RESUMEN
Postpartum depression affects about 10-20% of newly delivered women, which is harmful for both mothers and infants. However, the current diagnosis of postpartum depression depends on the subjective judgment of a practitioner, which may lead to misdiagnosis. Hence, an appended objective diagnosis index may help the practitioner to improve diagnosis. A metabolomic study can find biomarkers as an objective index to facilitate disease diagnosis. Forty-nine postpartum depressed patients and 50 healthy controls were recruited into this study. The metabolites in urine were scanned with LC-Q-TOF-MS. The metabolomic data were analyzed with a multivariate statistical analysis method. Data from 40 patients and 40 controls were used for partial least square-discriminate analysis (PLS-DA). The urine metabolomic profiles of patients were different from those of controls. The PLS-DA model was validated by a permutation test, and the model could accurately classify the other 9 patients and 10 controls in T-prediction. Ten differentiating metabolites were found as main contributors to this difference, which are involved in amino acid metabolism, neurotransmitter metabolism, bacteria population, etc. Some of these potential biomarkers, such as 4-hydroxyhippuric acid, homocysteine, and tyrosine, showed relatively high sensitivities and specificities. The metabolic profile alteration induced by postpartum depression was found, and some of the differentiating metabolites may serve as biomarkers to facilitate the diagnosis of postpartum depression.
Asunto(s)
Depresión Posparto/orina , Metaboloma , Adulto , Biomarcadores/orina , Femenino , Hipuratos/orina , Homocisteína/orina , Humanos , Espectrometría de Masas , Tirosina/orinaRESUMEN
Postpartum depression (PPD) occurs in 10-15 % of women. The appetite hormone ghrelin, which fluctuates during pregnancy, is associated with depression in nonpregnant samples. Here, we examine the association between PPD and active ghrelin from pregnancy to postpartum. We additionally examine whether ghrelin changes from pregnancy to postpartum and differs between breastfeeding and non-breastfeeding women. Sixty women who participated in a survey examining PPD and had information in regard to ghrelin concentrations were included in the study. The Edinburgh Postnatal Depression Scale was used to assess symptoms of PPD. Raw ghrelin levels and ghrelin levels adjusted for creatinine were included as outcomes. Women screening positive for PPD at 12 weeks postpartum had higher pregnancy ghrelin concentrations. Ghrelin concentrations significantly decreased from pregnancy to 6 weeks postpartum and this change differed based on pregnancy depression status. Finally, ghrelin levels were lower in women who breastfed compared with women who were bottle-feeding. No significant findings remained once ghrelin levels were adjusted for creatinine. Although results do not suggest an association between PPD and ghrelin after adjusting for creatinine, future research should continue to explore this possibility extending further across the postpartum period with larger sample sizes.
Asunto(s)
Ansiedad/diagnóstico , Lactancia Materna , Depresión Posparto/diagnóstico , Ghrelina/metabolismo , Lactancia/metabolismo , Periodo Posparto/metabolismo , Adolescente , Adulto , Ansiedad/psicología , Ansiedad/orina , Alimentación con Biberón , Depresión Posparto/psicología , Depresión Posparto/orina , Femenino , Ghrelina/orina , Humanos , Lactancia/orina , Periodo Posparto/orina , Embarazo , Adulto JovenRESUMEN
BACKGROUND: Maternal postpartum depression (PPD) carries long-term detrimental effects on children's well-being, yet the mechanisms of transmission remain unclear. One possible pathway of vulnerability involves the oxytocinergic (OT) system, which is transferred from mother to child via sensitive caregiving and is disrupted in PPD. METHOD: A large birth cohort (N = 1983) of women were repeatedly assessed for depression from birth to 6 years. Utilizing an extreme case design, two matched cohorts were formed; mothers chronically depressed from birth to 6 years and nondepressed controls (N = 97, depressed = 41, nondepressed; N = 56). At 6 years, mothers and children underwent psychiatric diagnosis, urinary OT was assayed from mother and child before and after social contact, and mother-child interactions were coded. RESULTS: Baseline OT and OT response of mother and child were interrelated and children of depressed mothers showed low baseline OT and attenuated OT response. Child OT response was negatively predicted by maternal depression, child Axis-I psychopathology, maternal expressed negative affect, and child social withdrawal. Interaction effect of maternal baseline OT and depression emerged. Slope analysis indicated that when maternal OT was medium or low, child OT response was negatively impacted by maternal depression. However, when maternal OT was high, child OT was unaffected, suggesting that maternal OT functionality buffers the effects of depression on the child. CONCLUSION: Results suggest involvement of the OT system in the cross-generational transfer of vulnerability, as well as resilience, from depressed mothers to their children. Because the OT system is open to interventions that enhance maternal touch and contact, findings have important implications for targeted early dyadic inventions.
