Department of Psychiatry, Tohoku University Hospital, Sendai, Japan.
Department of Psychiatry, Tohoku University Graduate School of Medicine, Sendai, Japan.
Depress Anxiety. 2021 Apr;38(4):422-430. doi: 10.1002/da.23134. Epub 2021 Jan 4.
A correlation between gonadal steroids and depressive symptoms during the perinatal period has long been suggested; however, the underlying mechanism for this relationship remains unclear.
This study was designed to examine the correlation between gonadal steroid concentrations of umbilical cord blood and postpartum depressive symptoms as well as longitudinal alterations in maternal plasma gonadal steroid concentrations among 204 perinatal women. The levels of postpartum depressive state at 1 month postpartum were evaluated using the Edinburgh Postnatal Depression Scale.
Umbilical progesterone, estradiol, and testosterone levels were significantly higher in infants delivered by depressed mothers (870.7 ± 281.7 ng/ml, 8607.7 ± 4354.6 pg/ml, and 2.5 ± 0.9 ng/ml, respectively) than those delivered by nondepressed mothers (741.3 ± 324.0 ng/ml, 5221.9 ± 3416.3 pg/ml, and 2.1 ± 0.6 ng/ml, p < .01, p < .05, and p < .05, respectively). Postpartum plasma progesterone levels of depressed mothers (3.5 ± 3.1 ng/ml) measured in the early postpartum period were significantly lower than those of nondepressed mothers (9.1 ± 9.7 ng/ml, p < .01). The decrease in progesterone from mid-pregnancy to the early postpartum period was significantly higher in depressed mothers than in nondepressed mothers. Subgroup analyses specific to primiparas or multiparas indicated that a significant drop of progesterone was seen only in primiparas.
The current study suggests that the delivery of a placenta/fetus with high gonadal steroid production may cause a wider range of fluctuations in maternal plasma gonadal steroid concentrations, which may be concurrent with postpartum depressive symptoms.
长期以来，人们一直认为性腺类固醇与围产期的抑郁症状之间存在相关性；然而，这种关系的潜在机制尚不清楚。
本研究旨在探讨 204 名围产期妇女脐带血中性腺类固醇浓度与产后抑郁症状之间的相关性，以及母体血浆性腺类固醇浓度的纵向变化。产后 1 个月时采用爱丁堡产后抑郁量表评估产后抑郁状态。
与非抑郁产妇（741.3±324.0ng/ml、5221.9±3416.3pg/ml 和 2.1±0.6ng/ml）相比，来自抑郁产妇的婴儿的脐带孕激素、雌二醇和睾酮水平明显更高（870.7±281.7ng/ml、8607.7±4354.6pg/ml 和 2.5±0.9ng/ml，p<.01、p<.05 和 p<.05）。产后早期抑郁产妇的血浆孕激素水平（3.5±3.1ng/ml）明显低于非抑郁产妇（9.1±9.7ng/ml，p<.01）。与非抑郁产妇相比，抑郁产妇从中孕期到产后早期孕激素的下降幅度明显更大。仅在初产妇中观察到孕激素明显下降的亚组分析。
本研究表明，胎盘/胎儿具有较高的性腺类固醇产生能力，可能导致母体血浆性腺类固醇浓度更广泛的波动，这可能与产后抑郁症状同时发生。
