Materiały źródłowe

• #1 Perinatal Depression – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519070/

  The pathogenesis of perinatal depression and postpartum blues is currently unknown but is likely multifactorial. Genetic, hormonal, psychological, and social life stressors have been suggested to play a role in the development of perinatal depression. The role of reproductive hormones in depressive behavior suggests neuroendocrine pathophysiology for perinatal depression. Ample data advocating that changes in the reproductive hormones stimulate the dysregulation of these hormones in sensitive individuals has been documented. The pathophysiology of perinatal depression can be from alterations of multiple biological and endocrine systems, for example, the immunological system, the hypothalamic-pituitary-adrenal axis (HPA), and lactogenic hormones. […] The HPA is known to be involved in the disease process of perinatal depression and postpartum blues. The HPA axis causes the release of cortisol in trauma and stress; with HPA axis dysfunction, the release of catecholamines is decreased, leading to a poor stress response. HPA-releasing hormones increase during pregnancy and remain elevated up to 12 weeks postpartum. Recent evidence suggests that perinatal depression is linked to the gamma-aminobutyric acid (GABA) neurotransmission system. The imbalance in GABA, the chief inhibitory neurotransmitter in the brain, likely plays a role in causing perinatal depression.

• #2 Biomarkers of Postpartum Depression: A Narrative Review

  https://www.mdpi.com/2077-0383/12/20/6519

  Postpartum depression (PPD) is a disorder that impairs the formation of the relationship between mother and child, and reduces the quality of life for affected women to a functionally significant degree. […] The purpose of this paper is to review biomarkers linked to PPD and to present selected theories on the pathogenesis of the disease based on data from biomarker studies. […] The etiopathogenesis of PPD is complex and multidirectional. As in MDD, PPD has a multicomponent pattern, in which inflammatory, hormonal, and genetic factors are attributed special roles. […] Numerous studies point to the dysregulation of the immune system during pregnancy and childbirth. […] The period of childbirth itself, associated with tremendous stress on the body, mobilization of the HPA axis, and increased inflammatory response, can be considered a causal factor in depression.

• #3 The role of reproductive hormones in postpartum depression | CNS Spectrums | Cambridge Core

  https://www.cambridge.org/core/journals/cns-spectrums/article/role-of-reproductive-hormones-in-postpartum-depression/AC701DEB8CE0A817B0F68C9BC33A532D

  Despite decades of research aimed at identifying the causes of postpartum depression (PPD), PPD remains common, and the causes are poorly understood. […] Many have attributed the onset of PPD to the rapid perinatal change in reproductive hormones. […] Although a number of human and nonhuman animal studies support the role of reproductive hormones in PPD, several studies have failed to detect an association between hormone concentrations and PPD. […] We discuss and integrate the literature on animal models of PPD and human studies of reproductive hormones and PPD. […] We also discuss alternative biological models of PPD to demonstrate the potential for multiple PPD phenotypes and to describe the complex interplay of changing reproductive hormones and alterations in thyroid function, immune function, hypothalamic-pituitary-adrenal (HPA) axis function, lactogenic hormones, and genetic expression that may contribute to affective dysfunction.

• #4 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Patients and their caregivers frequently overlook postpartum depression, despite the fact that effective nonpharmacologic and pharmacologic treatments are available for this condition. […] Untreated postpartum affective illness places the mother and infant at risk and is associated with significant long-term effects on child development and behavior. […] Therefore, appropriate screening for and prompt recognition and treatment of depression are essential for maternal and infant well-being and can improve outcomes. […] Postpartum psychiatric illness was initially conceptualized as a group of disorders specifically linked to pregnancy and childbirth and thus was considered diagnostically distinct from other types of psychiatric illness. Evidence now suggests, however, that postpartum psychiatric illness is virtually indistinguishable from psychiatric disorders that occur at other times during a woman’s life.

• #5 Biopsychosocial Models of Peripartum Depression: A Narrative Review | Revista de psicología

  https://journals.copmadrid.org/clysa/art/clysa2023a16

  Peripartum depression (PPD) is a prevalent, heterogeneous disorder with various underlying mechanisms and unwanted outcomes. Substantial uncertainty surrounding PPD aetiology exists. […] Several biopsychosocial models are identified, explaining antepartum, postpartum or peripartum depression. Integrative models show promise but differ in conceptualisation and proposed aetiological pathways underlying PPD. […] Research is ambiguous about whether PPD is distinct from depression occurring outside the peripartum period. However, there is an inclination toward the distinctiveness of PPD in the early postpartum period due to symptom severity and hormonal, genetic, and epigenetic mechanisms that differ from non-peripartum depression. […] Evidence suggests that the biological and psychosocial mechanisms of PPD are not distinct; instead, they interact together, thus supporting fundamental postulates of a biopsychosocial framework. Specifically, the risk for PPD is shaped by various biological factors e.g., (epi)genetic factors, inflammatory markers that are moderated or mediated by psychosocial settings.

• #6 Perinatal Depression – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519070/

  The pathogenesis of perinatal depression and postpartum blues is currently unknown but is likely multifactorial. Genetic, hormonal, psychological, and social life stressors have been suggested to play a role in the development of perinatal depression. The role of reproductive hormones in depressive behavior suggests neuroendocrine pathophysiology for perinatal depression. Ample data advocating that changes in the reproductive hormones stimulate the dysregulation of these hormones in sensitive individuals has been documented. The pathophysiology of perinatal depression can be from alterations of multiple biological and endocrine systems, for example, the immunological system, the hypothalamic-pituitary-adrenal axis (HPA), and lactogenic hormones. […] The HPA is known to be involved in the disease process of perinatal depression and postpartum blues. The HPA axis causes the release of cortisol in trauma and stress; with HPA axis dysfunction, the release of catecholamines is decreased, leading to a poor stress response. HPA-releasing hormones increase during pregnancy and remain elevated up to 12 weeks postpartum. Recent evidence suggests that perinatal depression is linked to the gamma-aminobutyric acid (GABA) neurotransmission system. The imbalance in GABA, the chief inhibitory neurotransmitter in the brain, likely plays a role in causing perinatal depression.

• #7 Treating Postpartum Depression – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/treating-postpartum-depression.asp

  Women with postpartum depression have intense feelings of sadness, anxiety, or despair that can interfere with their ability to do their daily tasks. It can occur up to one year after having a baby, but it most commonly starts about one to three weeks after childbirth. The term postpartum depression commonly includes major and minor depression, which differ in severity and prognosis, and have a combined incidence of 12% in healthy women, who gave birth to full-term infants. […] Risk factors for postpartum depression include a history of postpartum major depression with a previous pregnancy, antenatal depressive symptoms (relative risk [RR] = 5.6), a history of major depressive disorder (RR = 4.5), poor social support (RR = 2.6), major life events or stressors during pregnancy (RR = 2.5), and a family history of postpartum major depression (RR = 2.4).

