Mood changes in the first three weeks after childbirth

Kendell, R. E.; McGuire, Ross; Connor, Yvonne M.; Cox, John

doi:10.1016/0165-0327(81)90001-x

Cited by 146 publications

(62 citation statements)

References 7 publications

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“…Following the increase in THP during pregnancy when levels are increased several-fold beyond their levels during the cycle, the decline in THP at partrurition represents the most significant steroid withdrawal state. Emotional reactivity is very common in the early postpartum period, when anxiety and irritability are also reported (Kendell et al, 1981). In the pseudopregnancy rodent model, direct withdrawal from THP (Smith et al, 1998b) in the presence of high circulating levels of progesterone increased the α4 subunit in association with increases in anxiety.…”

Section: Postpartum and Postmenopausal Dysphoriamentioning

confidence: 99%

“…In the pseudopregnancy rodent model, direct withdrawal from THP (Smith et al, 1998b) in the presence of high circulating levels of progesterone increased the α4 subunit in association with increases in anxiety. Postpartum blues, however, may be related to changes other than GABAR-related alterations (Kendell et al, 1981).…”

Section: Postpartum and Postmenopausal Dysphoriamentioning

confidence: 99%

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Neurosteroid regulation of GABAA receptors: Focus on the α4 and δ subunits

Smith

Shen

Gong

et al. 2007

Pharmacology & Therapeutics

216

197

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Neurosteroids, such as the progesterone metabolite 3α-OH-5α[β]-pregnan-20-one (THP or [allo] pregnanolone), function as potent positive modulators of the GABA A receptor (GABAR) when acutely administered. However, fluctuations in the circulating levels of this steroid at puberty, across endogenous ovarian cycles, during pregnancy or following chronic stress produce periods of prolonged exposure and withdrawal, where changes in GABAR subunit composition may occur as compensatory responses to sustained levels of inhibition. A number of laboratories have demonstrated that both chronic administration of THP as well as its withdrawal transiently increase expression of the α4 subunit of the GABAR in several areas of the central nervous system (CNS) as well as in in vitro neuronal systems. Receptors containing this subunit are insensitive to benzodiazepine (BDZ) modulation and display faster deactivation kinetics, which studies suggest underlie hyperexcitability states. Similar increases in α4 expression are triggered by withdrawal from other GABA-modulatory compounds, such as ethanol and BDZ, suggesting a common mechanism. Other studies have reported puberty or estrous cycle-associated increases in δ-GABAR, the most sensitive target of these steroids which underlies a tonic inhibitory current. In the studies reported here, the effect of steroids on inhibition, which influence anxiety state and seizure susceptibility, depend not only on the subunit composition of the receptor but also on the direction of Cl -current generated by these target receptors. The effect of neurosteroids on GABAR function thus results in behavioral outcomes relevant for pubertal mood swings, premenstrual dysphoric disorder and catamenial epilepsy, which are due to fluctuations in endogenous steroids.

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Section: Postpartum and Postmenopausal Dysphoriamentioning

confidence: 99%

Section: Postpartum and Postmenopausal Dysphoriamentioning

confidence: 99%

Neurosteroid regulation of GABAA receptors: Focus on the α4 and δ subunits

Smith

Shen

Gong

et al. 2007

Pharmacology & Therapeutics

216

197

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“…The coincidence of the maternity blues with the major hormonal changes associated with parturition has led to investigations of a biological basis to the condition, but findings are generally inconsistent (Steiner, 1998). Similarly, there is no consistent evidence for the contribution of parity (Kendell et al, 1981), obstetric factors (Condon & Watson, 1987), hospital or home as place of delivery (Kendell et al, 1981), or personal or family history of mood disorder (O'Hara et al, 1991) to incidence or severity of the condition. The distress peaks between days 3 and 5 postpartum and usually resolves spontaneously without specialist intervention.…”

Section: Postpartum Blues or Mild Transient Mood Disturbancementioning

confidence: 99%

Maternal Perinatal Mental Health and Multiple Births: Implications for Practice

Fisher¹,

Stocky

2003

Twin res.

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“…History of major depression increases risk by 25% and past history of postpartum depression increases recurrence rates by 25%. 25 The signs and symptoms are generally the same as those associated with major depression occurring at other times, including depressed mood, anhedonia and low energy, anxiety and suicidal ideation.…”

Section: Postpartum Bluesmentioning

confidence: 99%