. New and anticipated interventions for perinatal depression: epigenetic biomarkers in postpartum depression and postpartum psychosis. Presentation at: 2026 ASCP Annual Meeting; May 26-29; Miami Beach, FL. Accessed June 1, 2026.