Cerebrospinal Fluid CRH Levels in Late Pregnancy Are Not Associated With New-Onset Postpartum Depressive Symptoms

Context: CRH participates in the hypothalamic-pituitary-adrenal axis and in neural circuits involved in the pathophysiology of depression. During pregnancy, the placenta produces large amounts of CRH, and production ceases abruptly after delivery. The relationship between CRH in the cerebrospinal fluid (CSF) during pregnancy and peripartum mood disorders has not been investigated. Objectives: The objectives were to determine whether there are differences in CSF CRH concentrations of pregnant and nonpregnant women and whether CSF CRH concentrations in late pregnancy are associated with the presence of depressive symptoms during pregnancy and in the early postpartum period. Design: This was a prospective cohort study conducted from January to April, 2011. Setting: The study was conducted in one public and two private hospitals in Brasilia, Brazil. Patients: Patients included 107 healthy pregnant women who underwent elective cesarean delivery and 22 nonpregnant healthy women who underwent spinal anesthesia for elective surgical sterilization. Intervention: CRH in CSF was measured in pregnant and nonpregnant women by ELISA. Main Outcome Measure: The association between CSF CRH concentration at delivery and maternal depression assessed before cesarean section and postpartum (4 to 8 wk) with the Edinburgh Postnatal Depression Scale (EPDS), with a cutoff of ≥ 13. Results: CRH concentration in the CSF was significantly higher in pregnant (4.1 ± 0.51 log CRH) than in nonpregnant women (3.6 ± 0.26 log CRH) (P < .001). Depressive symptoms starting after delivery occurred in 5.6% of women. CRH concentration in CSF was not different between women without depressive symptoms and women showing such symptoms during pregnancy or in the postpartum period. Conclusion: CRH concentration in the CSF was higher in pregnant women than in nonpregnant women. However, in this sample, CSF CRH in late pregnancy was not associated with new-onset depressive symptoms in the early postpartum period.

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Pregnancy, perinatal and postpartum complications as determinants of postpartum depression: the Rhea mother–child cohort in Crete, Greece

Epidemiology and Psychiatric Sciences ◽

10.1017/s2045796016001062 ◽

2016 ◽

Vol 27 (3) ◽

pp. 244-255 ◽

Cited By ~ 11

Author(s):

K. Koutra ◽

M. Vassilaki ◽

V. Georgiou ◽

A. Koutis ◽

P. Bitsios ◽

...

Keyword(s):

Depressive Symptoms ◽

Postpartum Depression ◽

Postpartum Period ◽

Depression Scale ◽

Effective Prevention ◽

Maternal Mood ◽

Early Postpartum Period ◽

Early Postpartum ◽

Wide Range ◽

Clinical Records

Aims.Few epidemiological studies evaluated associations between perinatal complications and maternal mood at the early postpartum period and the findings are inconsistent. We aimed at investigating a wide range of complications during pregnancy, at delivery, and at the early postpartum period as determinants of postpartum depression (PPD) at 8 weeks postpartum.Methods.A total of 1037 women who enrolled in the Rhea mother–child cohort in Crete, Greece participated in the present study. Information on pregnancy, perinatal and postpartum complications was obtained from clinical records or by questionnaires. Postpartum depressive symptoms were assessed at 8 weeks postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Multivariable linear and logistic regression models were fit to estimate the association between pregnancy, perinatal and postpartum complications and maternal depressive symptoms, adjusting also for potential confounders.Results.The prevalence of women with probable depression (EPDS score ≥ 13) was 13.6% at 8 weeks postpartum. Gestational hypertension and/or preeclampsia (β coefficient 1.86, 95% CI: 0.32, 3.41) and breastfeeding difficulties (β coefficient 0.77, 95% CI: 0.02, 1.53) were significantly associated with higher PPD symptoms. Sleep patterns during pregnancy, such as sleep deprivation (OR = 3.57, 95% CI: 1.91, 6.67) and snoring (OR = 1.81, 95% CI: 1.11, 2.93), and breastfeeding duration less than 2 months (OR = 1.77, 95% CI: 1.19, 2.64) were significantly associated with increase in the odds for PPD. Some other complications, such as unplanned pregnancy and hospitalisation during pregnancy were also associated with EPDS score, but these associations were explained by socio-demographic characteristics of the mother.Conclusions.We found that several pregnancy, perinatal and postpartum complications may have an adverse effect on maternal mood at the early postpartum period. These findings have considerable implications for developing effective prevention and early psychoeducational intervention strategies for women at risk of developing PPD.

