FROM GUT TO MIND: THE INFLUENCE OF MICROBIOTA COMPOSITION ON POSTPARTUM DEPRESSION
Abstract
Background: Postpartum depression is a significant mood disorder affecting women during the first year after childbirth. Emerging evidence indicates that gut microbiota may play a meaningful role in its development through inflammatory, metabolic, and neuroendocrine pathways. The purpose of this review is to synthesize current knowledge on gut microbiota alterations during pregnancy and postpartum and to evaluate their potential contribution to postpartum depression, with emphasis on mechanistic links and opportunities for therapeutic modulation.
Methodology: This review was conducted by analyzing clinical, mechanistic, and translational studies, using PubMed, the Cochrane Library, and Google Scholar databases, that focused on maternal microbiota composition, postpartum mood disturbances, and microbiota-modulating strategies.
Results: The reviewed evidence demonstrates that women with depressive symptoms commonly exhibit reduced levels of anti-inflammatory and short-chain-fatty-acid-producing bacteria and an increased presence of pro-inflammatory taxa. Pregnancy and postpartum are characterized by substantial microbial shifts, including changes in Firmicutes and Bacteroidetes, with postpartum reductions in beneficial genera such as Faecalibacterium and Bacteroides. These alterations may influence inflammation, neurotransmitter metabolism, intestinal barrier function, and stress-axis activity, collectively contributing to depressive risk. Interventions aimed at modulating the maternal microbiota, including dietary strategies and probiotic supplementation, show preliminary potential for reducing depressive symptoms or lowering postpartum depression risk.
Conclusions: Overall, current findings suggest that gut microbiota may represent both a biomarker and a modifiable factor in postpartum depression. Microbiota-targeted approaches warrant further investigation to determine their preventive and therapeutic utility in maternal mental health.
References
Buttner, M. M., O’Hara, M. W., & Watson, D. (2012). The structure of women’s mood in the early postpartum. Assessment, 19(2), 247–256. https://doi.org/10.1177/1073191111429388
Butts, C. A., Paturi, G., Blatchford, P., Bentley-Hewitt, K. L., Hedderley, D. I., Martell, S., Dinnan, H., Eady, S. L., Wallace, A. J., Glyn-Jones, S., Wiens, F., Stahl, B., & Gopal, P. (2020). Microbiota Composition of Breast Milk from Women of Different Ethnicity from the Manawatu-Wanganui Region of New Zealand. Nutrients, 12(6), 1756. https://doi.org/10.3390/nu12061756
Carrothers, J. M., York, M. A., Brooker, S. L., Lackey, K. A., Williams, J. E., Shafii, B., Price, W. J., Settles, M. L., McGuire, M. A., & McGuire, M. K. (2015). Fecal Microbial Community Structure Is Stable over Time and Related to Variation in Macronutrient and Micronutrient Intakes in Lactating Women. The Journal of Nutrition, 145(10), 2379–2388. https://doi.org/10.3945/jn.115.211110
Chang, L., Wei, Y., & Hashimoto, K. (2022). Brain-gut-microbiota axis in depression: A historical overview and future directions. Brain Research Bulletin, 182, 44–56. https://doi.org/10.1016/j.brainresbull.2022.02.004
Crusell, M. K. W., Hansen, T. H., Nielsen, T., Allin, K. H., Rühlemann, M. C., Damm, P., Vestergaard, H., Rørbye, C., Jørgensen, N. R., Christiansen, O. B., Heinsen, F.-A., Franke, A., Hansen, T., Lauenborg, J., & Pedersen, O. (2018). Gestational diabetes is associated with change in the gut microbiota composition in third trimester of pregnancy and postpartum. Microbiome, 6(1), 89. https://doi.org/10.1186/s40168-018-0472-x