• #8 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Women with a previous history of depression, a family history of a mood disorder, or depression during the current pregnancy are at increased risk for postpartum depression. […] A meta-analysis by Zacher Kjeldsen et al found that women who have a family history of any psychiatric disorder have almost two times the risk of postpartum depression as do women without such a history. […] Furthermore, women with a previous history of postpartum depression or psychosis have a risk of recurrence of up to 90%. […] Postpartum depression is more persistent and debilitating than postpartum blues, often interfering with the mother’s ability to care for herself or her child. […] The postpartum period is the most vulnerable time for a woman to develop psychiatric illness with postpartum depression occurring in 10-15% of women in the general population.

• #9 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Women with a previous history of depression, a family history of a mood disorder, or depression during the current pregnancy are at increased risk for postpartum depression. […] A meta-analysis by Zacher Kjeldsen et al found that women who have a family history of any psychiatric disorder have almost two times the risk of postpartum depression as do women without such a history. […] Furthermore, women with a previous history of postpartum depression or psychosis have a risk of recurrence of up to 90%. […] Postpartum depression is more persistent and debilitating than postpartum blues, often interfering with the mother’s ability to care for herself or her child. […] The postpartum period is the most vulnerable time for a woman to develop psychiatric illness with postpartum depression occurring in 10-15% of women in the general population.

• #10 Postpartum depression – Wikipedia

  https://en.wikipedia.org/wiki/Postpartum_depression

  A review of exploratory studies in PPD has observed that women with PPD have more dramatic changes in HPA axis activity, however, the directionality of specific hormone increases or decreases remain mixed. […] Hormones that have been studied include estrogen, progesterone, thyroid hormone, testosterone, corticotropin releasing hormone, endorphins, and cortisol. Estrogen and progesterone levels drop back to pre-pregnancy levels within 24 hours of giving birth, and that sudden change may cause it. […] Aberrant steroid hormone-dependent regulation of neuronal calcium influx via extracellular matrix proteins and membrane receptors involved in responding to the cell’s microenvironment might be important in conferring biological risk.

• #11 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20230919/Transforming-postpartum-depression-treatment-with-neurosteroids.aspx

  Brexanolone is a type of neurosteroid that has been studied for the treatment of postpartum depression (PPD) treatment and major depressive disorders (MDD). […] A new paper in Neuropsychopharmacology explores the mechanisms of action of brexanolone. […] Fluctuations in estrogen and progesterone levels during and after pregnancy and childbirth can be between 10- and 50-fold that of the non-pregnant healthy woman. This subsequently affects the hypothalamic-pituitary-adrenal (HPA) axis, which, in turn, alters cortisol levels. […] Neurological processes are fundamentally dependent for their regulation of these steroid hormones and play a key role in the origin of depression in women. Cortisol levels can affect various neurotransmitters, including dopamine, norepinephrine, serotonin, glutamate, and gamma-aminobutyric acid (GABA), in addition to regulating the stress-HPA link at many stages.

• #12 Postpartum depression – Wikipedia

  https://en.wikipedia.org/wiki/Postpartum_depression

  A review of exploratory studies in PPD has observed that women with PPD have more dramatic changes in HPA axis activity, however, the directionality of specific hormone increases or decreases remain mixed. […] Hormones that have been studied include estrogen, progesterone, thyroid hormone, testosterone, corticotropin releasing hormone, endorphins, and cortisol. Estrogen and progesterone levels drop back to pre-pregnancy levels within 24 hours of giving birth, and that sudden change may cause it. […] Aberrant steroid hormone-dependent regulation of neuronal calcium influx via extracellular matrix proteins and membrane receptors involved in responding to the cell’s microenvironment might be important in conferring biological risk.

• #13 Biomarkers of Postpartum Depression: A Narrative Review

  https://www.mdpi.com/2077-0383/12/20/6519

  The period of pregnancy and childbirth is subject to dysregulations of the HPA axis. […] Rapid changes in CRH concentrations as well as chronic hypercortisolism during pregnancy can be considered potential stressors. […] Elevated levels of Interleukin 1β (IL-1β) and reduced levels of BDNF were observed in rat hippocampal biopsies. […] The interaction effect between monoaminergic genes and environmental stressors is thought to be of great relevance to PPD susceptibility and have a possible predictive value.

• #14 Perinatal Depression – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519070/

  The pathogenesis of perinatal depression and postpartum blues is currently unknown but is likely multifactorial. Genetic, hormonal, psychological, and social life stressors have been suggested to play a role in the development of perinatal depression. The role of reproductive hormones in depressive behavior suggests neuroendocrine pathophysiology for perinatal depression. Ample data advocating that changes in the reproductive hormones stimulate the dysregulation of these hormones in sensitive individuals has been documented. The pathophysiology of perinatal depression can be from alterations of multiple biological and endocrine systems, for example, the immunological system, the hypothalamic-pituitary-adrenal axis (HPA), and lactogenic hormones. […] The HPA is known to be involved in the disease process of perinatal depression and postpartum blues. The HPA axis causes the release of cortisol in trauma and stress; with HPA axis dysfunction, the release of catecholamines is decreased, leading to a poor stress response. HPA-releasing hormones increase during pregnancy and remain elevated up to 12 weeks postpartum. Recent evidence suggests that perinatal depression is linked to the gamma-aminobutyric acid (GABA) neurotransmission system. The imbalance in GABA, the chief inhibitory neurotransmitter in the brain, likely plays a role in causing perinatal depression.

• #15 Perinatal Depression – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519070/

  The rapid drop in reproductive hormones, like estradiol and progesterone, following delivery can be a potential stressor in susceptible patients. These changes can lead to the onset of depressive symptoms as well as postpartum blues. Elevated cortisol levels and low tryptophan levels may be noted. Oxytocin and prolactin also play an essential role in the pathogenesis of perinatal depression. These hormones regulate the milk let-down reflex and the synthesis of breast milk. Failure to lactate and the onset of perinatal depression are often observed to coincide. Low levels of oxytocin are particularly observed in perinatal depression and unwanted early weaning. During the third trimester, lower levels of oxytocin are associated with increased depressive symptoms during pregnancy and following delivery.

• #16 Postpartum depression after adolescent stress shows a dysregulated HPA axis: a cross-species translational study – UAB News

  https://www.uab.edu/news/research-innovation/postpartum-depression-after-adolescent-stress-shows-a-dysregulated-hpa-axis-a-cross-species-translational-study

  Postpartum depression after adolescent stress shows a dysregulated HPA axis: a cross-species translational study […] Adverse life events are a known and predominant risk factor for postpartum depression in women after delivery of their baby. Furthermore, the postpartum depression in women who have experienced adverse life events tends to be refractory to treatment. […] In a study using a mouse model and human subjects, researchers from the University of Alabama at Birmingham and Johns Hopkins Medicine show that stress from adolescent social isolation in mice elicits a prolonged elevation of corticosterone levels and glucocorticoid signaling, which in turn results in long-lasting postpartum behavioral changes indicative of depression. Importantly for clinically relevant biology, this was associated with prolonged dysregulation of the neuro-hormone system that manages stress, called the hypothalamic-pituitary-adrenal, or HPA, axis.