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Relationship between inflammatory biomarkers and depressive symptoms during late pregnancy and the early postpartum period: a longitudinal study

Brazilian Journal of Psychiatry ◽

10.1590/1516-4446-2015-1899 ◽

2016 ◽

Vol 38 (3) ◽

pp. 190-196 ◽

Cited By ~ 23

Author(s):

William Simpson ◽

Meir Steiner ◽

Marg Coote ◽

Benicio N. Frey

Keyword(s):

Depressive Symptoms ◽

Longitudinal Study ◽

Postpartum Period ◽

Late Pregnancy ◽

Inflammatory Biomarkers ◽

Early Postpartum Period ◽

Early Postpartum

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Exclusive Breastfeeding Is Not Associated with Maternal–Infant Bonding in Early Postpartum, Considering Depression, Anxiety, and Parity

Nutrients ◽

10.3390/nu13041184 ◽

2021 ◽

Vol 13 (4) ◽

pp. 1184

Author(s):

Naoki Fukui ◽

Takaharu Motegi ◽

Yuichiro Watanabe ◽

Koyo Hashijiri ◽

Ryusuke Tsuboya ◽

...

Keyword(s):

Mental Health ◽

Path Analysis ◽

Exclusive Breastfeeding ◽

Postpartum Period ◽

Depression Scale ◽

Anxiety And Depression ◽

Women’S Mental Health ◽

Women's Mental Health ◽

Early Postpartum Period ◽

Early Postpartum

It is important to clarify how the breastfeeding method affects women’s mental health, and how women’s mental health affects the breastfeeding method in the early postpartum period when major depression and other psychiatric problems are most likely to occur. This study aimed to examine this bidirectional relationship in the early postpartum period. Participants were 2020 postpartum women who completed the Hospital Anxiety and Depression Scale (HADS) and Mother-to-Infant Bonding Scale (MIBS). We obtained data for participants’ breastfeeding method for four weeks after childbirth. We performed a path analysis with factors including breastfeeding method (exclusive breastfeeding or non-exclusive breastfeeding), parity (primipara or multipara), the two HADS subscales (anxiety and depression), and the two MIBS subscales (lack of affection and anger and rejection). The path analysis showed that breastfeeding method did not significantly affect depression, anxiety, and maternal–infant bonding in the early postpartum period. Women with higher anxiety tended to use both formula-feeding and breastfeeding. Our study suggests that exclusive breastfeeding is not associated with maternal-fetal bonding in early postpartum, considering depression, anxiety, and parity.

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Hemostatic profile during late pregnancy and early postpartum period in mares

Theriogenology ◽

10.1016/j.theriogenology.2013.12.003 ◽

2014 ◽

Vol 81 (4) ◽

pp. 639-643 ◽

Cited By ~ 9

Author(s):

M. Bazzano ◽

C. Giannetto ◽

F. Fazio ◽

S. Marafioti ◽

E. Giudice ◽

...

Keyword(s):

Postpartum Period ◽

Late Pregnancy ◽

Early Postpartum Period ◽

Early Postpartum

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Secretion of inhibin A and inhibin B throughout pregnancy and the early postpartum period in chimpanzees

Journal of Endocrinology ◽

10.1677/joe.0.1680257 ◽

2001 ◽

Vol 168 (2) ◽

pp. 257-262 ◽

Cited By ~ 4

Author(s):

M Kondo ◽

T Udono ◽

WZ Jin ◽

...

Keyword(s):

Menstrual Cycle ◽

Postpartum Period ◽

Plasma Concentrations ◽

Late Pregnancy ◽

Inhibin B ◽

Enzyme Linked Immunosorbent Assay ◽

Inhibin A ◽

Early Postpartum Period ◽

Early Postpartum ◽

Normal Menstrual Cycle

Plasma concentrations of inhibin A and inhibin B during pregnancy and early lactation in chimpanzees were determined by enzyme-linked immunosorbent assay (ELISA). Plasma samples were taken from five pregnant chimpanzees at 6-9, 10, 20 and 25 weeks of pregnancy, and following parturition. Throughout pregnancy and the early postpartum period, circulating inhibin A and inhibin B concentrations remained low, at similar levels to those during the normal menstrual cycle in chimpanzees. Concentrations of inhibin A in the placental homogenate were high enough to be measured by the ELISA and by bioassay, whereas circulating inhibin bioactivities in late pregnancy were too low to be measured. Plasma concentrations of FSH remained low with no significant changes throughout pregnancy and the postpartum period. Plasma concentrations of oestradiol-17beta and progesterone at 25 weeks of pregnancy were much higher than normal menstrual cycle levels. It was concluded that in chimpanzees the levels of circulating inhibin A and inhibin B remained low throughout pregnancy and the early postpartum period, and that the concentrations of bioactive dimeric inhibin did not increase towards the end of pregnancy. The suppression of circulating FSH levels during pregnancy is suggested to be controlled by steroid hormones that increased significantly in late pregnancy, and the present findings further suggest that the secretory pattern and role of inhibin during pregnancy in chimpanzees may be different from that in human and other primates.