Dahl, C., Stanislawski, M., Iszatt, N., Mandal, S., Lozupone, C., Clemente, J. C., Knight, R., Stigum, H., & Eggesbø, M. (2017). Gut microbiome of mothers delivering prematurely shows reduced diversity and lower relative abundance of Bifidobacterium and Streptococcus. PloS One, 12(10), e0184336. https://doi.org/10.1371/journal.pone.0184336
Goyal, D., Gay, C., & Lee, K. A. (2010). How much does low socioeconomic status increase the risk of prenatal and postpartum depressive symptoms in first-time mothers? Women’s Health Issues: Official Publication of the Jacobs Institute of Women’s Health, 20(2), 96–104. https://doi.org/10.1016/j.whi.2009.11.003
Guo, Y., & Chen, W. (2025). Meta-analysis of the association between gut microbiota and postpartum depression. Journal of Psychosomatic Obstetrics and Gynaecology, 46(1), 2548567. https://doi.org/10.1080/0167482X.2025.2548567
Haga, S. M., Ulleberg, P., Slinning, K., Kraft, P., Steen, T. B., & Staff, A. (2012). A longitudinal study of postpartum depressive symptoms: Multilevel growth curve analyses of emotion regulation strategies, breastfeeding self-efficacy, and social support. Archives of Women’s Mental Health, 15(3), 175–184. https://doi.org/10.1007/s00737-012-0274-2
Hawkins, S. S. (2023). Screening and the New Treatment for Postpartum Depression. Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN, 52(6), 429–441. https://doi.org/10.1016/j.jogn.2023.09.007
Ihongbe, T. O., & Masho, S. W. (2017). Do Successive Preterm Births Increase the Risk of Postpartum Depressive Symptoms? Journal of Pregnancy, 2017, 4148136. https://doi.org/10.1155/2017/4148136
Javdan, M., Bagheri, A., Moludi, J., Khazaee, S., & Saber, A. (2025). Investigating the relationship between MIND diet and postpartum depressive symptoms. BMC Women’s Health, 25(1), 166. https://doi.org/10.1186/s12905-025-03705-3
Jiang, H., Ling, Z., Zhang, Y., Mao, H., Ma, Z., Yin, Y., Wang, W., Tang, W., Tan, Z., Shi, J., Li, L., & Ruan, B. (2015). Altered fecal microbiota composition in patients with major depressive disorder. Brain, Behavior, and Immunity, 48, 186–194. https://doi.org/10.1016/j.bbi.2015.03.016
Jost, T., Lacroix, C., Braegger, C., & Chassard, C. (2014). Stability of the maternal gut microbiota during late pregnancy and early lactation. Current Microbiology, 68(4), 419–427. https://doi.org/10.1007/s00284-013-0491-6
Kunasegaran, T., Balasubramaniam, V. R. M. T., Arasoo, V. J. T., Palanisamy, U. D., & Ramadas, A. (2023). Diet Gut Microbiota Axis in Pregnancy: A Systematic Review of Recent Evidence. Current Nutrition Reports, 12(1), 203–214. https://doi.org/10.1007/s13668-023-00453-4
Lin, P., Ding, B., Feng, C., Yin, S., Zhang, T., Qi, X., Lv, H., Guo, X., Dong, K., Zhu, Y., & Li, Q. (2017). Prevotella and Klebsiella proportions in fecal microbial communities are potential characteristic parameters for patients with major depressive disorder. Journal of Affective Disorders, 207, 300–304. https://doi.org/10.1016/j.jad.2016.09.051
Liu, L., Wang, H., Chen, X., Zhang, Y., Zhang, H., & Xie, P. (2023). Gut microbiota and its metabolites in depression: From pathogenesis to treatment. EBioMedicine, 90, 104527. https://doi.org/10.1016/j.ebiom.2023.104527
Liu, L., Wang, H., Zhang, H., Chen, X., Zhang, Y., Wu, J., Zhao, L., Wang, D., Pu, J., Ji, P., & Xie, P. (2022). Toward a Deeper Understanding of Gut Microbiome in Depression: The Promise of Clinical Applicability. Advanced Science (Weinheim, Baden-Wurttemberg, Germany), 9(35), e2203707. https://doi.org/10.1002/advs.202203707
