Postpartum blues: Salivary cortisol and psychological factors

Ehlert, Ulrike; Patalla, U; Kirschbaum, Clemens; Piedmont, Eugene B.; Hellhammer, Dirk H.

doi:10.1016/0022-3999(90)90088-l

Cited by 65 publications

(38 citation statements)

References 22 publications

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“…In this laboratory, however, we observed sig nificant correlations of morning cortisol lev els in children and their mothers [27], as well as in adults between life partners [ 19], Marital relationships predict, in part, cortisol changes and postpartum blues in young mothers [30], Furthermore, we just finished a study demon strating significantly different cortisol re sponses to stress in groups of young men as a function of their positions in a dominance hierarchy. Thus, social relationships may in fluence PAA reactivity in stress situations to a considerable degree.…”

Section: Social Factors Modify Stress Reactivitymentioning

confidence: 97%

Endocrine Correlates of Stress Vulnerability

Hellhammer

Wade

1993

Psychother Psychosom

127

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Psychological stress is implicated as one element in a constellation of risk factors for the development and maintenance of psychosomatic disease. Endocrine responses to stressful experience vary widely among individuals, and may account for some of the individual variability in vulnerability to development of psychosomatic symptoms under stress. Endocrine stress responsiveness probably has a large genetic component, but is also known to be modifiable by prolonged and/or profound stressful experience. Social and cognitive factors influence the pituitary-adrenal response to stress, and sex differences may also be significant. It may be possible to develop specific tests of endocrine responsiveness, perhaps incorporating psychological and pharmacological challenges, that may serve as markers of chronic stress experience or of vulnerability to psychosomatic disorders.

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Section: Social Factors Modify Stress Reactivitymentioning

confidence: 97%

Endocrine Correlates of Stress Vulnerability

Hellhammer

Wade

1993

Psychother Psychosom

127

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“…In addition, dysregulation of the normal recuperation of the HPA axis in the postpartum period has been implicated in mood disorders occurring in that time period. For example, women who develop the postpartum 'blues' have been reported to have higher postpartum cortisol levels [133,134] , higher ACTH levels, a greater fall in CRH levels [62] and blunted responses to CRH testing [61] . In another study, patients with postpartum thoughts of harming the infant had higher levels of ACTH in the immediate postpartum period compared to women without these intrusive thoughts [135] .…”

Section: Maternal Consequences Of Stress and Altered Hpa Axis Activitmentioning

confidence: 99%

Changes in the Maternal Hypothalamic-Pituitary-Adrenal Axis in Pregnancy and Postpartum: Influences on Maternal and Fetal Outcomes

Duthie¹,

Reynolds²

2013

Neuroendocrinology

274

221

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Overexposure of the developing fetus to glucocorticoids is hypothesised to be one of the key mechanisms linking early life development with later life disease. The maternal hypothalamic-pituitary-adrenal (HPA) axis undergoes dramatic changes during pregnancy and postpartum. Although cortisol levels rise threefold by the third trimester, the fetus is partially protected from high cortisol by activity of the enzyme 11β-hydroxysteroid dehydrogenase type 2 (HSD11B2). Maternal HPA axis activity and activity of HSD11B2 may be modified by maternal stress and disease allowing greater transfer of glucocorticoids from mother to fetus. Here we review emerging data from human studies linking dysregulation of the maternal HPA axis to outcomes in both the mother and her offspring. For the offspring, greater glucocorticoid exposure is associated with lower birth weight and shorter gestation at delivery. In addition, evidence supports longer term consequences for the offspring including re-setting of the HPA axis and susceptibility to neurodevelopmental problems and cardiometabolic disease. For the mother, the changes in the HPA axis, particularly in the postpartum period, may increase vulnerability to mood disturbances. Further understanding of the changes in the HPA axis during pregnancy and the impact of these changes may ultimately allow early identification of those most at risk of future disease.

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“…7"post partum blues", einer kurzfristig negativen Gestimmtheit kurz nach der Geburt, von psychosozialen Faktoren beeinflusst zu werden. In einer Untersuchung von Frauen nach der Entbindung von einem gesunden Kind konnten wir zeigen, dass die betroffenen Frauen deutlich häufiger über präpartale Angst-und Depressivitätsepisoden berichteten, ein geringeres Ausmaß an sozialer Unterstützung schilderten und passivere Copingstrategien zeigten als Wöchnerinnen ohne postpartale Verstimmung (Ehlert et al 1990). Die Notwendigkeit einer sekundären Sectio (ungeplanter Kaiserschnitt aufgrund von Geburtskomplikationen) scheint die Geburtserfahrung sehr deutlich und nachhaltig negativ zu beeinflussen.…”

Section: Geburtskomplikationenunclassified

Einfluss von Stress auf den Schwangerschaftsverlauf und die Geburt

Ehlert

2004

Psychotherapeut

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Wenngleich viele Schwangerschaften und Geburten komplikationslos verlaufen, können bei werdenden Müttern psychische Missstimmungen wie Ängstlichkeit oder depressive Gestimmtheit infolge individueller psychosozialer Veränderungen auftreten. Dies gilt insbesondere für Schwangerschaften mit Komplikationen wie vorzeitige Wehentätigkeit und Gestosen. Die ätiologischen Faktoren solcher Komplikationen sind bisher häufig ungeklärt. Allerdings gibt es zahlreiche Hinweise auf eine Mitbeteiligung von Stress an der Entstehung der genannten Pathologien. Das sympathikoadrenomedulläre System und die Hypothalamus-Hypophysen-Nebennierenrinden-Plazenta-Achse scheinen die körperli-chen Effekte von psychosozialen Belastungen zu modulieren. Auch die Entstehung postpartaler psychischer Störungen kann durch Stresserleben während der Geburt, wie beispielsweise einer sekundären Sectio, beeinflusst werden. Aus diesen Gründen ist es wichtig, der psychosozialen Anpassung an eine Schwangerschaft besondere Aufmerksamkeit zu schenken und bei ausgeprägten Problemen frühzeitig eine psychotherapeutische Mitbehandlung einzuleiten. SchlüsselwörterSchwangerschaft · Geburt · Stress · Psychoendokrinologie · Kognitive Verhaltenstherapie Effects of stress on the course and outcome of pregnancy and childbirth AbstractAlthough the course of most pregnancies remains free of complications, psychosocial adaptation in pregnancy may be associated with anxious or depressive mood swings, especially in cases of pathologic processes such as early onset of spontaneous labor or gestational hypertension. The etiological factors of such complications remain unclear. Both the course of pregnancy and birth outcome seem to be influenced by the experience of stressful events. The sympathoadrenal medullary system and the hypothalamus-pituitary-adrenal-placenta axis seem to modulate the physical effects of psychosocial stress. Additionally, the development of postpartum psychiatric disturbances may be influenced by stressful experiences during childbirth such as secondary cesarean section. Taken together, it is important to explore psychosocial adaptation in all pregnant women and to initiate psychotherapeutic interventions in cases of severe psychosocial problems.

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Postpartum blues: Salivary cortisol and psychological factors

Cited by 65 publications

References 22 publications

Endocrine Correlates of Stress Vulnerability

Endocrine Correlates of Stress Vulnerability

Changes in the Maternal Hypothalamic-Pituitary-Adrenal Axis in Pregnancy and Postpartum: Influences on Maternal and Fetal Outcomes

Einfluss von Stress auf den Schwangerschaftsverlauf und die Geburt

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