Pedersen Cort A, Johnson Jacqueline L, Silva Susan, Bunevicius Robertas, Meltzer-Brody Samantha, Hamer Robert M, Leserman Jane
Department of Psychiatry CB# 7160, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7160, USA.
Psychoneuroendocrinology. 2007 Apr;32(3):235-45. doi: 10.1016/j.psyneuen.2006.12.010. Epub 2007 Mar 7.
We previously found significantly higher T3-resin uptake and nearly significantly lower total thyroxine concentrations at 38 weeks of pregnancy in women with higher postpartum depression ratings. This study further examined the relationship between thyroid status during late pregnancy and antenatal and postpartum depression scores. Thyroid measures were obtained at 32-35, 36, and 37 weeks of pregnancy in 31 women with normal range thyroid hormone levels. Subjects rated their mood at these antenatal time points and every other week between postpartum weeks 2 and 24 on the Edinburgh Postnatal Depression Scale and the Beck Depression Inventory. Mean antenatal thyroxine concentrations and free thyroxine indices correlated significantly and negatively with mean depression scores during each of three postpartum time periods (postpartum weeks 2-6, 14-18, 20-24). Women with total and free thyroxine concentrations that were, respectively, <10.1 microg/dl and <1.06 ng/dl at all three antenatal time points had significantly higher mean depression scores during all postpartum time periods. The fraction of subjects with pregravid major or minor depression history that was in the low antenatal thyroid group was significantly higher than the fraction of subjects with negative history (5/6 vs. 7/25). Women with antenatal total and free thyroxine concentrations in the lower euthyroid range may be at greater risk of developing postpartum depressive symptoms. Study of the relationships with antenatal thyroid status may provide new insights into the pathophysiology of perinatal mood disturbances.
我们之前发现，产后抑郁评分较高的女性在妊娠38周时，T3树脂摄取显著升高，总甲状腺素浓度几乎显著降低。本研究进一步探讨了妊娠晚期甲状腺状态与产前及产后抑郁评分之间的关系。对31名甲状腺激素水平在正常范围内的女性，在妊娠32 - 35周、36周和37周时进行甲状腺指标检测。受试者在这些产前时间点以及产后第2周和第24周之间每隔一周，使用爱丁堡产后抑郁量表和贝克抑郁量表对自己的情绪进行评分。产前甲状腺素平均浓度和游离甲状腺素指数在产后三个时间段（产后第2 - 6周、14 - 18周、20 - 24周）中的每一个时间段，均与抑郁平均评分呈显著负相关。在所有三个产前时间点，总甲状腺素浓度<10.1μg/dl且游离甲状腺素浓度<1.06ng/dl的女性，在所有产后时间段的平均抑郁评分显著更高。产前甲状腺水平低的组中，有孕前重度或轻度抑郁病史的受试者比例显著高于无此类病史的受试者比例（5/6 vs. 7/25）。产前总甲状腺素和游离甲状腺素浓度处于较低正常甲状腺范围的女性，产后发生抑郁症状的风险可能更高。研究与产前甲状腺状态的关系，可能为围产期情绪障碍的病理生理学提供新的见解。
