Wisner K L, Stowe Z N
Women's Services, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106, USA.
Semin Reprod Endocrinol. 1997 Feb;15(1):77-89. doi: 10.1055/s-2008-1067970.
Postpartum mood disorders are common. The clustering of mood-disorder episodes after birth compels a search for factors particularly potent during childbearing. In this article, the complex relationships between the dynamic postbirth physiological environment and mood disorder are discussed. Available studies show a lack of evidence that serum levels of gonadal hormones account for mood disturbance in women. However, substantial amounts of data demonstrate their ability to modulate other neuroendocrine systems. Alterations in hypothalamic-pituitary-adrenal (HPA) axis function attributable to childbearing show remarkable similarity to those observed in depressed women. Postpartum women are also at increased risk for hypothalamic-pituitary-thyroidal (HPT) axis dysfunction that may increase affective-disorder vulnerability. A decreased rate of postpartum recovery of HPA- and HPT-axis function may play a more central role than cross-sectional measures. Understanding the etiology of postpartum mood disorders will require integration of multiple psychosocial and biological risk factors. Further research is critically needed.
产后情绪障碍很常见。产后情绪障碍发作的聚集促使人们寻找在生育期间特别有影响力的因素。在本文中，我们讨论了产后动态生理环境与情绪障碍之间的复杂关系。现有研究表明，缺乏证据支持血清性腺激素水平会导致女性情绪紊乱。然而，大量数据证明了它们调节其他神经内分泌系统的能力。生育导致的下丘脑-垂体-肾上腺（HPA）轴功能改变与抑郁症女性中观察到的变化显著相似。产后女性下丘脑-垂体-甲状腺（HPT）轴功能障碍的风险也增加，这可能会增加患情感障碍的易感性。HPA轴和HPT轴功能产后恢复率降低可能比横断面测量起着更核心的作用。了解产后情绪障碍的病因需要整合多种社会心理和生物学风险因素。迫切需要进一步的研究。
