Evaluation of the Association Between Placental Corticotrophin-Releasing Hormone and Postpartum Depressive Symptoms

Glynn, Laura M.; Sandman, Curt A.

doi:10.1097/psy.0000000000000066

Cited by 71 publications

(80 citation statements)

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“…19 In addition, another study found that higher levels of pCRH during mid-pregnancy were associated with depressive symptoms at 3-months postpartum. 20 Together, these studies support the hypothesis that changes in certain HPA markers (sCORT and pCRH) may be associated with increased depressive symptoms in the postpartum period. However, contrary to our hypothesis, we did not find an association between emotional memory during pregnancy and postpartum depressive symptoms.…”

Section: Discussionsupporting

confidence: 65%

Salivary cortisol during memory encoding in pregnancy predicts postpartum depressive symptoms: a longitudinal study

Williams

Frey

2017

Trends Psychiatry Psychother.

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Trends in Psychiatry and Psychotherapy Brief Communication ResumoIntrodução: A depressão pós-parto é um transtorno prevalente que afeta negativamente a qualidade de vida da mãe e da criança. Neste estudo longitudinal, nós investigamos se a memória emocional, o cortisol salivar (salivary cortisol, sCORT) ou alfa-amilase durante a gravidez predizem sintomas depressivos no período pós-parto. Métodos: Um total de 44 mulheres grávidas [14 eutímicas com diagnóstico de transtorno depressivo maior (TDM) e 30 voluntárias sadias] entre 19 e 37 anos de idade (idade média = 29.5±4.1 anos) foram avaliadas longitudinalmente no 2º trimestre da gravidez (12-22 semanas de gestação) e na 14-17ª semana pós-parto. Sintomas depressivos foram avaliados com a Escala de Depressão Pós-Natal de Edimburgo (Edinburgh Postnatal Depression Scale, EPDS). Resultados: Quarenta e uma mulheres completaram o seguimento (7% de perda). sCORT coletado imediatamente antes de um teste de aquisição memória durante a gravidez foi preditor dos escores da escala EPDS no período pós-parto (b=-0.78, t -2.14 , p=0.04). Memória emocional positiva (p=0.27) ou negativa (p=0.85) não foram preditores dos escores da escala EPDS no período pós-parto. Conclusão: Os resultados deste estudo indicam que altos níveis de sCORT durante um teste de aquisição de memória no 2º trimestre da gravidez foram associados com baixos escores na escala EPDS no período pós-parto. Uma vez que o eixo hipotálamo-hipófise-adrenal (HHA) tenha sido envolvido na neurobiologia do TDM, o papel do eixo HHA na depressão perinatal merece mais atenção. Descritores: Gravidez, depressão pós-parto, transtorno depressivo maior, cortisol salivar, memória emocional. AbstractIntroduction: Postpartum depression (PPD) is a common disorder that substantially decreases quality of life for both mother and child. In this longitudinal study, we investigated whether emotional memory, salivary cortisol (sCORT) or alphaamylase during pregnancy predict postpartum depressive symptoms. Methods: Forty-four pregnant women (14 euthymic women with a diagnosis of major depressive disorder [MDD] and 30 healthy women) between the ages of 19 and 37 years (mean age = 29.5±4.1 years) were longitudinally assessed in the 2nd trimester of pregnancy (12-22 weeks of gestational age) and again at 14-17 weeks postpartum. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Results: Follow-ups were completed for 41 women (7% attrition). Postpartum EPDS scores were predicted by sCORT collected immediately after an incidental encoding memory task during pregnancy (b=-0.78, t -2.14 , p=0.04). Postpartum EPDS scores were not predicted by positive (p=0.27) or negative (p=0.85) emotional memory. Conclusions:The results of this study indicate that higher levels of sCORT during a memory encoding task in the 2nd trimester of pregnancy are associated with lower postpartum EPDS scores. While the hypothalamus-pituitary-adrenal (HPA) axis has long been associated with the neurobiology of MDD, the role of the HPA...

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Section: Discussionsupporting

confidence: 65%

Salivary cortisol during memory encoding in pregnancy predicts postpartum depressive symptoms: a longitudinal study

Williams

Frey

2017

Trends Psychiatry Psychother.

