Jaramillo Isabel, Karl Marlene, Bergunde Luisa, Mack Judith T, Weise Victoria, Weidner Kerstin, Gao Wei, Steudte-Schmiedgen Susann, Garthus-Niegel Susan
Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany; Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
J Affect Disord. 2023 Oct 15;339:974-983. doi: 10.1016/j.jad.2023.07.034. Epub 2023 Jul 15.
Having a negative childbirth experience is a known risk-factor for developing postpartum depression (PPD). Alterations of the hypothalamus-pituitary-adrenal (HPA)-axis have been discussed as a potential underlying mechanism. However, research on the association between negative birth experiences and long-term integrated glucocorticoids (GCs) is lacking. This study aimed to examine whether objective and subjective birth experience predicted long-term GCs and PPD symptoms.
Measures of objective and subjective birth experience, PPD symptoms, and hair strands for the assessment of hair cortisol concentrations (HairF), hair cortisone concentrations (HairE), and HairF/HairE ratio, were provided eight weeks after childbirth by 235 mothers participating in the study DREAM.
A negative objective birth experience predicted a higher HairF/HairE ratio but was not associated with HairF or HairE. The subjective birth experience did not explain additional variance in hair GCs but was a significant predictor for PPD symptoms. A higher HairF/HairE ratio predicted PPD symptoms when controlling for prepartum depressive symptoms and number of lifetime traumatic events.
Analyses were based on a relatively homogeneous sample and women reported in general positive birth experiences and low levels of depressive symptoms. Therefore, results should be applied to the broader population with caution.
Our results suggest that negative objective birth experience is associated with an altered HairF/HairE ratio, which in turn, seems to be a promising biomarker to identify women at risk for developing PPD. A negative subjective birth experience may be less critical for alterations of the HPA-axis but remains an essential risk factor for PPD.
分娩经历负面是产后抑郁症（PPD）发病的已知风险因素。下丘脑 - 垂体 - 肾上腺（HPA）轴的改变被认为是一种潜在的潜在机制。然而，关于负面分娩经历与长期综合糖皮质激素（GCs）之间关联的研究尚缺。本研究旨在探讨客观和主观分娩经历是否能预测长期的GCs和PPD症状。
参与DREAM研究的235名母亲在产后8周提供了客观和主观分娩经历、PPD症状的测量数据，以及用于评估头发皮质醇浓度（HairF）、头发可的松浓度（HairE）和HairF/HairE比值的头发样本。
客观分娩经历负面可预测较高的HairF/HairE比值，但与HairF或HairE无关。主观分娩经历并不能解释头发GCs的额外变异，但却是PPD症状的显著预测因素。在控制产前抑郁症状和终生创伤事件数量后，较高的HairF/HairE比值可预测PPD症状。
分析基于相对同质的样本，且女性报告的总体分娩经历为积极，抑郁症状水平较低。因此，结果应用于更广泛人群时应谨慎。
我们的结果表明，客观分娩经历负面与HairF/HairE比值改变有关，而这反过来似乎是识别有PPD发病风险女性的一个有前景的生物标志物。主观分娩经历负面可能对HPA轴改变的影响较小，但仍是PPD的一个重要风险因素。
