Postpartum depression is the most common complication of pregnancy.

Given our current ability to measure it we think it will affect 10-15% of pregnancies, but it can be a tricky condition to diagnose because in the past, diagnosis has depended on the postpartum person answering a survey meant to identify it, or recognizing the condition in themselves and seeking help.

There are relatable reasons why women may not answer this survey in a way that reflects their true feelings, and it may be a real challenge to catch it in yourself given everything else a postpartum mother is doing.

But these obstacles to diagnosis are changing.

I interviewed this researcher when she was working on securing FDA approval of her blood test that can use biomarkers to predict the risk of PPD before symptoms arise. Now that test is available in limited release for clinical use in select states: California, Texas and Florida. It's called myLuma. I’m re releasing this episode, originally released last summer, so that you can get a sense of some of the science underlying this potentially pregnancy changing test.

MyLuma: https://myluma.health/

Note: I have no connection with this company, but am so excited to see progress on physical tests for depression, especially in the context of pregnancy.

One of the first things on an embryo's to-do list is to make a placenta, but to do this, it will need to work well with the decidual cells occupying the future Placenta construction site, otherwise known as the decidua or uterine lining that's beefed up for pregnancy.

There are likely many contributors to this process, but how this negotiation goes down between a specific set of immune cells called uterine natural killer cells, or uNK cells and the fetal cells from the embryo that set up the bridge between the mother's body and the placenta called the trophoblast cells, or EVTs is the subject of today's episode.

Also: why great obstetrical syndromes (preeclampsia, IUGR, stillbirth) is more of an issue for humans than other mammals.

Although your OB usually doesn’t want to see you in the early weeks of pregnancy—there’s a lot going on that is of critical importance to the ease or complications of a pregnancy—specifically , the introduction of fetus to your uterine lining, and the subsequent merging, if implantation happens.

The weeks that follow are equally consequential. Exactly how those cells of your uterine lining negotiate the migration of trophoblast cells, fetal cells that are building the placenta can be the difference between preeclampsia, premature birth intra uterine growth restriction and a normal pregnancy. One main negotiator of this migration is a specific type of immune cell, uNK cells. Today we talk to a world expert on how certain elements of the immune cell function in early pregnancy.

Dr. Ashley Moffett's 2022 paper in Nature Review Immunology: https://pmc.ncbi.nlm.nih.gov/articles/PMC9527719/#Sec1