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“…Although pregnancy is accompanied by profound changes in the neuroendocrine system, characterized by pituitary gland enlargement, and increases in pituitary peptide output (Glynn et al 2013) and CRH production (Horan et al 2000; Glynn et al 2013), chronic overproduction of glucocorticoid hormones, particularly CRH, before and during pregnancy in women with early life stress, may play a role in higher rates of adverse pregnancy outcomes among these women (Horan et al 2000). This hypothesis is supported by research linking elevated CRH concentrations with increased risk of depression in postpartum (Yim et al 2009; Hahn-Holbrook et al 2013; Glynn and Sandman 2014). …”

Section: Discussionmentioning

confidence: 79%

History of childhood sexual abuse and risk of prenatal and postpartum depression or depressive symptoms: an epidemiologic review

Wosu

Gelaye

Williams

2015

Arch Womens Ment Health

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Purpose The objective of this review is to summarize the literature (and to the extent possible, report the magnitude and direction of the association) concerning history of CSA and depression or depressive symptoms among pregnant and postpartum women. Methods Publications were identified through literature searches of seven databases (PubMed, EMBASE, PyscINFO, CINAHL, Web of Science, BIOSIS, and Science Direct) using keywords including “child abuse,” “depression,” “pregnancy,” “prenatal,” “pregnancy,” and “postpartum”. Results The literature search yielded seven eligible studies on the prenatal period and another seven studies on the postpartum period. All, but one prenatal study observed statistically significant positive associations of CSA with depression or depressive symptoms during pregnancy. Findings on the association of CSA with postpartum depression or depressive symptoms were inconsistent; pooled unadjusted and adjusted odds ratios were 1.82 (95% CI 0.92, 3.60) and 1.20 (95% CI 0.81, 1.76). Conclusions In sum, findings suggest a positive association of history of CSA with depression and depressive symptoms in the prenatal period. Findings on the postpartum period were inconsistent. Clinical and public health implications of evidence from the available literature are discussed, as are desirable study design characteristics of future research.

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“…Intra-assay and interassay coefficients ranged from 5% to 15%, respectively. For additional details, see Glynn and Sandman (2014).…”

Section: Methodsmentioning

confidence: 99%

Fetal exposure to placental corticotropin-releasing hormone is associated with child self-reported internalizing symptoms

Howland

Sandman

Glynn

et al. 2016

Psychoneuroendocrinology

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Objective Fetal exposure to maternal prenatal stress hormones such as cortisol exerts influences on the developing nervous system that persist and include risk for internalizing symptoms later in life. Placental corticotropin-releasing hormone (pCRH) is a feto-placental stress signal that also shapes fetal neurodevelopment and may be a more direct indicator of the fetal experience than maternal stress hormones. The programming effects of pCRH on child development are unknown. The current investigation examined associations between prenatal maternal and placental stress hormone exposures (maternal cortisol and pCRH) and child self-reported internalizing symptoms at age 5. Method Maternal plasma cortisol and pCRH levels were measured at 15, 19, 25, 31, and 36 weeks’ gestation in a sample of 83 women and their 91 children (8 sibling pairs from separate pregnancies), who were born full-term. Child self-reported internalizing symptoms at age 5 were obtained using scales of the Berkeley Puppet Interview. Results Placental CRH profiles (including elevations in mid-gestation) were associated with higher levels of internalizing symptoms at age 5. This effect was not explained by critical prenatal or postnatal influences, including obstetric risk, concurrent maternal psychological state, and family socio-economic status. Prenatal maternal cortisol was not significantly associated with child self-reported internalizing symptoms. Conclusions Findings suggest that elevated exposures to the feto-placental stress signal pCRH exert programming effects on the developing fetal central nervous system, with lasting consequences for child mental health.

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Evaluation of the Association Between Placental Corticotrophin-Releasing Hormone and Postpartum Depressive Symptoms

Abstract: The current prospective study provides results that reconcile both the positive and negative findings in the existing literature and identifies elevated pCRH as a marker of risk for the development of PPD symptoms.

Cited by 71 publications

References 71 publications

Salivary cortisol during memory encoding in pregnancy predicts postpartum depressive symptoms: a longitudinal study

Salivary cortisol during memory encoding in pregnancy predicts postpartum depressive symptoms: a longitudinal study

History of childhood sexual abuse and risk of prenatal and postpartum depression or depressive symptoms: an epidemiologic review

Fetal exposure to placental corticotropin-releasing hormone is associated with child self-reported internalizing symptoms

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