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Risk for postpartum depression identified by hormone level during pregnancy
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Women with higher levels of placental corticotropin-releasing hormone during pregnancy were more likely to develop postpartum depression. These results suggested that placental corticotropin-releasing hormone may be a sensitive and specific early diagnostic test for symptoms of postpartum depression.
The researchers studied the link between placental corticotropin-releasing hormone and postpartum depression in 100 pregnant women. They collected blood samples at gestational weeks 15, 19, 25, 31 and 37 and assessed depression symptoms at the last four pregnancy visits and about 8.7 weeks after delivery.
Sixteen women developed postpartum depression symptoms at the follow-up visit. Levels of placental corticotropin-releasing hormone at 25 weeks gestation predicted the development of postpartum depression (P<.001).
A cutoff of 56.86 pg/mL of placental corticotropin-releasing hormone had a sensitivity of 0.75 and specificity of 0.74 for postpartum depression. Three-quarters of women with future postpartum depression would be identified using that cutoff marker and only 24% of women would be misclassified, according to the researchers. Further, the predictive capability of hormone levels increased when depressive symptoms were also assessed midpregnancy. The narrow window of time in which placental corticotropin-releasing hormone levels predicted postpartum depression symptoms (23 to 26 weeks gestational age) coincided with a surge in hormone levels.
Arch Gen Psychiatry. 2009;66:162-169.