• #17 Postpartum depression after adolescent stress shows a dysregulated HPA axis: a cross-species translational study – UAB News

  https://www.uab.edu/news/research-innovation/postpartum-depression-after-adolescent-stress-shows-a-dysregulated-hpa-axis-a-cross-species-translational-study

  Similar to the mouse results, the researchers found that childhood or adolescent stress significantly impacted HPA axis dysregulation and postpartum depression in a study of 116 women. […] Most importantly, we demonstrated that a short-term, one-week, postdelivery treatment against this pathological mechanism was sufficient to block the behavioral changes in stressed mouse dams, whereas other medicines currently used for postpartum depression in the clinical setting are ineffective, Niwa said. The effective treatment used a glucocorticoid receptor antagonist, a drug not currently used to treat postpartum depression. This antagonist, which blocks the effects of elevated glucocorticoids (cortisol in humans and corticosterone in rodents), could be a novel treatment option for postpartum depression. […] The novelty of this study, researchers say, lies in discovering and defining the role and mechanism of the HPA axis and glucocorticoid signaling in the context of postpartum depression.

• #18 Postpartum depression after adolescent stress shows a dysregulated HPA axis: a cross-species translational study – UAB News

  https://www.uab.edu/news/research-innovation/postpartum-depression-after-adolescent-stress-shows-a-dysregulated-hpa-axis-a-cross-species-translational-study

  Similar to the mouse results, the researchers found that childhood or adolescent stress significantly impacted HPA axis dysregulation and postpartum depression in a study of 116 women. […] Most importantly, we demonstrated that a short-term, one-week, postdelivery treatment against this pathological mechanism was sufficient to block the behavioral changes in stressed mouse dams, whereas other medicines currently used for postpartum depression in the clinical setting are ineffective, Niwa said. The effective treatment used a glucocorticoid receptor antagonist, a drug not currently used to treat postpartum depression. This antagonist, which blocks the effects of elevated glucocorticoids (cortisol in humans and corticosterone in rodents), could be a novel treatment option for postpartum depression. […] The novelty of this study, researchers say, lies in discovering and defining the role and mechanism of the HPA axis and glucocorticoid signaling in the context of postpartum depression.

• #19 Perinatal Depression – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519070/

  The rapid drop in reproductive hormones, like estradiol and progesterone, following delivery can be a potential stressor in susceptible patients. These changes can lead to the onset of depressive symptoms as well as postpartum blues. Elevated cortisol levels and low tryptophan levels may be noted. Oxytocin and prolactin also play an essential role in the pathogenesis of perinatal depression. These hormones regulate the milk let-down reflex and the synthesis of breast milk. Failure to lactate and the onset of perinatal depression are often observed to coincide. Low levels of oxytocin are particularly observed in perinatal depression and unwanted early weaning. During the third trimester, lower levels of oxytocin are associated with increased depressive symptoms during pregnancy and following delivery.

• #20 Biomarkers of Postpartum Depression: A Narrative Review

  https://www.mdpi.com/2077-0383/12/20/6519

  The activity of IDO and other enzymes of the pathway increases with placental development. […] The decreasing amount of available serotonin leads to depressive disorders. […] The study by O’Hara et al. showed lower serum estradiol levels measured in women with PPD compared to healthy women, at 36 weeks pregnant and day 2 postpartum. […] Data collected by Zonana et al. indicate that the low levels of estrogen observed after delivery may be associated with PPD, suggesting an important role of steroid hormones especially in the first days after delivery and their significance as a possible trigger for depression. […] The introduction of hormone doses at pregnancy-like level and their decrease mimicking the transition to the postpartum period resulted in the appearance of depressive symptoms, suggesting that there is a subgroup of women who are sensitive to hormonal fluctuations.

• #21 Biomarkers of Postpartum Depression: A Narrative Review

  https://www.mdpi.com/2077-0383/12/20/6519

  The activity of IDO and other enzymes of the pathway increases with placental development. […] The decreasing amount of available serotonin leads to depressive disorders. […] The study by O’Hara et al. showed lower serum estradiol levels measured in women with PPD compared to healthy women, at 36 weeks pregnant and day 2 postpartum. […] Data collected by Zonana et al. indicate that the low levels of estrogen observed after delivery may be associated with PPD, suggesting an important role of steroid hormones especially in the first days after delivery and their significance as a possible trigger for depression. […] The introduction of hormone doses at pregnancy-like level and their decrease mimicking the transition to the postpartum period resulted in the appearance of depressive symptoms, suggesting that there is a subgroup of women who are sensitive to hormonal fluctuations.

• #22 Biomarkers of Postpartum Depression: A Narrative Review

  https://www.mdpi.com/2077-0383/12/20/6519

  The activity of IDO and other enzymes of the pathway increases with placental development. […] The decreasing amount of available serotonin leads to depressive disorders. […] The study by O’Hara et al. showed lower serum estradiol levels measured in women with PPD compared to healthy women, at 36 weeks pregnant and day 2 postpartum. […] Data collected by Zonana et al. indicate that the low levels of estrogen observed after delivery may be associated with PPD, suggesting an important role of steroid hormones especially in the first days after delivery and their significance as a possible trigger for depression. […] The introduction of hormone doses at pregnancy-like level and their decrease mimicking the transition to the postpartum period resulted in the appearance of depressive symptoms, suggesting that there is a subgroup of women who are sensitive to hormonal fluctuations.

• #23 Perinatal Depression – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519070/

  The rapid drop in reproductive hormones, like estradiol and progesterone, following delivery can be a potential stressor in susceptible patients. These changes can lead to the onset of depressive symptoms as well as postpartum blues. Elevated cortisol levels and low tryptophan levels may be noted. Oxytocin and prolactin also play an essential role in the pathogenesis of perinatal depression. These hormones regulate the milk let-down reflex and the synthesis of breast milk. Failure to lactate and the onset of perinatal depression are often observed to coincide. Low levels of oxytocin are particularly observed in perinatal depression and unwanted early weaning. During the third trimester, lower levels of oxytocin are associated with increased depressive symptoms during pregnancy and following delivery.

• #24 Perinatal Depression – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519070/

  The rapid drop in reproductive hormones, like estradiol and progesterone, following delivery can be a potential stressor in susceptible patients. These changes can lead to the onset of depressive symptoms as well as postpartum blues. Elevated cortisol levels and low tryptophan levels may be noted. Oxytocin and prolactin also play an essential role in the pathogenesis of perinatal depression. These hormones regulate the milk let-down reflex and the synthesis of breast milk. Failure to lactate and the onset of perinatal depression are often observed to coincide. Low levels of oxytocin are particularly observed in perinatal depression and unwanted early weaning. During the third trimester, lower levels of oxytocin are associated with increased depressive symptoms during pregnancy and following delivery.

• #25 Perinatal Depression – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK519070/

  The pathogenesis of perinatal depression and postpartum blues is currently unknown but is likely multifactorial. Genetic, hormonal, psychological, and social life stressors have been suggested to play a role in the development of perinatal depression. The role of reproductive hormones in depressive behavior suggests neuroendocrine pathophysiology for perinatal depression. Ample data advocating that changes in the reproductive hormones stimulate the dysregulation of these hormones in sensitive individuals has been documented. The pathophysiology of perinatal depression can be from alterations of multiple biological and endocrine systems, for example, the immunological system, the hypothalamic-pituitary-adrenal axis (HPA), and lactogenic hormones. […] The HPA is known to be involved in the disease process of perinatal depression and postpartum blues. The HPA axis causes the release of cortisol in trauma and stress; with HPA axis dysfunction, the release of catecholamines is decreased, leading to a poor stress response. HPA-releasing hormones increase during pregnancy and remain elevated up to 12 weeks postpartum. Recent evidence suggests that perinatal depression is linked to the gamma-aminobutyric acid (GABA) neurotransmission system. The imbalance in GABA, the chief inhibitory neurotransmitter in the brain, likely plays a role in causing perinatal depression.