Lu, X., Shi, Z., Jiang, L., & Zhang, S. (2024). Maternal gut microbiota in the health of mothers and offspring: From the perspective of immunology. Frontiers in Immunology, 15, 1362784. https://doi.org/10.3389/fimmu.2024.1362784
Meng, Y., Chiu, C., Kapoor, M., Li, S.-A., Kaur, N., Marr, P., Kwan, D., Leblanc, K., Ji, C., & Papoushek, C. (2024). Patient Perceived Barriers and Enablers to Medication Adherence in the Treatment of Depression: A Qualitative Study. Journal of Primary Care & Community Health, 15, 21501319241286313. https://doi.org/10.1177/21501319241286313
Morais, J., Marques, C., Teixeira, D., Durão, C., Faria, A., Brito, S., Cardoso, M., Macedo, I., Pereira, E., Tomé, T., & Calhau, C. (2020). Extremely preterm neonates have more Lactobacillus in meconium than very preterm neonates—The in utero microbial colonization hypothesis. Gut Microbes, 12(1), 1785804. https://doi.org/10.1080/19490976.2020.1785804
Nikolova, V. L., Smith, M. R. B., Hall, L. J., Cleare, A. J., Stone, J. M., & Young, A. H. (2021). Perturbations in Gut Microbiota Composition in Psychiatric Disorders: A Review and Meta-analysis. JAMA Psychiatry, 78(12), 1343–1354. https://doi.org/10.1001/jamapsychiatry.2021.2573
O’Hara, M. W., Schlechte, J. A., Lewis, D. A., & Wright, E. J. (1991). Prospective study of postpartum blues. Biologic and psychosocial factors. Archives of General Psychiatry, 48(9), 801–806. https://doi.org/10.1001/archpsyc.1991.01810330025004
Oliveira, T. A., Luzetti, G. G. C. M., Rosalém, M. M. A., & Mariani Neto, C. (2022). Screening of Perinatal Depression Using the Edinburgh Postpartum Depression Scale. Revista Brasileira De Ginecologia E Obstetricia: Revista Da Federacao Brasileira Das Sociedades De Ginecologia E Obstetricia, 44(5), 452–457. https://doi.org/10.1055/s-0042-1743095
Paganini, D., Uyoga, M. A., Kortman, G. A. M., Boekhorst, J., Schneeberger, S., Karanja, S., Hennet, T., & Zimmermann, M. B. (2019). Maternal Human Milk Oligosaccharide Profile Modulates the Impact of an Intervention with Iron and Galacto-Oligosaccharides in Kenyan Infants. Nutrients, 11(11), 2596. https://doi.org/10.3390/nu11112596
Pan, R., Guo, M., Chen, Y., Lin, G., Tian, P., Wang, L., Zhao, J., Chen, W., & Wang, G. (2024). Dynamics of the Gut Microbiota and Faecal and Serum Metabolomes during Pregnancy-A Longitudinal Study. Nutrients, 16(4), 483. https://doi.org/10.3390/nu16040483
Pompili, M., Serafini, G., Del Casale, A., Rigucci, S., Innamorati, M., Girardi, P., Tatarelli, R., & Lester, D. (2009). Improving adherence in mood disorders: The struggle against relapse, recurrence and suicide risk. Expert Review of Neurotherapeutics, 9(7), 985–1004. https://doi.org/10.1586/ern.09.62
Sanada, K., Nakajima, S., Kurokawa, S., Barceló-Soler, A., Ikuse, D., Hirata, A., Yoshizawa, A., Tomizawa, Y., Salas-Valero, M., Noda, Y., Mimura, M., Iwanami, A., & Kishimoto, T. (2020). Gut microbiota and major depressive disorder: A systematic review and meta-analysis. Journal of Affective Disorders, 266, 1–13. https://doi.org/10.1016/j.jad.2020.01.102
Simpson, C. A., Diaz-Arteche, C., Eliby, D., Schwartz, O. S., Simmons, J. G., & Cowan, C. S. M. (2021). The gut microbiota in anxiety and depression—A systematic review. Clinical Psychology Review, 83, 101943. https://doi.org/10.1016/j.cpr.2020.101943
