Etebary Sahabeh, Nikseresht Sara, Sadeghipour Hamid Reza, Zarrindast Mohammad Reza
Department of Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran J Psychiatry. 2010 Spring;5(2):40-6.
Postpartum depression (PPD) is a major depressive disorder that most often emerges within 6 to 12 weeks of delivery, but can happen any time up to 1 year after birth. In developed countries, the incidence of postnatal depression is about 10-15% in adult women depending upon the diagnostic criteria, timing of screening and screening instruments used. Mothers with depressive symptoms have been found to have more complex behavioral contacts with their children; this situation can damage family relationships, and even leads to infanticide. Various pathophysiologies are proposed for postpartum depression: Nutritional deficiencies, iron deficiency anemia, rapid decrease in the levels of reproductive hormones following delivery, alterations in hypothalamic-pituitary-adernocortical mechanism and alterations in neurotransmitter levels. Among pathophysiologies of postpartum depression, the role of trace elements is highlighted. The purpose of this review is to assess the role of trace elements including zinc, magnesium, iron and copper in PPD. Zinc as a trace element has the second highest concentration of all transition metals in the brain, and its deficiency is associated with behavioral disturbances. Lower zinc blood concentration was found in women with postpartum depression. Another trace element, magnesium, also influences the nervous system via its actions on the release and metabolism of neurotransmitters. Various studies have focused on antidepressant-like effects of magnesium and its deficiency has been reported in depression. Depletion of magnesium stores during pregnancy is hypothesized to be the cause of postpartum depression. Iron deficiency is the most common single nutrient deficiency in the world. There is an association between anemia and depressive disorders. Copper has been recognized as an essential element for many years. Iron also plays a vital role in neurological disorders and its levels are relevant to postpartum depression. Involvement of trace elements can be seen in pathophysiologies of PPD in different ways. Therefore, trace element supplementation can be an alternative treatment for patients with PPD.
产后抑郁症(PPD)是一种重度抑郁障碍,最常出现在分娩后的6至12周内,但在产后1年内的任何时候都可能发生。在发达国家,根据诊断标准、筛查时间和所用筛查工具的不同,成年女性产后抑郁症的发病率约为10%-15%。已发现有抑郁症状的母亲与孩子的行为接触更为复杂;这种情况会破坏家庭关系,甚至导致杀婴。产后抑郁症有多种病理生理学机制被提出:营养缺乏、缺铁性贫血、分娩后生殖激素水平迅速下降、下丘脑-垂体-肾上腺皮质机制改变以及神经递质水平改变。在产后抑郁症的病理生理学机制中,微量元素的作用受到关注。本综述的目的是评估锌、镁、铁和铜等微量元素在产后抑郁症中的作用。锌作为一种微量元素,在大脑中所有过渡金属中的浓度排名第二,其缺乏与行为障碍有关。产后抑郁症女性的血液锌浓度较低。另一种微量元素镁,也通过对神经递质释放和代谢的作用影响神经系统。各种研究都聚焦于镁的抗抑郁样作用,并且已有报道称抑郁症患者存在镁缺乏的情况。孕期镁储备的消耗被认为是产后抑郁症的病因。缺铁是世界上最常见的单一营养素缺乏症。贫血与抑郁障碍之间存在关联。铜多年来一直被认为是一种必需元素。铁在神经疾病中也起着至关重要的作用,其水平与产后抑郁症相关。微量元素以不同方式参与产后抑郁症的病理生理过程。因此,补充微量元素可以作为产后抑郁症患者的一种替代治疗方法。