Luo Yang, Zheng Le-zhi, Zhou Jian-wei, Pi Pi-xiang
Department of Clinical Nursing, Nursing School in Central South University, Changsha 410013, China.
Zhonghua Fu Chan Ke Za Zhi. 2007 Nov;42(11):745-8.
To explore the relationship of estradiol (E(2)), monoamine neurotransmitters 5-hydroxytryptamine (5-HT), dopamine (DA) and postpartum depression.
Totally 342 women within 42 days after childbirth were assessed with Edinburgh postnatal depression scale (EPDS), Beck depression inventory (BDI), and general health questionnaire (GHQ). Above or equal to 13 of overall score of EPDS was the diagnosis standard of postpartum depression, and the women tested were divided into depression group and normal group accordingly, using the reagent box of radio immunoassay to test estradiol and 5-HT and DA level in the serum.
(1) Incidence: the incidence of postpartum depression was 16.7% (57/342). The highest incidence occurred in patients above 35 (22.2%); the incidence among women under 23 years old was lowest (12.5%), with a significant difference between them (P < 0.01); the incidence in persons with a bachelor degree and above (21.3%) was higher than that of persons with a lower degree of education (7.9%), with a significant difference between the two groups. (2) Biological indicator: the levels of E(2), and 5-HT in depression group (64.39 +/- 0.22) pmol/L, (1.09 +/- 0.21) micromol/L were significantly lower than those in the normal group (126.18 +/- 0.47) pmol/L, (2.67 +/- 0.36) micromol/L (P < 0.01); whereas the level of DA in depression group (5.21 +/- 0.54) micromol/L was significantly higher than that in the normal group (3.16 +/- 0.98) micromol/L (P < 0.01). (3) The levels of E(2) and 5-HT were negatively correlated with the score of EPDS, BDI, GHQ (P < 0.05); but the level of DA was positively related to the scores of EPDS and BDI (P < 0.05), while it had no relationship with GHQ (P > 0.05).
Evaluation scales such as EPDS, BDI, and GHQ should be used to screen for postpartum depression. The measurement of estradiol and monoamine neurotransmitter (5-HT, DA) level can be used as biological objective indicators for prevention and treatment of postpartum depression.
探讨雌二醇（E₂）、单胺类神经递质5-羟色胺（5-HT）、多巴胺（DA）与产后抑郁的关系。
采用爱丁堡产后抑郁量表（EPDS）、贝克抑郁量表（BDI）及一般健康问卷（GHQ）对342例产后42天内的妇女进行测评。以EPDS总分≥13分为产后抑郁的诊断标准，将受测妇女分为抑郁组和正常组，采用放射免疫分析试剂盒检测血清中雌二醇、5-HT及DA水平。
（1）发病率：产后抑郁发病率为16.7%（57/342）。35岁以上患者发病率最高（22.2%）；23岁以下妇女发病率最低（12.5%），两者差异有统计学意义（P<0.01）；本科及以上学历者发病率（21.3%）高于低学历者（7.9%），两组差异有统计学意义。（2）生物学指标：抑郁组E₂、5-HT水平分别为（64.39±0.22）pmol/L、（1.09±0.21）μmol/L，显著低于正常组（126.18±0.47）pmol/L、（2.67±0.36）μmol/L（P<0.01）；而抑郁组DA水平（5.21±0.54）μmol/L显著高于正常组（3.16±0.98）μmol/L（P<0.01）。（3）E₂、5-HT水平与EPDS、BDI、GHQ评分呈负相关（P<0.05）；但DA水平与EPDS、BDI评分呈正相关（P<0.05），与GHQ评分无关（P>0.05）。
应采用EPDS、BDI、GHQ等评估量表筛查产后抑郁。雌二醇及单胺类神经递质（5-HT、DA）水平测定可作为产后抑郁防治的生物学客观指标。