Asunto(s)
Depresión Posparto/psicología , Depresión/psicología , Conducta Materna , Relaciones Madre-Hijo , Madres/psicología , Oxitocina/orina , Tacto , Adulto , Estudios de Casos y Controles , Niño , Preescolar , Enfermedad Crónica , Depresión/diagnóstico , Depresión/orina , Depresión Posparto/diagnóstico , Depresión Posparto/orina , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Conducta SocialRESUMEN
BACKGROUND: Postpartum depression (PPD) is a common condition and may be exacerbated unless treated. There is, however, a lack of longitudinal studies about the relationship between PPD and changes in physiological status and social role postpartum. METHODS: We enrolled longitudinally 65 Japanese mothers (36 primiparas) and measured their psychological responses at 1 week, 1 month, and 4 months postpartum. The physiological indicators were three urine catecholamine fraction levels, cortisol levels, and heart-rate variability. We used the Edinburgh Postnatal Depression Scale (EPDS) and 28-item General Health Questionnaire (GHQ) for psychological evaluation. RESULTS: Eleven participants had an EPDS score ≥9 (cutoff point) at 1 month and five at 4 months. With GHQ total score, 32 participants had ≥6 (cutoff point) at 1 month and 17 at 4 months. The psychological indicators underwent change from childbirth to 4 months postpartum. However, there was no correlation between the psychological and physiological indicators. We likewise found EPDS and GHQ scores were not influenced by parity or undertaking of social activities. LIMITATIONS: The mothers׳ high education level may mean that the results are not generalizable to Japan overall. We were unable to evaluate the status of 11 mothers who dropped out. The participants may have lacked sufficient time to complete questionnaires, resulting in diminished accuracy. We could not determine the prevalence of PPD. CONCLUSIONS: Irrespective of parity status, postpartum mothers showed physiological and mental changes caused by childrearing-related stress. To prevent PPD, postnatal mothers need continuous screening with appropriate evaluating indicators and individualized advice.
Asunto(s)
Depresión Posparto/fisiopatología , Depresión Posparto/psicología , Conducta Social , Adulto , Catecolaminas/orina , Depresión Posparto/orina , Femenino , Estado de Salud , Frecuencia Cardíaca/fisiología , Humanos , Hidrocortisona/orina , Japón , Estudios Longitudinales , Embarazo , Factores de TiempoRESUMEN
OBJECTIVE: To compare 24-hour melatonin level and timing in postpartum and nonpregnant nulliparous women. Melatonin release provides information regarding circadian rhythm timing, which influences health. DESIGN: 2-group comparison of data derived from intensive within-subject data collection. SETTING: Participants' typical daily environment. PARTICIPANTS: 38 postpartum and 20 nonpregnant nulliparous women. Mothers' infants were 4 to 10 weeks of postnatal age. MAIN OUTCOME MEASURES: Urinary 6-sulfatoxymelatonin assayed from each voiding and corrected for volume using creatinine. RESULTS: Postpartum women had significantly higher baseline, lower maximum, lower percent rise, and differing pattern of 6-sulfatoxymelatonin than nonpregnant nulliparous women. CONCLUSION: Differences in melatonin suggest possible circadian rhythm disruption in the postnatal period.
Asunto(s)
Ritmo Circadiano/fisiología , Melatonina/análogos & derivados , Melatonina/fisiología , Paridad/fisiología , Periodo Posparto/fisiología , Adulto , Creatinina/orina , Estudios Transversales , Depresión Posparto/diagnóstico , Depresión Posparto/etiología , Depresión Posparto/orina , Femenino , Homeostasis , Humanos , Melatonina/orina , Análisis Multivariante , Embarazo , Escalas de Valoración Psiquiátrica , Trastornos Puerperales/diagnóstico , Trastornos Puerperales/etiología , Trastornos Puerperales/orina , Trastornos del Sueño-Vigilia/diagnóstico , Trastornos del Sueño-Vigilia/etiología , Trastornos del Sueño-Vigilia/orina , Factores de TiempoRESUMEN
Plasma tryptophan and other putative amino acids, cortisol, folate and vitamin B12 and urinary biopterin (B) and neopterins (N) were measured in three groups of women: 62 women in the early postpartum period, 23 pregnant and 38 non-gravid controls. Sixty-two postpartum women were screened for depression by the Edinburgh postnatal depression scale (EPDS) on day 7 after delivery. Postpartum women had significantly lower tryptophan, vitamin B12 and significantly greater levels of cortisol, folate, neopterins and biopterins than controls. Comparisons between women who were classified on the EPDS as cases and non-cases revealed only a statistically significant difference for lower N:B (P<0.01) and lower folate (P<0.01) ratio in cases than non-cases. Multiple regression analysis showed a significant contribution for low tryptophan to increased EPDS which also showed significant correlations with low methionine, low tyrosine, low N:B ratio and high vitamin B12.
Asunto(s)
Depresión Posparto/etiología , Ácido Fólico/fisiología , Pterinas/metabolismo , Triptófano/fisiología , Adulto , Análisis de Varianza , Biopterinas/análogos & derivados , Biopterinas/metabolismo , Depresión Posparto/sangre , Depresión Posparto/metabolismo , Depresión Posparto/orina , Femenino , Ácido Fólico/sangre , Humanos , Hidrocortisona/sangre , Hidrocortisona/fisiología , Periodo Posparto/metabolismo , Pterinas/orina , Triptófano/sangreRESUMEN
Phenylethylamine and cortisol were measured in 24-h urine samples taken from women day 2/3 postpartum, and matched controls. They also completed self-rating blues and highs scales. There was no significant difference in phenylethylamine excretion in those who scored highly with blues or highs, and either postpartum or normal controls. The number of raised values for phenylethylamine output was significantly greater in the postpartum women, who had no psychopathology, than in normal controls. Cortisol levels were significantly raised in postpartum controls compared with normal controls; women with the highs excreted significantly less cortisol than other postpartum women.