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Reference ranges of rotational thromboelastometry parameters in pregnant women and puerperas: a single-center randomized trial

Тромбоз, гемостаз и реология ◽

10.25555/thr.2020.3.0928 ◽

2020 ◽

Author(s):

Ю.С. Распопин ◽

В.В. Потылицина ◽

А.И. Грицан ◽

А.В. Ковалев ◽

И.А. Ольховский

Keyword(s):

Pregnant Women ◽

Postpartum Period ◽

Reference Intervals ◽

Reference Ranges ◽

Rotational Thromboelastometry ◽

Early Postpartum Period ◽

Krasnoyarsk Region ◽

Early Postpartum ◽

Coagulation Tests ◽

Obstetric Surgery

Введение: В последнее время стали востребованы интегральные тесты оценки системы гемостаза у женщин во время беременности, а также во время акушерских операций, связанных с кровотечением. В нашей стране отсутствуют работы по определению популяционных норм ротационной тромбоэластометрии (РОТЕМ) у беременных, рожениц и родильниц. Цель исследования: определить пределы референсных интервалов показателей РОТЕМ во время физиологически протекающей беременности и в раннем послеродовом периоде и провести корреляционный анализ со стандартными показателями коагулограммы. Материалы и методы: Обследовано 229 женщин Красноярского края, которые были поделены на 5 групп: небеременные (контроль), беременные II и III триместров, женщины раннего послеродового периода после операции кесарева сечения и естественных родов. Все женщины были сопоставимы по возрасту, индексу массы тела, сопутствующей патологии. Референсные интервалы рассчитывали либо через среднее и стандартное отклонение (для нормального распределения), либо через медиану и 2,5 и 97,5% перцентили (для ненормального распределения). Результаты: В процессе исследования подтвердилось, что во время беременности и в раннем послеродовом периоде происходят изменения в системе гемостаза в сторону гиперкоагуляции. Показатели ROTЕM у женщин в III триместре беременности и раннем послеродовом периоде существенно отличаются от показателей небеременных в популяции. У женщин после родов вне зависимости от способа родоразрешения различий между параметрами ROTЕM не установлено. Корреляция между параметрами ROTЕM и традиционными лабораторными тестами коагуляции выявила взаимосвязь между амплитудой плотности сгустка в тесте FIBTEM и уровнем фибриногена по Клаусу. Заключение: Представлены референсные интервалы параметров РОТЕМ у женщин Красноярского края. Найдена корреляция между параметрами РОТЭМ и уровнем фибриногена. Background: Recently, integral tests for hemostasis assessment in pregnant women as well as during obstetric surgery associated with bleeding have become popular. In our country, there are no studies of population norms for rotational thromboelastometry (ROTEM) in pregnant women, parturients and puerperants. Objectives: to identify reference intervals limits for ROTEM parameters during physiological pregnancy and in early postpartum period and to carry out correlation analysis with standard coagulogram parameters. Patients/Methods: We examined 229 women in Krasnoyarsk region; they were divided into 5 groups: nonpregnant (control), pregnant women in II and III trimesters, women in early postpartum period after cesarean section and after vaginal delivery. All women were comparable in age, body mass index, and concomitant pathology. Reference intervals were calculated either as the mean and standard deviation (for normal distribution), or as the median and 2.5 and 97.5% percentiles (for abnormal distribution). Results: The study confirmed hemostasis hypercoagulation changes during pregnancy and in early postpartum period. ROTEM parameters in women in III trimester of pregnancy and in early postpartum period differ significantly from those in non-pregnant women. Differences between ROTEM parameters in puerperants, regardless of the delivery method, not found. The correlation between ROTEM parameters and traditional laboratory coagulation tests revealed a relationship between clot density amplitude in FIBTEM test and Klaus fi brinogen level. Conclusions: Reference intervals of ROTEM parameters in women of Krasnoyarsk region are presented. A correlation was found between ROTEM parameters and fibrinogen level

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