Sex differences in depression during pregnancy and the postpartum period

Abstract

Women have a lifetime risk of major depression double that of men but only during their reproductive years. This sex difference has been attributed partially to activational effects of female sex steroids and also to the burdens of pregnancy, childbirth, and parenting. Men, in contrast, have a reproductive period difficult to delineate, and research on the mental health of men has rarely considered the effects of fatherhood. However, the couple goes through a number of potentially stressing events during the reproductive period, and both mothers and fathers are at risk of developing peripartum depression. This Review discusses the literature on maternal and paternal depression and the endocrine changes that may predispose a person to depression at this stage of life, with specific focus on the hypothalamus-pituitary axis, oxytocin, and testosterone levels in men. Important findings on sex differences in the neural correlates of maternal and paternal behavior have emerged, highlighting the relevance of the emotional brain in mothers and the sociocognitive brain in fathers and pointing toward the presence of a common parents' brain. Additionally, sex differences in neurogenesis and brain plasticity are described in relation to peripartum depression.

Global burden of antenatal depression and its association with adverse birth outcomes: an umbrella review

“…Depression is relatively common across the population but is known to be more prevalent in females relative to males [18,[67][68][69][70]. Risk for depression in females doubles during pregnancy [71], which is thought to be due to a mixture of hormonal changes and a range of psychosocial factors [72][73][74][75] that may continue to impact on mental health throughout the lifespan [74].…”

The relationship of dietary diversity score with depression and anxiety among prenatal and post‐partum women

“…How dietary diversity might interfere in the referred effects of anxiety and depression on the offspring has not been explored. It has been reported that nutritional status during pregnancy may also play an important role in the physical and mental development of offspring . Early nutritional exposures were independently related with increased risk of behavioral and emotional problems .…”

Emotional anticipation after delivery – a longitudinal neuroimaging study of the postpartum period

“…Clearly, the postpartum period involves changes not only in ovarian steroid levels but also in γ-Aminobutyric acid 19 -active progesterone metabolites, the hypothalamus-pituitary-adrenal axis, and the oxytocinergic system 4, 20 . In addition, the postpartum period is characterized by both attenuated serotonergic activity 21–24 and decreased cortical GABA concentrations 25 .…”