• #26 Novel neurosteroid therapeutics for post-partum depression: perspectives on clinical trials, program development, active research, and future directions | Neuropsychopharmacology

  https://www.nature.com/articles/s41386-023-01721-1

  Preclinical and clinical studies in PPD have demonstrated the potential roles of dysfunctional GABAergic signaling, and specifically, allopregnanolone levels, in the development of PPD. […] The observation that these behavioral changes in the mice were all reversed by the administration of allopregnanolone served as compelling evidence for the development of brexanolone, a proprietary formulation of allopregnanolone. […] Brexanolone became the first Food and Drug Administration (FDA) approved treatment for PPD in human mothers, which is administered intravenously over 60 hours and has demonstrated rapid and sustained improvement in symptoms of PPD. […] Throughout all phases of the clinical trials, the drug was well-tolerated overall. […] The most common side effects included flushing or hot flashes, dry mouth, and sleepiness.

• #27 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Antidepressants remain the first line of treatment. […] However, there are preliminary data to suggest that estrogen, alone or in combination with an antidepressant, may be beneficial. […] The GABA system is the major inhibitory signaling pathway of the brain and CNS and contributes to regulating brain function (eg, mood, arousal, behavior, cognition). The mechanism of action for the treatment of PPD is not fully understood, but is believed to be related to positive allosteric modulation of both synaptic and extrasynaptic GABA-A receptors.

• #28 4 Targeting GABA Receptors to Treat Postpartum Depression | Novel Molecular Targets for Mood Disorders and Psychosis: Proceedings of a Workshop | The National Academies Press

  https://nap.nationalacademies.org/read/26218/chapter/5

  Brexanolone, which targets GABA receptors, is the first treatment approved PPD and the first neuroactive steroid approved for a psychiatric condition (Meltzer-Brody, Zorumski). […] Although the underlying cause of PPD is not fully understood, it is likely multifactorial involving inflammatory signaling, fluctuations in perinatal hormones, dysregulation of stress pathways, and GABA signaling dysfunction, she continued. […] Brexanolone was already known to be a positive allosteric modulator of GABAA receptors, said Meltzer-Brody. […] Therefore, Maguire proposed that high levels of neurosteroids during pregnancy are associated with a homeostatic downregulation of GABAA receptors to maintain an ideal level of inhibition during the pregnancy. […] When these neurosteroids begin to dramatically decrease at the time of delivery, the GABAA receptors need to be recovered to maintain an ideal level of inhibition in the postpartum period, she said.

• #29 4 Targeting GABA Receptors to Treat Postpartum Depression | Novel Molecular Targets for Mood Disorders and Psychosis: Proceedings of a Workshop | The National Academies Press

  https://nap.nationalacademies.org/read/26218/chapter/5

  Deficits in the ability to recover these receptors at the time of delivery may increase the mothers vulnerability to PPD, she explained. […] She also proposed that potentiating GABAA receptors may be therapeutic for the treatment of PPD. […] Taken together, Maguire said, these preclinical studies laid the foundation for the idea that GABA PAMs would be beneficial for the treatment of PPD in humans. […] Harder to explain, said Maguire, is how the action of PAMs on GABA receptors results in the persistent antidepressant effect of brexanolone seen in women with PPD. […] Maguire and colleagues proposed that these neurosteroids may help potentiate a high level of tonic inhibition that synchronizes the neural network and mediates a transition to a more stable and a healthier network state (Pavlov et al., 2014).

• #30 Novel neurosteroid therapeutics for post-partum depression: perspectives on clinical trials, program development, active research, and future directions | Neuropsychopharmacology

  https://www.nature.com/articles/s41386-023-01721-1

  Preclinical and clinical studies in PPD have demonstrated the potential roles of dysfunctional GABAergic signaling, and specifically, allopregnanolone levels, in the development of PPD. […] The observation that these behavioral changes in the mice were all reversed by the administration of allopregnanolone served as compelling evidence for the development of brexanolone, a proprietary formulation of allopregnanolone. […] Brexanolone became the first Food and Drug Administration (FDA) approved treatment for PPD in human mothers, which is administered intravenously over 60 hours and has demonstrated rapid and sustained improvement in symptoms of PPD. […] Throughout all phases of the clinical trials, the drug was well-tolerated overall. […] The most common side effects included flushing or hot flashes, dry mouth, and sleepiness.

• #31 Mechanism for Postpartum Depression Found in Mice | Technology Networks

  https://www.technologynetworks.com/genomics/news/mechanism-for-postpartum-depression-found-in-mice-200474

  Much like human mothers suffering from postpartum depression, the genetically altered mouse mothers were more lethargic and less pleasure-seeking than normal mice. […] „Improper functioning of the delta subunit could impair the GABA system’s ability to adapt to hormone fluctuations during the highly vulnerable post partum period,” explained Maguire. „Targeting this subunit might be a promising strategy in developing new treatments for postpartum depression.”

• #32 Novel neurosteroid therapeutics for post-partum depression: perspectives on clinical trials, program development, active research, and future directions | Neuropsychopharmacology

  https://www.nature.com/articles/s41386-023-01721-1

  Preclinical and clinical studies in PPD have demonstrated the potential roles of dysfunctional GABAergic signaling, and specifically, allopregnanolone levels, in the development of PPD. […] The observation that these behavioral changes in the mice were all reversed by the administration of allopregnanolone served as compelling evidence for the development of brexanolone, a proprietary formulation of allopregnanolone. […] Brexanolone became the first Food and Drug Administration (FDA) approved treatment for PPD in human mothers, which is administered intravenously over 60 hours and has demonstrated rapid and sustained improvement in symptoms of PPD. […] Throughout all phases of the clinical trials, the drug was well-tolerated overall. […] The most common side effects included flushing or hot flashes, dry mouth, and sleepiness.

• #33 Novel neurosteroid therapeutics for post-partum depression: perspectives on clinical trials, program development, active research, and future directions | Neuropsychopharmacology

  https://www.nature.com/articles/s41386-023-01721-1

  Preclinical and clinical studies in PPD have demonstrated the potential roles of dysfunctional GABAergic signaling, and specifically, allopregnanolone levels, in the development of PPD. […] The observation that these behavioral changes in the mice were all reversed by the administration of allopregnanolone served as compelling evidence for the development of brexanolone, a proprietary formulation of allopregnanolone. […] Brexanolone became the first Food and Drug Administration (FDA) approved treatment for PPD in human mothers, which is administered intravenously over 60 hours and has demonstrated rapid and sustained improvement in symptoms of PPD. […] Throughout all phases of the clinical trials, the drug was well-tolerated overall. […] The most common side effects included flushing or hot flashes, dry mouth, and sleepiness.

