Hostname: page-component-8448b6f56d-dnltx Total loading time: 0 Render date: 2024-04-25T05:29:37.821Z Has data issue: false hasContentIssue false

Cardiff Puerperal Mood and Hormone Study. III. Postnatal Depression at 5 to 6 Weeks Postpartum, and its Hormonal Correlates Across the Peripartum Period

Published online by Cambridge University Press:  02 January 2018

Brian Harris*
Affiliation:
Whitchurch Hospital
Lisetta Lovett
Affiliation:
Department of Psychiatry, Leighton Hospital, Crewe CW1 4QJ
Jonathan Smith
Affiliation:
Whitchurch Hospital, Cardiff CF4 7XB
Graham Read
Affiliation:
Steroid Assay Laboratory, Tenovus Institute, Cardiff CF4 4XW
Richard Walker
Affiliation:
Llandough Hospital and Community Trust, S. Glam CF6 42XX
Robert Newcombe
Affiliation:
Department of Medical Computing and Statistics, University of Wales College of Medicine, Cardiff CF4 4XW
*
Dr Harris, Department of Psychiatry, (University of Wales College of Medicine), Whitchurch Hospital, Cardiff CF4 7XB

Abstract

Background

We assessed associations of mood at 5–6 weeks postpartum with peripartum saliva cortisol and progesterone profiles.

Method

A prospective study involved 120 primiparous women free of major marital, socioeconomic and health problems, who collected saliva twice daily from 2 weeks before delivery to day 35 postpartum. This allowed intensive characterisation of cortisol and progesterone profiles. At the conclusion of the study, mood was assessed according to standard criteria.

Results

Seven women developed major depression according to DSM–III–R criteria No associations emerged between progesterone and mood at 5 to 6 weeks. Lower levels of evening cortisol in the immediate peripartum period, were associated with postnatal depression.

Conclusion

The study provides no support for the treatment strategy of progesterone augmentation following delivery, as a prophylactic against postnatal depression. The HPA axis and its associations with postnatal mood warrants further investigation.

Type
Papers
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: American Psychiatric Press.Google Scholar
Cook, N., Harris, B., Walker, R., et al (1986) Clinical utility of the dexamethasone suppression test assessed by plasma and salivary cortisol determinations. Psychiatry Research, 18, 143150.Google Scholar
Cooper, P. J. & Murray, L. (1995) The course and recurrence of postnatal depression: Evidence for the specificity of the diagnostic concept British Journal of Psychiatry, 166, 191196.CrossRefGoogle ScholarPubMed
Cox, J. L., Connor, Y. & Kendell, R. E. (1982) Prospective study of the psychiatric disorders of childbirth. British Journal of Psychiatry, 140, 111117.Google Scholar
Cox, J. L., Holden, J. M. & Sagovsky, R. (1987) Detection of postnatal depression: development of a 10-item Edinburgh Postnatal Depression Scale. British Journal of Psychiatry, 150, 782786.Google Scholar
Dalton, K. (1989) Successful prophylactic progesterone for ideopathic post-natal depression. International Journal of Prenatal and Perinatal Studies, 322327.Google Scholar
Harris, B., Othman, S., Davies, J. A., et al (1992) Association between postpartum thyroid dysfunction and thyroid antibodies and depression. British Medical Journal, 305, 152156.Google Scholar
Harris, B., Lovett, L., Newcombe, R. G., et al (1994) Maternity blues and major endocrine changes: Cardiff puerperal mood and hormone study 2. British Medical Journal, 308, 949953.Google Scholar
McEwen, B. S. (1991) Non-genomic and genomic effects of steroids on neural activity. Trends in Neurosciences, 12, 141146.Google ScholarPubMed
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382389.Google Scholar
O'Hara, M. W., Schlechte, J. A., Lewis, D. A., et al (1991) Prospective study of postpartum blues. Archives of General Psychiatry, 48, 801806.Google Scholar
Paykel, E. S., Emms, E. M., Fletcher, J., et al (1980) Life events and social support in puerperal depression. British Journal of Psychiatry, 136, 339346.CrossRefGoogle ScholarPubMed
Pederson, C. A., Stern, R. A., Pate, J., et al (1993) Thyroid and adrenal measures during late pregnancy and the puerperium in women who have been major depressed or who become dysphoric postpartum. Journal of Affective Disorders, 29, 201211.CrossRefGoogle Scholar
Raskin, A., Schulterbrandt, J., Reatig, N., et al (1970) Differential response to chlorpromazine, imipramine and placebo – a study of subgroups of hospitalised depressed patients. Archives of General Psychiatry, 23, 164173.Google Scholar
Stein, G. S. (1980) The pattern of mental change and body weight change in the first post partum week. Journal of Psychosomatic Research, 24, 165171.Google Scholar
Walker, R. F., Read, G. F. & Riad-Fahmy, D. (1979) Radioimmunoassay of progesterone in saliva: application to the assessment of ovarian function. Clinical Chemistry, 25, 20302037.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.