Sadeghi-Bahmani Dena, Brand Serge, Meinlschmidt Gunther, Tegethoff Marion, Kurath Jennifer, Bürki Nicole, Hösli Irene, Mikoteit Thorsten
Department of Psychology, Stanford University, Stanford, California.
Department of Epidemiology and Population Health, Stanford University, Stanford, California.
Biol Psychiatry Glob Open Sci. 2025 Jan 29;5(3):100454. doi: 10.1016/j.bpsgos.2025.100454. eCollection 2025 May.
Postpartum depression (PPD) is a serious mental health problem that affects about 17% of mothers. The aims of the current study were to observe the associations between prenatal stress, self- and expert-rated PPD, and prepartal and postpartal hair cortisol and cortisone concentrations as proxies for altered hypothalamic-pituitary-adrenal axis activity (HPA-AA).
A total of 129 mothers (mean age 33.1 years) completed the Edinburgh Postnatal Depression Scale 3 days (baseline) and 12 weeks (study end) postpartum. At the end of the study, participants reported on prepartum stressful life events, experts rated participants' symptoms of depression, and participants provided 6 cm of hair strands for analysis of hair glucosteroid levels 12 weeks before and 12 weeks after delivery.
Prepartal stress was associated with higher scores for self- and expert-rated PPD and with lower hair cortisone concentrations as a proxy for less adaptive HPA-AA. Higher prepartal and postpartal hair cortisol/cortisone ratios (i.e., higher cortisol/lower cortisone concentrations) were associated with higher PPD symptom scores.
Women with prepartal stress were at increased risk of experiencing PPD 12 weeks after delivery. Altered hair steroid levels (lower cortisone concentrations) as a proxy for altered HPA-AA further substantiated this association. Results suggest that 1) both prepartal stress and the suppression of HPA-AA appear to be involved in the development of PPD; 2) hair steroid analysis can be used to predict PPD; and 3) women with prepartal stressful life events may benefit from timely support and relief to decrease their risk of developing PPD.
产后抑郁症（PPD）是一个严重的心理健康问题，影响着约17%的母亲。本研究的目的是观察产前应激、自我评定和专家评定的产后抑郁症，以及产前和产后头发皮质醇和可的松浓度之间的关联，以此作为下丘脑-垂体-肾上腺轴活动（HPA-AA）改变的指标。
共有129名母亲（平均年龄33.1岁）在产后3天（基线）和12周（研究结束）时完成了爱丁堡产后抑郁量表。在研究结束时，参与者报告产前应激性生活事件，专家对参与者的抑郁症状进行评分，参与者提供6厘米长的头发样本，用于分析分娩前12周和分娩后12周的头发糖皮质激素水平。
产前应激与自我评定和专家评定的产后抑郁症较高得分相关，且与较低的头发可的松浓度相关，这表明HPA-AA适应性较低。产前和产后头发皮质醇/可的松比值较高（即较高的皮质醇/较低的可的松浓度）与较高的产后抑郁症症状评分相关。
产前有应激的女性在分娩后12周患产后抑郁症的风险增加。头发类固醇水平改变（较低的可的松浓度）作为HPA-AA改变的指标进一步证实了这种关联。结果表明：1）产前应激和HPA-AA抑制似乎都与产后抑郁症的发生有关；2）头发类固醇分析可用于预测产后抑郁症；3）产前有应激性生活事件的女性可能会从及时的支持和缓解中受益，以降低患产后抑郁症的风险。