• #34 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Antidepressants remain the first line of treatment. […] However, there are preliminary data to suggest that estrogen, alone or in combination with an antidepressant, may be beneficial. […] The GABA system is the major inhibitory signaling pathway of the brain and CNS and contributes to regulating brain function (eg, mood, arousal, behavior, cognition). The mechanism of action for the treatment of PPD is not fully understood, but is believed to be related to positive allosteric modulation of both synaptic and extrasynaptic GABA-A receptors.

• #35 Researchers confirm postpartum depression heritability, home in on treatment mechanism

  https://medicalxpress.com/news/2023-10-postpartum-depression-heritability-home-treatment.html

  Postpartum depression (PPD), a common subtype of major depressive disorder, is more heritable than other psychiatric conditions, yet the genetics of PPD are understudied compared to these other psychiatric conditions, such as anxiety and bipolar disorder. […] A patient’s PPD is often not merely the result of environmental factors, such as past trauma. Instead PPD susceptibility carries a significant genetic component. […] The researchers also discovered that genetic regions involving GABAergic neurons is associated with PPD, particularly in the thalamus and hypothalamus. GABAergic neurons control the release of the neurotransmitter GABA. […] Brexanolone, the only FDA-approved PPD treatment, is known to circulate throughout the body and brain. UNC researchers had discovered earlier this year that the drug worked through GABAergic neurons to treat PPD symptoms so effectively. But now, this new research suggests brexanolone likely acts on GABAergic neurons in two particular brain regions. […] „We view our finding as a refinement of the mechanism by which brexanolone works,” Guintivano said. „We now have preliminary evidence suggesting we should target GABAergic neurons in the thalamus and hypothalamus for future research.”

• #36

  https://link.springer.com/article/10.1007/s00213-023-06427-2

  This article describes the critical role of neurosteroids in postpartum depression (PPD) and outlines the landmark pharmacological journey of brexanolone as a first-in-class neurosteroid antidepressant with significant advantages over traditional antidepressants. […] The main pathology behind PPD is the postpartum reduction of neurosteroids, referred to as neurosteroid withdrawal, a concept pioneered by our preclinical studies. […] The neurosteroid, brexanolone (BX), is a progesterone-derived allopregnanolone that rapidly relieves anxiety and mood deficits by activating GABA-A receptors, making it a transformational treatment for PPD. […] We identified the molecular mechanism of BX in a neuronal PPD-like milieu. The mechanism of BX involves activation of both synaptic and extrasynaptic GABA-A receptors, which promote tonic inhibition and serve as a key target for PPD and related conditions.

• #37

  https://link.springer.com/article/10.1007/s00213-023-06427-2

  This article describes the critical role of neurosteroids in postpartum depression (PPD) and outlines the landmark pharmacological journey of brexanolone as a first-in-class neurosteroid antidepressant with significant advantages over traditional antidepressants. […] The main pathology behind PPD is the postpartum reduction of neurosteroids, referred to as neurosteroid withdrawal, a concept pioneered by our preclinical studies. […] The neurosteroid, brexanolone (BX), is a progesterone-derived allopregnanolone that rapidly relieves anxiety and mood deficits by activating GABA-A receptors, making it a transformational treatment for PPD. […] We identified the molecular mechanism of BX in a neuronal PPD-like milieu. The mechanism of BX involves activation of both synaptic and extrasynaptic GABA-A receptors, which promote tonic inhibition and serve as a key target for PPD and related conditions.

• #38 Novel neurosteroid therapeutics for post-partum depression: perspectives on clinical trials, program development, active research, and future directions | Neuropsychopharmacology

  https://www.nature.com/articles/s41386-023-01721-1

  With an established protocol in place, we have infused over 60 women with commercially available brexanolone in our clinical program at UNC since its approval in 2019. […] These naturalistic data suggest that those who benefit from brexanolone will continue to benefit in the months following treatment, which is very meaningful to those suffering from PPD. […] While the etiology of postpartum depression is believed to be multifactorial, there is increasing evidence that inflammatory signaling plays a significant role. […] Laboratory studies have shown that allopregnanolone inhibits inflammatory signaling through toll-like receptors (TLRs) in mouse and human macrophages and rat brain. […] This is a tremendous advancement in our understanding of why brexanolone is effective and further suggests that inflammatory signaling may contribute to the etiology of PPD.

• #39 Mechanism of Drug for Postpartum Depression Revealed | Technology Networks

  https://www.technologynetworks.com/drug-discovery/news/mechanism-of-drug-for-postpartum-depression-revealed-370416

  Post-partum depression (PPD) develops after childbirth and affects both the mothers and the infants health by preventing healthy bonding. […] A research team led by A. Leslie Morrow, PhD, has found that brexanolone works within the body by inhibiting the key systemic inflammatory pathways that are associated with depression. The new finding is monumental in that it suggests that PPD is likely caused, at least in part, by inflammation. […] Our results provide the first human data showing that blockade of specific inflammatory pathways is likely involved, at least in women who were unresponsive to other medications. […] But recent data and this new study suggest that inflammation may be contributing to the syndrome. […] The research suggests that the therapeutic effects of brexanolone are likely brought on by its ability to inhibit toll-like receptor pathways and reduce inflammatory markers. The same inflammatory markers have been shown to be up-regulated in PPD, which means that inflammation may be at least partially responsible for the condition.

• #40 Biomarkers of Postpartum Depression: A Narrative Review

  https://www.mdpi.com/2077-0383/12/20/6519

  Postpartum depression (PPD) is a disorder that impairs the formation of the relationship between mother and child, and reduces the quality of life for affected women to a functionally significant degree. […] The purpose of this paper is to review biomarkers linked to PPD and to present selected theories on the pathogenesis of the disease based on data from biomarker studies. […] The etiopathogenesis of PPD is complex and multidirectional. As in MDD, PPD has a multicomponent pattern, in which inflammatory, hormonal, and genetic factors are attributed special roles. […] Numerous studies point to the dysregulation of the immune system during pregnancy and childbirth. […] The period of childbirth itself, associated with tremendous stress on the body, mobilization of the HPA axis, and increased inflammatory response, can be considered a causal factor in depression.

• #41 Biomarkers of Postpartum Depression: A Narrative Review

  https://www.mdpi.com/2077-0383/12/20/6519

  Postpartum depression (PPD) is a disorder that impairs the formation of the relationship between mother and child, and reduces the quality of life for affected women to a functionally significant degree. […] The purpose of this paper is to review biomarkers linked to PPD and to present selected theories on the pathogenesis of the disease based on data from biomarker studies. […] The etiopathogenesis of PPD is complex and multidirectional. As in MDD, PPD has a multicomponent pattern, in which inflammatory, hormonal, and genetic factors are attributed special roles. […] Numerous studies point to the dysregulation of the immune system during pregnancy and childbirth. […] The period of childbirth itself, associated with tremendous stress on the body, mobilization of the HPA axis, and increased inflammatory response, can be considered a causal factor in depression.

