Objective:

To investigate associations between routine prenatal inflammatory biomarkers and postpartum depression (PPD) symptoms in women with twin deliveries.

Approach:

• Study Design: Retrospective cohort study including 846 women with twin pregnancies delivered between May 2022 and May 2024.
• Data Collection: Blood samples were analyzed for complete blood counts and inflammatory biomarkers; PPD symptoms were screened using the Edinburgh Postnatal Depression Scale.
• Statistical Analysis: Multivariable logistic regression was used to assess associations between inflammatory biomarkers and PPD symptoms.

Key Findings:

• 17.14% of participants exhibited PPD symptoms.
• Women with PPD symptoms had significantly higher neutrophil, lymphocyte, and monocyte counts (P<0.05).
• Higher neutrophil count (OR = 1.46, 95% CI: 1.01–2.12, P = 0.047), higher lymphocyte-to-monocyte ratio (LMR) (OR = 1.36, 95% CI: 1.01–1.83, P = 0.041), and lower platelet-to-lymphocyte ratio (PLR) (OR = 0.98, 95% CI: 0.96–0.99, P = 0.029) were independently associated with PPD symptoms.
• Lymphocyte count showed a borderline protective effect (OR = 0.33, 95% CI: 0.11–1.02, P = 0.055).
• Significant dose-response relationships were found for neutrophils, lymphocytes, monocytes, and SIRI.

Interpretation:

The study supports the involvement of immune-inflammatory dysregulation in the pathophysiology of PPD among women with twin pregnancies.

Limitations:

• Retrospective design may introduce biases.
• Study population limited to a single tertiary hospital, affecting generalizability.

Conclusion:

Higher neutrophil count, higher LMR, and lower PLR are independently associated with PPD symptoms in twin pregnancies.