Steroid Hormones in the Development of Postpartum Depression

Abstract

Postpartum depression affects 10-15 % women after childbirth. There is no currently generally accepted theory about the causes and mechanisms of postpartum mental disorders. The principal hypothesis concerns the association with sudden changes in the production of hormones affecting the nervous system of the mother and, on the other hand, with the ability of receptor systems to adapt to these changes. We observed changes in steroidogenesis in the period around spontaneous delivery. We collected three samples of maternal blood. The first sampling was 4 weeks prior to term; the second sampling was after the onset of uterine contractions (the beginning of spontaneous labour); the third sampling was during the third stage of labour (immediately after childbirth). Additionally, we collected mixed umbilical cord blood. The almost complete steroid metabolome was analyzed by gas chromatography-mass spectrometry followed by RIA for some steroids. Mental changes in women in the peripartum period were observed using the Hamilton Depression Rating Scale. The local Ethics Committee approved the study. We found already the changes in androgens levels correlating with postpartum mood disorders four weeks prior to childbirth. The strongest correlations between steroid and postpartum mood change were found in venous blood samples collected from mothers after childbirth and from umbilical cord blood. The main role played testosterone, possibly of maternal origin, and estrogens originating from the fetal compartment. These results suggest that changes in both maternal and fetal steroidogenesis are involved in the development of mental changes in the postpartum period. Descriptions of changes in steroidogenesis in relation to postpartum depression could help clarify the causes of this disease, and changes in some steroid hormones are a promising marker of mental changes in the postpartum period.

The delivery of a placenta/fetus with high gonadal steroid production contributes to postpartum depressive symptoms

“…It is noteworthy that the fetus and placenta, as well as maternal gonadal glands, produce gonadal steroids; therefore, the delivery of the fetus and placenta should theoretically have an impact on the drop in the concentration of gonadal steroids in women through the loss of the additive production of gonadal steroids from the fetus and placenta. Only one study with a fairly small sample size (44 mothers) reported a correlation between gonadal steroid levels in umbilical cord blood and maternal mental health (Parizek et al, 2014). Higher levels of estradiol and progesterone were observed in the umbilical cord blood of newborns with mothers who developed some degree of depression in the postpartum period.…”

Who Is Suffering from the “Corona Blues”? An Analysis of the Impacts of the COVID-19 Pandemic on Depression and Its Implications for Health Policy

“…Moreover, regarding physical and genetic factors influencing depression, Seney et al [ 72 ] showed that sex chromosome complement regulates expression of mood-related genes. Pařízek et al [ 73 ] demonstrated that the strongest correlations between steroid and postpartum depression change. Other variables other than demographic variables were not included in this study, which is a limitation of this paper.…”

Transcriptome Sequencing in the Preoptic Region of Rat Dams Reveals a Role of Androgen Receptor in the Control of Maternal Behavior

“…In the postpartum and peripartum period, androgens correlated in humans with mood disorders. Androgen levels in venous blood samples collected from mothers after childbirth correlated positively with severity of depressive symptoms [46]. Markedly elevated testosterone levels were measured in postpartum depression at 24-28 h after childbirth, when compared to controls.…”