• #42 Biomarkers of Postpartum Depression: A Narrative Review

  https://www.mdpi.com/2077-0383/12/20/6519

  The exacerbation of rheumatoid arthritis, a Th1-dependent disease, about 3 months after delivery, indicates a long recovery period for lymphocyte subpopulations. […] The role of inflammation and the immune system as central to postpartum mood is underscored by the drug brexanolone (an analog of allopregnanolone, which in turn is a metabolite of progesterone), a modulator of the GABA-a receptor, which is thought to inhibit the inflammatory response elicited by Toll-like receptors 4 and 7 and the activity of kynurenine pathway enzymes. […] It is believed that in the case of these cells, those substances have no peripheral, but only auto and paracrine action. […] The stress of childbirth may also interfere with neuromodulation and reduce the plasticity of synapses in the hippocampus, especially since high concentrations of GCS inhibit hippocampal neuromodulation, presumably via the NMDA receptor.

• #43 Researchers Uncover Mechanisms of Brexanolone and the Role of Inflammation in Post-partum Depression | Newsroom

  https://news.unchealthcare.org/2023/02/researchers-uncover-mechanisms-of-brexanolone-and-the-role-of-inflammation-in-post-partum-depression/

  Post-partum depression (PPD) develops after childbirth and affects both the mothers and the infants health by preventing healthy bonding. […] A research team led by A. Leslie Morrow, PhD, has found that brexanolone works within the body by inhibiting the key systemic inflammatory pathways that are associated with depression. […] The research suggests that the therapeutic effects of brexanolone are likely brought on by its ability to inhibit toll-like receptor pathways and reduce inflammatory markers. […] The same inflammatory markers have been shown to be up-regulated in PPD, which means that inflammation may be at least partially responsible for the condition. […] But recent data and this new study suggest that inflammation may be contributing to the syndrome.

• #44 Researchers Uncover Mechanisms of Brexanolone and the Role of Inflammation in Post-partum Depression | Newsroom

  https://news.unchealthcare.org/2023/02/researchers-uncover-mechanisms-of-brexanolone-and-the-role-of-inflammation-in-post-partum-depression/

  Post-partum depression (PPD) develops after childbirth and affects both the mothers and the infants health by preventing healthy bonding. […] A research team led by A. Leslie Morrow, PhD, has found that brexanolone works within the body by inhibiting the key systemic inflammatory pathways that are associated with depression. […] The research suggests that the therapeutic effects of brexanolone are likely brought on by its ability to inhibit toll-like receptor pathways and reduce inflammatory markers. […] The same inflammatory markers have been shown to be up-regulated in PPD, which means that inflammation may be at least partially responsible for the condition. […] But recent data and this new study suggest that inflammation may be contributing to the syndrome.

• #45 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20230919/Transforming-postpartum-depression-treatment-with-neurosteroids.aspx

  Allopregnanolone reduces the production of several inflammatory mediators through its action on TLR2, TLR4, and TLR7 in rodent brains. […] Brexanolone also prevents blood cells from reacting to the presence of lipopolysaccharide (LPS) and other activators of the inflammatory immune system, thereby preventing the activation of TRL4 and TLR7, a response that has been predictive of symptomatic improvement. […] The efficacy of brexanolone as a rapid therapeutic for PPD has been demonstrated; however, further studies are needed to understand how and which inflammatory pathways are impacted by this drug. […] The effect of brexanolone on GABAA receptors may be enhanced by its anti-inflammatory activity. However, continued inflammation could overcome its GABA-ergic effects. […] We propose that pleotropic actions of allopregnanolone are essential to its therapeutic potential in PPD and possibly other forms of depression and inflammatory brain disease.

• #46 Azthena logo with the word Azthena

  https://www.news-medical.net/news/20230919/Transforming-postpartum-depression-treatment-with-neurosteroids.aspx

  Allopregnanolone reduces the production of several inflammatory mediators through its action on TLR2, TLR4, and TLR7 in rodent brains. […] Brexanolone also prevents blood cells from reacting to the presence of lipopolysaccharide (LPS) and other activators of the inflammatory immune system, thereby preventing the activation of TRL4 and TLR7, a response that has been predictive of symptomatic improvement. […] The efficacy of brexanolone as a rapid therapeutic for PPD has been demonstrated; however, further studies are needed to understand how and which inflammatory pathways are impacted by this drug. […] The effect of brexanolone on GABAA receptors may be enhanced by its anti-inflammatory activity. However, continued inflammation could overcome its GABA-ergic effects. […] We propose that pleotropic actions of allopregnanolone are essential to its therapeutic potential in PPD and possibly other forms of depression and inflammatory brain disease.

• #47 Biomarkers of Postpartum Depression: A Narrative Review

  https://www.mdpi.com/2077-0383/12/20/6519

  The activity of IDO and other enzymes of the pathway increases with placental development. […] The decreasing amount of available serotonin leads to depressive disorders. […] The study by O’Hara et al. showed lower serum estradiol levels measured in women with PPD compared to healthy women, at 36 weeks pregnant and day 2 postpartum. […] Data collected by Zonana et al. indicate that the low levels of estrogen observed after delivery may be associated with PPD, suggesting an important role of steroid hormones especially in the first days after delivery and their significance as a possible trigger for depression. […] The introduction of hormone doses at pregnancy-like level and their decrease mimicking the transition to the postpartum period resulted in the appearance of depressive symptoms, suggesting that there is a subgroup of women who are sensitive to hormonal fluctuations.

• #48 Biomarkers of Postpartum Depression: A Narrative Review

  https://www.mdpi.com/2077-0383/12/20/6519

  The activity of IDO and other enzymes of the pathway increases with placental development. […] The decreasing amount of available serotonin leads to depressive disorders. […] The study by O’Hara et al. showed lower serum estradiol levels measured in women with PPD compared to healthy women, at 36 weeks pregnant and day 2 postpartum. […] Data collected by Zonana et al. indicate that the low levels of estrogen observed after delivery may be associated with PPD, suggesting an important role of steroid hormones especially in the first days after delivery and their significance as a possible trigger for depression. […] The introduction of hormone doses at pregnancy-like level and their decrease mimicking the transition to the postpartum period resulted in the appearance of depressive symptoms, suggesting that there is a subgroup of women who are sensitive to hormonal fluctuations.

• #49 Biomarkers of Postpartum Depression: A Narrative Review

  https://www.mdpi.com/2077-0383/12/20/6519

  The period of pregnancy and childbirth is subject to dysregulations of the HPA axis. […] Rapid changes in CRH concentrations as well as chronic hypercortisolism during pregnancy can be considered potential stressors. […] Elevated levels of Interleukin 1β (IL-1β) and reduced levels of BDNF were observed in rat hippocampal biopsies. […] The interaction effect between monoaminergic genes and environmental stressors is thought to be of great relevance to PPD susceptibility and have a possible predictive value.

• #50 Postpartum Depression: Etiology, Treatment, and Consequences for Maternal Care

  https://www.mdpi.com/2075-4418/14/9/865

  Postpartum depression (PPD) is a disabling condition that has recently shown an increase in prevalence, becoming an essential public health problem. […] Research on the genetic basis for PPD has taken place in recent years to identify the genes responsible for establishing targeted therapeutic methods and understanding its pathogenesis. […] There is evidence that biological factors, such as hormonal factors, genetics, and immune function, among other types of causes, play an essential role in triggering PPD. […] The following demographic risk factors can be grouped according to the strength of association with PPD: depression and anxiety in pregnancy, history of depression, excessive stress caused by life events, poor marital relations, lack of social support, and low self-esteem are strongly associated with PPD.

