Prenatal and Postnatal Hair Steroid Levels Predict Post-Partum Depression 12 Weeks after Delivery
Abstract
:1. Introduction
1.1. Plasma Cortisol in Healthy Pregnant Women
1.2. Salivary, Blood and Urine Cortisol in Pregnant Women with Major Depressive Disorders
1.3. Hair Cortisol in Women with Post-Partum Depression
1.4. Other Steroids during Pregnancy and after Delivery
1.5. Hypotheses of the Current Study
2. Methods
2.1. Procedure
2.2. Sample
2.3. Sample Size Calculation
2.4. Tools
Self-Ratings of Symptoms of Depression
Edinburgh Postnatal Depression Scale (EPDS)
Beck Depression Inventory (BDI)
Symptoms of Depression in the Past
2.5. Apgar Score
2.6. Hair Strands Sampling
2.7. Assessment of Hair Steroids
2.8. Statistical Analysis
3. Results
3.1. Sample Characteristics
3.2. Hair Steroids, Separately for Participants with (n = 48) and without (n = 50) Post-Partum Depression, and Separately for Prenatal and Postnatal Hair Segments
3.3. Correlations between Symptoms of Depression and Steroid Levels (Prenatal and Postnatal Stage)
3.4. Current Post-Partum Depression and Issues of Depression before Pregnancy
3.5. Predicting Postnatal Depression Levels (Edinburgh Depression Rating Scale) Based on Prenatal Hair Steroids
3.6. Predicting Postnatal Depression Status on the Basis of Prenatal and Postnatal Hair Steroid Levels
4. Discussion
Clinical Implications
5. Conclusions
Supplementary Materials
Author Contributions
Acknowledgments
Conflicts of Interest
References
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Group | Statistics | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
With PPD | Healthy Controls | |||||||||||
N | 48 | 48 | 50 | 50 | ||||||||
Time period of steroid levels | Prenatal | Postnatal | d | Prenatal | Postnatal | d | ||||||
Hair steroids | M (SD) | M (SD) | M (SD) | M (SD) | Time | Group | Time × Group interaction | |||||
F | ηp2 | F | ηp2 | F | ηp2 | |||||||
Cortisol | 5.62 (3.98) | 4.18 (2.59) | 0.43 (S) | 16.71 (9.51) | 7.77 (5.47) | 1.15 (L) | 40.43 *** | 0.296 (L) | 10.47 *** | 0.373 (M) | 21.08 *** | 0.180 (L) |
Cortisone | 12.48 (7.57) | 6.14 (3.50) | 1.08 (L) | 48.49 (26.35) | 17.94 (12.83) | 1.47 (L) | 59.44 *** | 0.282 (L) | 17.97 *** | 0.158 (L) | 25.63 *** | 0.211 (L) |
Testosterone | 0.34 (0.53) | 0.42 (0.45) | 0.16 (T) | 0.58 (0.79) | 0.82 (0.95) | 0.27 (S) | 1.00 | 0.010 (S) | 1.52 | 0.016 (S) | 0.79 | 0.008 (S) |
Progesterone | 30.66 (26.44) | 40.58 (25.37) | 0.38 (S) | 107.59 (45.03) | 86.91 (51.55) | 0.42 (S) | 0.60 | 0.006 (S) | 19.13 *** | 0.166 (L) | 4.80 * | 0.049 (S) |
DHEA | 7.74 (4.56) | 6.34 (5.37) | 0.28 (S) | 3.93 (2.97) | 2.95 (2.64) | 0.34 (S) | 3.53 (*) | 0.035 (S) | 7.48 ** | 0.072 (M) | 0.11 | 0.001 (S) |
Groups | Statistics | |||
---|---|---|---|---|
Individuals with PPD | Individuals without PPD | |||
N | 48 | 50 | ||
n (%) | n (%) | X2-test | ||
Depressive episode in life (yes/no) | 21/27 | 1/49 | X2 (N = 98, df = 1) = 24.52 *** | |
M (SD) | M (SD) | t-tests | Cohen’s d | |
Age (years) | 25.88 (4.28) | 25.22 (4.88) | t(96) = 0.71 | 0.14 (S) |
Beck Depression Inventory | 28.08 (9.19) | 4.30 (3.13) | t(96) = 17.28 *** | 3.49 (L) |
Edinburgh Postnatal Depression Scale | 15.69 (3.47) | 3.82 (2.76) | t(96) = 18.77 *** | 3.78 (L) |
Gestational age (days) | 270.23 (12.79) | 274.04 (11.92) | t(96) = 1.53 | 0.00 (-) |
