This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via ISI Web of Science (2) Citing Articles via Google Scholar Google Scholar Articles by Jolley, S. N. Articles by Carr, D. B. Search for Related Content PubMed PubMed Citation Articles by Jolley, S. N. Articles by Carr, D. B. Social Bookmarking                   What's this?

Dysregulation of the Hypothalamic-Pituitary-Adrenal Axis in Postpartum Depression

Department of Obstetrics and Gynecology, University of Washington, Seattle, sjolley{at}u.washington.edu

Shawn Elmore, PhD

Department of Obstetrics and Gynecology, University of Washington, Seattle

Kathryn E. Barnard, PhD, RN

Department of Obstetrics and Gynecology, University of Washington, Seattle

Darcy B. Carr, MD, MS

Department of Obstetrics and Gynecology, University of Washington, Seattle

Postpartum depression (PPD) affects at least 10% to 15% of postpartum women, including more than 600,000 American mothers in 2003 alone. Dramatic changes in the hypothalamic-pituitary-adrenal (HPA) system in the transition from pregnancy to postpartum coupled with research on the psychobiology of depression provided the foundation for this study. The purpose of this study was to compare the reactivity and regulation of the HPA axis components, adrenocorticotropic hormone (ACTH) and cortisol, in depressed and nondepressed postpartum women. A comparative, longitudinal study design was used with 22 normal, healthy, nondepressed pregnant women. Physiologic and postpartum depression data were collected at 6 and 12 weeks postpartum at a university clinical research center. Maximal treadmill exercise stimulated plasma ACTH and serum cortisol levels which were measured before, during, and after 20 min of exercise. Postpartum depression was measured with the Postpartum Depression Screening Scale. Lag within-subject ACTH levels predicting cortisol regression slopes were significantly different between the depressed and nondepressed groups at both 6 and 12 weeks. The depressed group showed no relationship between their ACTH and cortisol levels, with higher ACTH and lower cortisol levels when compared with the nondepressed group. The expected regulated relationship with cortisol levels rising in response to rising ACTH levels was found in the non-depressed group. These findings indicate that the HPA axis was dysregulated in the depressed group, but regulated in the nondepressed group at 6 and 12 weeks postpartum. This pattern of higher ACTH levels to stimulate less cortisol is similar to patterns found in women with early life stresses.

Key Words: postpartum depression • hypothalamic-pituitary-adrenal axis regulation and reactivity • ACTH • cortisol • HPA axis dysregulation

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?