• #51 Postpartum Depression: Etiology, Treatment, and Consequences for Maternal Care

  https://www.mdpi.com/2075-4418/14/9/865

  Postpartum depression (PPD) is a disabling condition that has recently shown an increase in prevalence, becoming an essential public health problem. […] Research on the genetic basis for PPD has taken place in recent years to identify the genes responsible for establishing targeted therapeutic methods and understanding its pathogenesis. […] There is evidence that biological factors, such as hormonal factors, genetics, and immune function, among other types of causes, play an essential role in triggering PPD. […] The following demographic risk factors can be grouped according to the strength of association with PPD: depression and anxiety in pregnancy, history of depression, excessive stress caused by life events, poor marital relations, lack of social support, and low self-esteem are strongly associated with PPD.

• #52 Postpartum Depression: Etiology, Treatment, and Consequences for Maternal Care

  https://www.mdpi.com/2075-4418/14/9/865

  PPD may also be associated with different sensitivity to hormonal fluctuations. […] The involvement of the serotoninergic system was suggested by other studies that evaluated altered platelet serotonin transporter binding and decreased postsynaptic serotonin 1-A receptor binding in the anterior cingulate cortex and mesial temporal cortex. […] Research on the genetic basis for PPD has taken place in recent years to identify the genes responsible for establishing targeted therapeutic methods and understanding its pathogenesis. […] The most frequently studied candidate gene was the serotonin transporter gene (SERT), which presents two primary polymorphisms, of which the 5-HTTLPR polymorphism is the most frequently associated with PPD. […] The genetic risk for PPD may have a component that overlaps with the genetic risk for major depressive disorder (MDD) and/or bipolar disorder and, in addition, a component that is specific to PPD itself.

• #53 Postpartum Depression: Etiology, Treatment, and Consequences for Maternal Care

  https://www.mdpi.com/2075-4418/14/9/865

  PPD may also be associated with different sensitivity to hormonal fluctuations. […] The involvement of the serotoninergic system was suggested by other studies that evaluated altered platelet serotonin transporter binding and decreased postsynaptic serotonin 1-A receptor binding in the anterior cingulate cortex and mesial temporal cortex. […] Research on the genetic basis for PPD has taken place in recent years to identify the genes responsible for establishing targeted therapeutic methods and understanding its pathogenesis. […] The most frequently studied candidate gene was the serotonin transporter gene (SERT), which presents two primary polymorphisms, of which the 5-HTTLPR polymorphism is the most frequently associated with PPD. […] The genetic risk for PPD may have a component that overlaps with the genetic risk for major depressive disorder (MDD) and/or bipolar disorder and, in addition, a component that is specific to PPD itself.

• #54 Genetic Markers Associated with Postpartum Depression | NDT

  https://www.dovepress.com/genetic-markers-associated-with-postpartum-depression-a-review-peer-reviewed-fulltext-article-NDT

  Postpartum depression (PPD) is caused by various biological and psychosocial factors. […] Genetic polymorphisms and epigenetic modifications have been proposed to be potential PPD biomarkers. […] The serotonin gene (5-HTTLPR) and oxytocin genes (OXTR) have the most significant associations with PPD among other genes. […] The incidence of low serotonin expression and transcriptional efficiency is associated with the short allele of 5-HTTLPR. Carriers of this 5-HTTLPR short allele are at high risk of developing a PPD disorder. […] The Val158Met polymorphism, which is a variation of the COMT and MAO-A genes, has been widely studied concerning the pathogenesis of PPD. […] Estrogen contributes to PPD disorders by affecting serotonin transmission. […] The oxytocin receptor (OXTR) has a vital function in regulating anxiety and stress and could be affected by various hormonal fluctuations and psychosocial factors associated with reproduction, making the OXTR a promising area of study for PPD pathophysiologies.

• #55 Genetic Markers Associated with Postpartum Depression | NDT

  https://www.dovepress.com/genetic-markers-associated-with-postpartum-depression-a-review-peer-reviewed-fulltext-article-NDT

  Postpartum depression (PPD) is caused by various biological and psychosocial factors. […] Genetic polymorphisms and epigenetic modifications have been proposed to be potential PPD biomarkers. […] The serotonin gene (5-HTTLPR) and oxytocin genes (OXTR) have the most significant associations with PPD among other genes. […] The incidence of low serotonin expression and transcriptional efficiency is associated with the short allele of 5-HTTLPR. Carriers of this 5-HTTLPR short allele are at high risk of developing a PPD disorder. […] The Val158Met polymorphism, which is a variation of the COMT and MAO-A genes, has been widely studied concerning the pathogenesis of PPD. […] Estrogen contributes to PPD disorders by affecting serotonin transmission. […] The oxytocin receptor (OXTR) has a vital function in regulating anxiety and stress and could be affected by various hormonal fluctuations and psychosocial factors associated with reproduction, making the OXTR a promising area of study for PPD pathophysiologies.

• #56 Genetic Markers Associated with Postpartum Depression | NDT

  https://www.dovepress.com/genetic-markers-associated-with-postpartum-depression-a-review-peer-reviewed-fulltext-article-NDT

  Postpartum depression (PPD) is caused by various biological and psychosocial factors. […] Genetic polymorphisms and epigenetic modifications have been proposed to be potential PPD biomarkers. […] The serotonin gene (5-HTTLPR) and oxytocin genes (OXTR) have the most significant associations with PPD among other genes. […] The incidence of low serotonin expression and transcriptional efficiency is associated with the short allele of 5-HTTLPR. Carriers of this 5-HTTLPR short allele are at high risk of developing a PPD disorder. […] The Val158Met polymorphism, which is a variation of the COMT and MAO-A genes, has been widely studied concerning the pathogenesis of PPD. […] Estrogen contributes to PPD disorders by affecting serotonin transmission. […] The oxytocin receptor (OXTR) has a vital function in regulating anxiety and stress and could be affected by various hormonal fluctuations and psychosocial factors associated with reproduction, making the OXTR a promising area of study for PPD pathophysiologies.

• #57 Genetic Markers Associated with Postpartum Depression | NDT

  https://www.dovepress.com/genetic-markers-associated-with-postpartum-depression-a-review-peer-reviewed-fulltext-article-NDT

  Postpartum depression (PPD) is caused by various biological and psychosocial factors. […] Genetic polymorphisms and epigenetic modifications have been proposed to be potential PPD biomarkers. […] The serotonin gene (5-HTTLPR) and oxytocin genes (OXTR) have the most significant associations with PPD among other genes. […] The incidence of low serotonin expression and transcriptional efficiency is associated with the short allele of 5-HTTLPR. Carriers of this 5-HTTLPR short allele are at high risk of developing a PPD disorder. […] The Val158Met polymorphism, which is a variation of the COMT and MAO-A genes, has been widely studied concerning the pathogenesis of PPD. […] Estrogen contributes to PPD disorders by affecting serotonin transmission. […] The oxytocin receptor (OXTR) has a vital function in regulating anxiety and stress and could be affected by various hormonal fluctuations and psychosocial factors associated with reproduction, making the OXTR a promising area of study for PPD pathophysiologies.