Apgar score at delivery | 8.81 (0.70) | 9.98 (0.25) | t(96) = 1.58 | 2.23 (L) |
Apgar score 10′ after delivery | 9.85 (0.50) | 9.96 (0.20) | t(96) = 1.38 | 0.29 (S) |
Dimensions | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | ||
1 | BDI | - | 0.90 *** | −0.28 ** | −0.13 | −0.36 *** | −0.23 * | −0.14 | −0.08 | −0.40 *** | −0.23 * | 0.21 * | 0.21 * |
2 | EPDS | - | −0.23 ** | −0.15 | −0.35 ** | −0.24 * | −0.16 | −0.14 | −0.40 *** | −0.22 * | 0.19 (*) | 0.20 * | |
3 | Cortisol pre | - | 0.91 *** | 0.94 *** | 0.86 *** | −0.12 | −0.04 | 0.04 | −0.02 | 0.07 | 0.11 | ||
4 | Cortisol post | - | 0.86 *** | 0.04 *** | −0.09 | −0.03 | −0.01 | −0.03 | 0.07 | 0.17 | |||
5 | Cortisone pre | - | 0.91 *** | −0.15 | −0.07 | 0.03 | −0.03 | 0.00 | 0.09 | ||||
6 | Cortisone post | - | −0.11 | −0.08 | −0.02 | −0.03 | 0.00 | 0.11 | |||||
7 | Testosterone pre | - | 0.90 *** | 0.61 *** | 0.22 * | 0.01 | 0.00 | ||||||
8 | Testosterone post | - | 0.05 | −0.05 | −0.04 | −0.02 | |||||||
9 | Progesterone pre | - | 0.65 *** | −0.16 | −0.14 | ||||||||
10 | Progesterone post | - | −0.15 | −0.10 | |||||||||
11 | DHEA pre | - | 0.65 ** | ||||||||||
12 | DHEA post | - |
Dimension | Variables | Coefficient | Standard Error | Coefficient β | t | p | R | R2 | Durbin-Watson Coefficient |
---|---|---|---|---|---|---|---|---|---|
Edinburgh Postnatal Depression Scale | Intercept | 12.69 | 1.038 | - | 12.22 | 0.001 | 0.552 | 0.30 | 1.78 |
Antenatal cortisol | 0.152 | 0.111 | 0.127 | 1.373 | 0.173 | ||||
Antenatal cortisone | −0.105 | 0.041 | −0.664 | −2.548 | 0.012 | ||||
Antenatal testosterone | 0.219 | 1.112 | 0.022 | 0.197 | 0.884 | ||||
Antenatal progesterone | −0.032 | 0.009 | −0.393 | −3.453 | 0.001 | ||||
Antenatal DHEA | 0.099 | 0.085 | 0.1.06 | 1.164 | 0.248 |
Dimension | Variables | Coefficient | Standard Error | Wald | p | Nagelkerke R2 |
---|---|---|---|---|---|---|
Depression (yes vs. no) | Intercept | 2.99 | 1.074 | 7.729 | 0.003 | 0.924 |
Cortisol prenatal | −0.526 | 0.150 | 12.366 | 0.000 | ||
Cortisol postnatal | 1.083 | 0.307 | 12.471 | 0.001 | ||
Cortisone postnatal | −0.304 | 0.131 | 5.440 | 0.020 | ||
Progesterone prenatal | −0.019 | 0.007 | 7.043 | 0.008 | ||
Progesterone postnatal | −0.024 | 0.011 | 4.759 | 0.029 | ||
DHEA prenatal | 0.211 | 0.099 | 4.525 | 0.033 | ||
Excluded variables | Cortisone prenatal, testosterone prenatal, testosterone postnatal, DHEA postnatal, (all Wald’s < 1.8, all p’s > 0.10). |
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Share and Cite
Jahangard, L.; Mikoteit, T.; Bahiraei, S.; Zamanibonab, M.; Haghighi, M.; Sadeghi Bahmani, D.; Brand, S. Prenatal and Postnatal Hair Steroid Levels Predict Post-Partum Depression 12 Weeks after Delivery. J. Clin. Med. 2019, 8, 1290. https://doi.org/10.3390/jcm8091290
Jahangard L, Mikoteit T, Bahiraei S, Zamanibonab M, Haghighi M, Sadeghi Bahmani D, Brand S. Prenatal and Postnatal Hair Steroid Levels Predict Post-Partum Depression 12 Weeks after Delivery. Journal of Clinical Medicine. 2019; 8(9):1290. https://doi.org/10.3390/jcm8091290
Chicago/Turabian StyleJahangard, Leila, Thorsten Mikoteit, Saman Bahiraei, Mehrangiz Zamanibonab, Mohammad Haghighi, Dena Sadeghi Bahmani, and Serge Brand. 2019. "Prenatal and Postnatal Hair Steroid Levels Predict Post-Partum Depression 12 Weeks after Delivery" Journal of Clinical Medicine 8, no. 9: 1290. https://doi.org/10.3390/jcm8091290