Biological Aspects of Postpartum Depression

Abstract

In comparison with the vast epidemiological literature on postpartum depression (PPD), relatively few studies have examined the biological aspects of the disorder. However, research into the biological mechanisms of PPD is a challenging task, as normal pregnancy and the postpartum period cause adaptive endocrine changes, which would otherwise be considered pathological in nonpregnant women. This review focuses on the adaptive changes of childbearing and nursing, which ultimately may put women at increased risk of PPD. In light of the normal physiology, the authors also attempt to describe the current evidence of the biological changes associated with the development of depression in the postpartum period, including ovarian steroids, the hypothalamic-pituitary-adrenal axis, the serotonergic neurotransmitter system, the thyroid system and inflammatory markers. In addition, current knowledge on candidate genes associated with PPD is reviewed.

Serotonin Transporter Gene (SLC6A4) Polymorphism May Be Associated with Chinese Globus Pharyngeus and Its Antidepressant Effects

“…This relationship has been observed in both human and animal studies [23]. Stein indicated a high relationship between the presence of the S/S genotype or S allele and a greater susceptibility to affective disorders, and when combined with adverse environmental effects, an increased likelihood of the development of depression was also observed [25]. A meta-analysis showed an interaction between the number of stressful life events and the number of 5HTTLPR S alleles in the risk for depression [26].…”

Serum leptin level measured 48 h after delivery is associated with development of postpartum depressive symptoms: a 3-month follow-up study

“…In the past, many risk factors, such as psychosocial aspects, low socioeconomic status, low level of education, alcohol and drug abuse, and low levels of social or partner support for PPD, have been studied (Skalkidou et al 2012). In addition, obstetric factors such as unplanned pregnancy, pregnancy complications, and delivery modes have been debated as potential risk factors (Azorin et al 2012).…”

Supraphysiological hormonal status, anxiety disorders, and COMT Val/Val genotype are associated with reduced sensorimotor gating in women

“…In comparison with non-pregnant women, estradiol levels at term are increased by approximately 50 times, and progesterone levels by 10 times, while additional hormone changes also involve the hypothalamus-pituitary-adrenal axis, thyroid hormones, prolactin as well as placenta-specific hormones (Skalkidou et al, 2012). Additionally, while the prevalence of anxiety disorders is similar to non-pregnant women (Goodman et al, 2014;Vesga-Lopez et al, 2008), anxiety symptoms may be more common than depressive also disappears following menopause (Kumari et al, 2008).…”