University of Notre Dame, Notre Dame, IN, USA.
Vanderbilt University, Nashville, TN, USA.
Psychoneuroendocrinology. 2025 Jan;171:107194. doi: 10.1016/j.psyneuen.2024.107194. Epub 2024 Sep 23.
Peripartum depression is a global health concern, characterized by mood disturbances inclusive of pregnancy through up to 12-months postpartum. Hormones play a vital role in pregnancy maintenance, fetal development, and labor and delivery and change significantly as a function of pregnancy and childbirth. However, such life sustaining changes may have consequences related to risk for peripartum depression. To date, most studies that have examined hormones in relation to peripartum depression have focused on blood or saliva sampling approaches, though hair analysis offers unique information on trajectories of hormone concentrations over more sustained periods of time (i.e., over months). The aim of this systematic review was to provide a comprehensive review of the association between hair measures of hormones (i.e., cortisol, progesterone, estrogen, and testosterone) and depression during the peripartum period. Forty-one studies were identified for inclusion. A majority of studies reported statistically null associations. Between-person studies varied widely in reported direction and magnitude of hair hormone-depression associations, most likely attributable to a wide range of methodological approaches including timing of assessments and sample size. Studies using within-person approaches observed positive coupling of cortisol concentration and symptoms across time. Most studies focused exclusively on cortisol. We recommend future research consider both stress and reproductive hormones, prioritize within-person change in hormone levels given this is a period of dramatic change, and include contextual (e.g., social support, adverse and benevolent childhood experiences, physical and psychiatric conditions) features that may modify both changes in hormones and the association between hormone levels and depression in the peripartum period.
围产期抑郁症是一个全球性的健康问题，其特征是情绪紊乱，包括怀孕到产后 12 个月。激素在妊娠维持、胎儿发育、分娩中起着至关重要的作用，并且随着妊娠和分娩的变化而显著变化。然而，这些维持生命的变化可能会对围产期抑郁症的风险产生影响。迄今为止，大多数研究激素与围产期抑郁症的关系的研究都集中在血液或唾液取样方法上，尽管头发分析提供了关于激素浓度在更长时间内（即几个月）的轨迹的独特信息。本系统综述的目的是全面综述围产期头发激素（即皮质醇、孕酮、雌激素和睾酮）测量值与抑郁之间的关联。确定了 41 项纳入研究。大多数研究报告了统计学上的零关联。个体间研究在头发激素与抑郁之间的关联的报告方向和幅度上差异很大，这很可能归因于广泛的方法学方法，包括评估时间和样本量。使用个体内方法的研究观察到皮质醇浓度和症状随时间的正耦合。大多数研究仅关注皮质醇。我们建议未来的研究同时考虑应激和生殖激素，鉴于这是一个急剧变化的时期，优先考虑激素水平的个体内变化，并包括可能改变围产期激素变化和激素水平与抑郁之间关联的环境（如社会支持、不良和良性童年经历、身体和精神疾病）特征。
