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Published on: June 13, 2021
Altered functioning of the HPA axis in depressed postpartum women
Marcos Gonçalves de Rezende1, Cybele Garcia-Leal1, Felipe Pinheiro de Figueiredo1
1Departments of Neuroscience and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil.
Background:
The present study aimed to evaluate the relationship between the functioning of the hypothalamic-pituitary-adrenal (HPA) axis and major depressive episodes in the remote postpartum period.
Methods:
The sample (mean age, 28.0±5.3 years) consisted of 37 depressed postpartum women (DPP), 42 euthymic postpartum women (EPP) and 25 non-postpartum healthy women (HC). Salivary cortisol samples were collected immediately after awakening and 30min, 3 and 12h later, at approximately the sixth month postpartum (mean, 169.6±60.3 days).
Results:
Differences in cortisol levels were observed at awakening (DPP
Limitations:
The main limitation was cortisol collection on a single day and without measurement at midnight.
Conclusions:
Our findings suggest that the remote postpartum period involves attenuation of HPA axis reactivity; this dysregulation is more pronounced in the presence of DPP, which is associated with a reduction in cortisol diurnal variation. Abnormalities in the neuroendocrine system related to stress processing, present even several months after delivery, can represent vulnerability to mental disorders. Thus, improvements in the mental health care of postpartum women are needed.
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