Thyroid peroxidase antibodies during gestation are a marker for subsequent depression postpartum

Abstract

Objective: Depression is not adequately diagnosed in many cases. Therefore, the question arises as to whether markers exist for depression. We investigated whether the presence of thyroperoxidase antibodies (TPOAbs) during pregnancy can be regarded as a marker for depression in the ®rst year postpartum, particularly in relation to (overt or subclinical) thyroid dysfunction and other determinants of depression. Design: This work was a prospective observational study. Patients: A cohort of 310 unselected women (residing in the Kempen Region, southeastern Netherlands) were visited at 12 and 32 weeks gestation and at 4, 12, 20, 28 and 36 weeks postpartum. Methods: At each visit, TSH, free thyroxine and TPOAb testing was performed, determinants associated with depression were asked for, and depression was assessed (according to the Research Diagnostic Criteria). Multiple logistic regression was performed to determine independent risk factors (odds ratios, ORs) for depression in gestation and/or postpartum depression. Results: Data for 291 women were available for analysis; 41 women (14.1%) had TPOAbs at one or more time points, and 117 women (40.1%) had depression at one or more time points postpartum. The multiple logistic regression analysis showed that TPOAbs were independently associated with depression at 12 weeks gestation and at 4 and 12 weeks postpartum (OR, 95% con®dence interval: 2.4 (1.1±6.0), 3.8 (1.3±7.3) and 3.6 (1.2±7.1) respectively). After the exclusion of women who were depressed at 12 weeks gestation n 70, the presence of TPOAbs during early pregnancy was still found to be associated with the development of postpartum depression (OR, 95% con®dence interval: 2.8 (1.7±4.5); after exclusion of women who had had depression in earlier life n 51, TPOAb during early gestation was still associated with postpartum depression (OR, 95% con®dence interval: 2.9 (1.8±4.3). Conclusions: The presence of TPOAbs during gestation is associated with the occurrence of subsequent depression during the postpartum period and as such can be regarded as a marker for depression.

Vitamin D Level, Thyroid Function, and Maternal Depression in Late Pregnancy

“…However, several studies have been conducted on thyroid function and postpartum depression, and the current researchers found a few studies reporting a relationship between AND and thyroid function. A recent prior publication by Kuijpens et al reported an association between TPOAb positivity and mood disturbance during pregnancy (39). In line with the current study, in studies by Koleva et of AND (42).…”

Thyrotropin, but not a polymorphism in type II deiodinase, predicts response to paroxetine in major depression

“…Because of the low prevalence of patients with a positive TPO antibody titer in our study, we could not address this hypothesis. Some indication of the importance of TPO antibodies was given by a study wherein the presence of TPO-antibodies in the first trimester of pregnancy, but not subclinical hypothyroidism per se, predicted postpartum depression (33). A recent study described that the presence of Thyroid Binding Inhibitory Immunoglobulins was related to treatment non-response in depressed patients (34).…”

Post-partum thyroiditis--a clinical update

“…Positive TPOAb pregnant women have an increased risk of developing post-partum depression (22) and of giving birth to neonates that in childhood will have a lower IQ in comparison with children of mothers without TPOAb during pregnancy (23). However, it should be considered that L-T 4 treatment will not prevent depression and probably will be beneficial only in pregnant women with low serum FT 4 concentrations.…”