Allopregnanolone and depression and anxiety symptoms across the peripartum: an exploratory study

Standeven, Lindsay R.; Osborne, Lauren M.; Betz, Joshua; Yenokyan, Gayane; Voegtline, Kristin; Hantsoo, Liisa; Payne, Jennifer L.

doi:10.1007/s00737-021-01186-5

Cited by 8 publications

(4 citation statements)

References 23 publications

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“…These hypotheses are centered on our previous work finding elevations of innate immune cytokines in women with anxiety during pregnancy and early postpartum and our work finding that low ALLO in pregnancy is associated with current and future symptoms of anxiety [ 1 , 2 , 65 ]. These prior studies were carried out in extremely different populations (both in a high-income country, one with largely low-income Black and Hispanic participants and the other with largely high-income White participants).…”

Section: Discussionmentioning

confidence: 99%

Biological Mechanisms in Pregnant Women With Anxiety (Happy Mother-Healthy Baby Supplement Study): Protocol for a Longitudinal Mixed Methods Observational Study

Sherer¹,

Malik²,

Osborne³

et al. 2023

JMIR Res Protoc

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Background Anxiety and depression are common in the perinatal period and negatively affect the health of the mother and baby. Our group has developed “Happy Mother-Healthy Baby” (HMHB), a cognitive behavioral therapy–based psychosocial intervention to address risk factors specific to anxiety during pregnancy in low- and middle-income countries (LMICs). Objective The purpose of this study is to examine biological mechanisms that may be linked to perinatal anxiety in conjunction with a randomized controlled trial of HMHB in Pakistan. Methods We are recruiting 120 pregnant women from the Holy Family Hospital, a public facility in Rawalpindi, Pakistan. Participants are assessed for at least mild anxiety symptoms using the Hospital Anxiety and Depression Scale (ie, a score ≥8 on the anxiety scale is necessary for inclusion in the anxiety groups and <8 for inclusion in the healthy control group). Women who meet the criteria for an anxiety group are randomized into either the HMHB intervention group or an enhanced usual care (EUC) control group. Participants receive HMHB or EUC throughout pregnancy and undergo blood draws at 4 time points (baseline, second trimester, third trimester, and 6 weeks post partum). We will assess peripheral cytokine concentrations using a multiplex assay and hormone concentrations using gas chromatography and mass spectrometry. The statistical analysis will use generalized linear models and mixed effects models to assess the relationships across time among anxiety, immune dysregulation, and hormone levels, and to assess whether these biological factors mediate the relationship between anxiety and birth and child development outcomes. Results Recruitment started on October 20, 2020, and data collection was completed on August 31, 2022. The start date for recruitment for this biological supplement study was delayed by approximately half a year due to the COVID-19 pandemic. The trial was registered at ClinicalTrials.gov (NCT03880032) on September 22, 2020. The last blood samples were shipped to the United States on September 24, 2022, where they will be processed for analysis. Conclusions This study is an important addition to the HMHB randomized controlled trial of an intervention for antenatal anxiety. The intervention itself makes use of nonspecialist providers and, if effective, will represent an important new tool for the treatment of antenatal anxiety in LMICs. Our biological substudy is one of the first attempts to link biological mechanisms to antenatal anxiety in an LMIC in the context of a psychosocial intervention, and our findings have the potential to significantly advance our knowledge of the biological pathways of perinatal mental illness and treatment efficacy. Trial Registration ClinicalTrials.gov NCT03880032; https://clinicaltrials.gov/ct2/show/NCT03880032 International Registered Report Identifier (IRRID) DERR1-10.2196/43193

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Section: Discussionmentioning

confidence: 99%

Biological Mechanisms in Pregnant Women With Anxiety (Happy Mother-Healthy Baby Supplement Study): Protocol for a Longitudinal Mixed Methods Observational Study

Sherer¹,

Malik²,

Osborne³

et al. 2023

JMIR Res Protoc

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“…This research is an unpaired categorical analytic study (Dahlan, 2010) which reveals the effect of family support on the incidence of psychological disorders during pregnancy (Standeven LR et al, 2022). The research was started by identifying the risk factors for psychological disorders during pregnancy in the form of family support obtained by the mother during pregnancy and then carrying out tests to identify the types of psychological disorders in pregnant women at this time (Oktalia Juli.et al, 2016).…”

Section: Methodsmentioning

confidence: 99%

Effect of Family Support on Psychological Disorders in Pregnant Women in Pulo Lor Village, Pulo Lor District, Jombang Regency

Pitriawati,

Srirahandayani,

Grah Prihartanti

et al. 2023

Int. J. Multidiscipline. Approach. Res. Sci.

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Psychological health disorders during pregnancy can cause poor pregnancy outcomes in the form of complications including the risk of preterm labor, delays in the delivery process, low birth weight, hypertension and impaired fetal neurodevelopment and development. The risk of these complications can be reduced by improving the factors that affect the psychological health of pregnant women including interpersonal relationships, family roles and social support. The purpose of this study was to determine the effect of family support on the psychological health status of pregnant women using the unpaired categorical analytic research method of more than two groups with univariate, bivariate and multivariate data analysis. The research process carried out on pregnant women in Jombang Regency has found that influential family support can reduce the risk of psychological disorders in the form of anxiety during pregnancy.

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“…As other authors have previously pointed out, the inconsistent findings in studies of allopregnanolone levels in postpartum depression may be explained by population selection, assays L. C. Susser used, and trimester of allopregnanolone measurement. [67][68][69][70][71][72][73][74] Inclusion of women with concomitant histories of nonreproductive major depression can influence results. 25,68 Obsborne and colleagues 67 included only women with a history of mood disorders and found a negative association between second trimester allopregnanolone levels and postpartum depression.…”

Section: Future Directionsmentioning

confidence: 99%

“…However, the relationship between absolute allopregnanolone levels and postpartum depression remains controversial. As other authors have previously pointed out, the inconsistent findings in studies of allopregnanolone levels in postpartum depression may be explained by population selection, assays used, and trimester of allopregnanolone measurement 67-74 . Inclusion of women with concomitant histories of nonreproductive major depression can influence results 25,68 .…”

Section: Future Directionsmentioning

confidence: 99%

Clinical Implications of the Neurosteroid Allopregnanolone in Reproductive Depression

Susser

2023

Harv Rev Psychiatry

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Certain women develop depression with fluctuations in hormone levels whereas other women do not; this hormonally driven depression has been termed reproductive depression. The pathophysiology of reproductive depression differs from that of major depressive disorder, and this distinction has important clinical—including treatment—implications. Recent advances have revealed that the neurosteroid, allopregnanolone, plays a central role in reproductive depression. Appreciation of allopregnanolone’s role in reproductive depression aids in selecting targeted treatments and in predicting symptom worsening during subsequent reproductive stages, and it can be used to reduce risk of relapse. This knowledge is also guiding the development of new pharmacologic treatments for reproductive depression.

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Allopregnanolone and depression and anxiety symptoms across the peripartum: an exploratory study

Cited by 8 publications

References 23 publications

Biological Mechanisms in Pregnant Women With Anxiety (Happy Mother-Healthy Baby Supplement Study): Protocol for a Longitudinal Mixed Methods Observational Study

Biological Mechanisms in Pregnant Women With Anxiety (Happy Mother-Healthy Baby Supplement Study): Protocol for a Longitudinal Mixed Methods Observational Study

Effect of Family Support on Psychological Disorders in Pregnant Women in Pulo Lor Village, Pulo Lor District, Jombang Regency

Clinical Implications of the Neurosteroid Allopregnanolone in Reproductive Depression

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