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Updated: Jul 12, 2025

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Thyroid Predictors of Postpartum Mood Disorders.

Sean Backer1, Janeta Yancheva2, Camelia Garcia3

  • 1Osteopathic Medicine, Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Tampa, USA.

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|October 23, 2023
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Summary

Thyroid autoimmunity, particularly anti-thyroid peroxidase (TPO) antibodies, may predict late postpartum depression (PPD). A postpartum cortisol drop can trigger thyroid autoimmunity in TPO-positive women, leading to hypothyroidism and depressive symptoms.

Keywords:
hypothyroidismlate postpartum depressionpostpartum bluespostpartum depressionpostpartum mood disorderspostpartum psychosissecond and third trimesterthyroid markersthyroid predictorstpo-antibody positive

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Area of Science:

  • Endocrinology
  • Psychiatry
  • Reproductive Medicine

Background:

  • Postpartum mood disorders (PMD) are a significant cause of maternal morbidity and mortality.
  • The exact causes of PMDs, including postpartum blues (PB) and postpartum depression (PPD), are unclear, with hormonal fluctuations being a leading hypothesis.
  • Thyroid function is linked to psychiatric disorders, but its specific role in PMDs requires further investigation.

Purpose of the Study:

  • To investigate the pathophysiological link between thyroid function and PMDs.
  • To assess the potential of thyroid markers in predicting the occurrence and severity of PMDs.
  • To explore the relationship between thyroid autoimmunity and postpartum depressive symptoms.

Main Methods:

  • A narrative literature review was conducted.
  • Searches were performed on PubMed using specific inclusion and exclusion criteria.
  • Studies examining thyroid markers in relation to PMD incidence or pathophysiology were included.

Main Results:

  • Thyroid autoimmunity shows potential as a predictor for late-onset PPD.
  • Hypothyroidism, low euthyroid hormone levels, and thyroid autoantibodies correlate with increased PPD incidence.
  • A postpartum cortisol drop may induce thyroid autoimmunity in anti-TPO antibody-positive women, potentially causing hypothyroidism and depressive symptoms.

Conclusions:

  • Thyroid autoimmunity, specifically TPO antibodies in the third trimester, may serve as a predictor for late PPD.
  • While PMD pathogenesis remains ambiguous, thyroid function markers offer potential insights.
  • Insufficient evidence links thyroid function to postpartum psychosis.