Predicting Postpartum Depression

Postpartum Depression
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The report published in the February issue of Archives of General Psychiatry suggests measuring the levels of a hormone produced by the placenta during pregnancy might predict whether a woman is likely to develop postpartum depression.

The hormone is placental corticotropin-releasing hormone (pCRH). There appears to be a sensitive period in mid-pregnancy during which pCRH is a moderate and independent predictor of PPD symptoms.

Postpartum mood disorders can range from the mild and common postpartum "blues" to much rarer incidences of severe postpartum psychosis. The most commonly studied postpartum mood disorder is postpartum depression (PPD). Postpartum depression not only influences the well-being of the new mother but also has adverse effects on the cognitive and behavioral development of her infant. Reports of PPD prevalence vary widely, but is estimated to affect 13-19.2% of women within the first 3 months post partum. Once a woman has had postpartum depression, she is more likely to have future bouts of depression.

The study followed one hundred adult women with a singleton pregnancy. Blood samples were obtained to assess pCRH, cortisol, and ACTH levels at various stages of the pregnancey. Depressive symptoms were assessed at the last 4 time points during pregnancy and again at the postpartum visit.

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Sixteen women developed PPD symptoms. In each case, the women had had high levels of pCRH at 25 weeks into their pregnancies, the study found.

The blood test, which was found to have a high degree of both specificity and sensitivity. It was possible to identify about 75 percent of women who would develop postpartum depression. The test misclassified about 25 percent of the women.

If the study results can be replicated by future studies, it would appear by means of a simple blood draw, doctors could correctly identify 75 percent of women who would later develop postpartum depression.

Postpartum depression generally begins within four to six weeks after delivery. Risk factors include a history of depression, stressful life events, a lack of social support, low self-esteem and depression, anxiety or stress during pregnancy.

More information on Depression and Pregnancy
The National Women's Health Information Center

Source
Risk of Postpartum Depressive Symptoms With Elevated Corticotropin-Releasing Hormone in Human Pregnancy; Arch Gen Psychiatry. 2009;66(2):162-169; Ilona S. Yim, PhD; Laura M. Glynn, PhD; Christine Dunkel Schetter, PhD; Calvin J. Hobel, MD; Aleksandra Chicz-DeMet, PhD; Curt A. Sandman, PhD

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