Slykerman, R. F., Hood, F., Wickens, K., Thompson, J. M. D., Barthow, C., Murphy, R., Kang, J., Rowden, J., Stone, P., Crane, J., Stanley, T., Abels, P., Purdie, G., Maude, R., Mitchell, E. A., & Probiotic in Pregnancy Study Group. (2017). Effect of Lactobacillus rhamnosus HN001 in Pregnancy on Postpartum Symptoms of Depression and Anxiety: A Randomised Double-blind Placebo-controlled Trial. EBioMedicine, 24, 159–165. https://doi.org/10.1016/j.ebiom.2017.09.013
Sudo, N., Chida, Y., Aiba, Y., Sonoda, J., Oyama, N., Yu, X.-N., Kubo, C., & Koga, Y. (2004). Postnatal microbial colonization programs the hypothalamic-pituitary-adrenal system for stress response in mice. The Journal of Physiology, 558(Pt 1), 263–275. https://doi.org/10.1113/jphysiol.2004.063388
Turroni, F., Peano, C., Pass, D. A., Foroni, E., Severgnini, M., Claesson, M. J., Kerr, C., Hourihane, J., Murray, D., Fuligni, F., Gueimonde, M., Margolles, A., De Bellis, G., O’Toole, P. W., van Sinderen, D., Marchesi, J. R., & Ventura, M. (2012). Diversity of bifidobacteria within the infant gut microbiota. PloS One, 7(5), e36957. https://doi.org/10.1371/journal.pone.0036957
Vigod, S. N., Villegas, L., Dennis, C.-L., & Ross, L. E. (2010). Prevalence and risk factors for postpartum depression among women with preterm and low-birth-weight infants: A systematic review. BJOG: An International Journal of Obstetrics and Gynaecology, 117(5), 540–550. https://doi.org/10.1111/j.1471-0528.2009.02493.x
Wang, X., Qiu, Q., Shen, Z., Yang, S., & Shen, X. (2023). A systematic review of interpersonal psychotherapy for postpartum depression. Journal of Affective Disorders, 339, 823–831. https://doi.org/10.1016/j.jad.2023.07.067
Wang, Z., Liu, J., Shuai, H., Cai, Z., Fu, X., Liu, Y., Xiao, X., Zhang, W., Krabbendam, E., Liu, S., Liu, Z., Li, Z., & Yang, B. X. (2021). Mapping global prevalence of depression among postpartum women. Translational Psychiatry, 11(1), 543. https://doi.org/10.1038/s41398-021-01663-6
Weerasuriya, W., Saunders, J. E., Markel, L., Ho, T. T. B., Xu, K., Lemas, D. J., Groer, M. W., & Louis-Jacques, A. F. (2023). Maternal gut microbiota in the postpartum Period: A Systematic review. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 285, 130–147. https://doi.org/10.1016/j.ejogrb.2023.03.042
Xiong, R.-G., Li, J., Cheng, J., Zhou, D.-D., Wu, S.-X., Huang, S.-Y., Saimaiti, A., Yang, Z.-J., Gan, R.-Y., & Li, H.-B. (2023). The Role of Gut Microbiota in Anxiety, Depression, and Other Mental Disorders as Well as the Protective Effects of Dietary Components. Nutrients, 15(14), 3258. https://doi.org/10.3390/nu15143258
Yang, J., Zheng, P., Li, Y., Wu, J., Tan, X., Zhou, J., Sun, Z., Chen, X., Zhang, G., Zhang, H., Huang, Y., Chai, T., Duan, J., Liang, W., Yin, B., Lai, J., Huang, T., Du, Y., Zhang, P., … Xie, P. (2020). Landscapes of bacterial and metabolic signatures and their interaction in major depressive disorders. Science Advances, 6(49), eaba8555. https://doi.org/10.1126/sciadv.aba8555
Zhang, S., Lu, B., & Wang, G. (2023). The role of gut microbiota in the pathogenesis and treatment of postpartum depression. Annals of General Psychiatry, 22(1), 36. https://doi.org/10.1186/s12991-023-00469-8
Zhao, X.-H., & Zhang, Z.-H. (2020). Risk factors for postpartum depression: An evidence-based systematic review of systematic reviews and meta-analyses. Asian Journal of Psychiatry, 53, 102353. https://doi.org/10.1016/j.ajp.2020.102353
Copyright (c) 2025 Marta Czarnowska, Radosław Sciepuro, Nina Czarnowska, Layla Settaf-Cherif, Katarzyna Malinowska, Joanna Barwacz, Magdalena Adamik, Dagmara Gładysz, Agnieszka Zaleszczyk
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
