Graduate Program in Neuroscience, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada.
Department of Psychology, University of British Columbia, Canada; Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Canada.
Front Neuroendocrinol. 2020 Oct;59:100854. doi: 10.1016/j.yfrne.2020.100854. Epub 2020 Aug 1.
Perinatal depression (PND) can have either an antepartum or postpartum onset. Although the greatest risk factor for PND is previous depression history,de novoPND occurs with the majority of cases occurring in the postpartum. Timing of depression can impact etiology, prognosis, and response to treatment. Thus, it is crucial to study the impact of the heterogeneity of PND for better health outcomes. In this review, we outline the differences between antepartum and postpartum depression onset of PND. We discuss maternal physiological changes that differ between pregnancy and postpartum and how these may differentially impact depression susceptibility. We highlight changes in the maternal steroid and peptide hormone levels, immune signalling, serotonergic tone, metabolic factors, brain morphology, and the gut microbiome. Finally, we argue that studying the heterogeneity of PND in clinical and preclinical models can lead to improved knowledge of disease etiopathology and treatment outcomes.
围产期抑郁症（PND）可发生于产前或产后。虽然 PND 的最大危险因素是既往抑郁史，但大多数病例发生在产后，新发 PND 仍占多数。抑郁发生的时间会影响病因、预后和治疗反应。因此，研究 PND 的异质性对改善健康结果至关重要。在这篇综述中，我们概述了 PND 产前和产后抑郁发作的差异。我们讨论了妊娠和产后母体生理变化的不同，以及这些变化如何对抑郁易感性产生不同的影响。我们强调了母体甾体激素和肽类激素水平、免疫信号、5-羟色胺能神经递质、代谢因素、脑形态和肠道微生物组的变化。最后，我们认为在临床和临床前模型中研究 PND 的异质性可以提高对疾病发病机制和治疗结果的认识。