• #58 Genetic Markers Associated with Postpartum Depression | NDT

  https://www.dovepress.com/genetic-markers-associated-with-postpartum-depression-a-review-peer-reviewed-fulltext-article-NDT

  Postpartum depression (PPD) is caused by various biological and psychosocial factors. […] Genetic polymorphisms and epigenetic modifications have been proposed to be potential PPD biomarkers. […] The serotonin gene (5-HTTLPR) and oxytocin genes (OXTR) have the most significant associations with PPD among other genes. […] The incidence of low serotonin expression and transcriptional efficiency is associated with the short allele of 5-HTTLPR. Carriers of this 5-HTTLPR short allele are at high risk of developing a PPD disorder. […] The Val158Met polymorphism, which is a variation of the COMT and MAO-A genes, has been widely studied concerning the pathogenesis of PPD. […] Estrogen contributes to PPD disorders by affecting serotonin transmission. […] The oxytocin receptor (OXTR) has a vital function in regulating anxiety and stress and could be affected by various hormonal fluctuations and psychosocial factors associated with reproduction, making the OXTR a promising area of study for PPD pathophysiologies.

• #59 Genetic Markers Associated with Postpartum Depression | NDT

  https://www.dovepress.com/genetic-markers-associated-with-postpartum-depression-a-review-peer-reviewed-fulltext-article-NDT

  Postpartum depression (PPD) is caused by various biological and psychosocial factors. […] Genetic polymorphisms and epigenetic modifications have been proposed to be potential PPD biomarkers. […] The serotonin gene (5-HTTLPR) and oxytocin genes (OXTR) have the most significant associations with PPD among other genes. […] The incidence of low serotonin expression and transcriptional efficiency is associated with the short allele of 5-HTTLPR. Carriers of this 5-HTTLPR short allele are at high risk of developing a PPD disorder. […] The Val158Met polymorphism, which is a variation of the COMT and MAO-A genes, has been widely studied concerning the pathogenesis of PPD. […] Estrogen contributes to PPD disorders by affecting serotonin transmission. […] The oxytocin receptor (OXTR) has a vital function in regulating anxiety and stress and could be affected by various hormonal fluctuations and psychosocial factors associated with reproduction, making the OXTR a promising area of study for PPD pathophysiologies.

• #60 Researchers confirm postpartum depression heritability, home in on treatment mechanism | ScienceDaily

  https://www.sciencedaily.com/releases/2023/10/231019151814.htm

  Postpartum depression (PPD), a common subtype of major depressive disorder, is more heritable than other psychiatric conditions, yet the genetics of PPD are understudied compared to these other psychiatric conditions, such as anxiety and bipolar disorder. […] A patient’s PPD is often not merely the result of environmental factors, such as past trauma. Instead PPD susceptibility carries a significant genetic component. […] The researchers also discovered that genetic regions involving GABAergic neurons is associated with PPD, particularly in the thalamus and hypothalamus. GABAergic neurons control the release of the neurotransmitter GABA. […] UNC researchers had discovered earlier this year that the drug worked through GABAergic neurons to treat PPD symptoms so effectively. But now, this new research suggests brexanolone likely acts on GABAergic neurons in two particular brain regions. […] „We view our finding as a refinement of the mechanism by which brexanolone works,” Guintivano said. „We now have preliminary evidence suggesting we should target GABAergic neurons in the thalamus and hypothalamus for future research.”

• #61 Researchers confirm postpartum depression heritability, home in on treatment mechanism | ScienceDaily

  https://www.sciencedaily.com/releases/2023/10/231019151814.htm

  Postpartum depression (PPD), a common subtype of major depressive disorder, is more heritable than other psychiatric conditions, yet the genetics of PPD are understudied compared to these other psychiatric conditions, such as anxiety and bipolar disorder. […] A patient’s PPD is often not merely the result of environmental factors, such as past trauma. Instead PPD susceptibility carries a significant genetic component. […] The researchers also discovered that genetic regions involving GABAergic neurons is associated with PPD, particularly in the thalamus and hypothalamus. GABAergic neurons control the release of the neurotransmitter GABA. […] UNC researchers had discovered earlier this year that the drug worked through GABAergic neurons to treat PPD symptoms so effectively. But now, this new research suggests brexanolone likely acts on GABAergic neurons in two particular brain regions. […] „We view our finding as a refinement of the mechanism by which brexanolone works,” Guintivano said. „We now have preliminary evidence suggesting we should target GABAergic neurons in the thalamus and hypothalamus for future research.”

• #62 Researchers confirm postpartum depression heritability, home in on treatment mechanism | ScienceDaily

  https://www.sciencedaily.com/releases/2023/10/231019151814.htm

  Postpartum depression (PPD), a common subtype of major depressive disorder, is more heritable than other psychiatric conditions, yet the genetics of PPD are understudied compared to these other psychiatric conditions, such as anxiety and bipolar disorder. […] A patient’s PPD is often not merely the result of environmental factors, such as past trauma. Instead PPD susceptibility carries a significant genetic component. […] The researchers also discovered that genetic regions involving GABAergic neurons is associated with PPD, particularly in the thalamus and hypothalamus. GABAergic neurons control the release of the neurotransmitter GABA. […] UNC researchers had discovered earlier this year that the drug worked through GABAergic neurons to treat PPD symptoms so effectively. But now, this new research suggests brexanolone likely acts on GABAergic neurons in two particular brain regions. […] „We view our finding as a refinement of the mechanism by which brexanolone works,” Guintivano said. „We now have preliminary evidence suggesting we should target GABAergic neurons in the thalamus and hypothalamus for future research.”

• #63 Neurobiological Mechanism for Postpartum Depression Identified

  https://www.medscape.com/viewarticle/721584

  During the first postpartum week, when postpartum blues tend to occur, women experience a „dramatic” increase in monoamine oxidase A (MAO-A) binding in key areas of the brain that affect mood, according to results of a study in the May issue of the Archives of General Psychiatry. […] „Elevated MAO-A levels in the early postpartum period can be interpreted as a marker of a monoamine-lowering process that contributes to the mood change of postpartum blues,” Dr. Meyer and colleagues write. […] Rather than a purely psychosocial model, they propose a „neurobiological model of estrogen decline, followed by elevated MAO-A binding, low mood, and subsequently a period of high risk for major depressive episodes.” […] A spike in MAO-A right after delivery, fueled by rapidly declining estrogen levels, could be one such change.

• #64 Neurobiological Mechanism for Postpartum Depression Identified

  https://www.medscape.com/viewarticle/721584

  During the first postpartum week, when postpartum blues tend to occur, women experience a „dramatic” increase in monoamine oxidase A (MAO-A) binding in key areas of the brain that affect mood, according to results of a study in the May issue of the Archives of General Psychiatry. […] „Elevated MAO-A levels in the early postpartum period can be interpreted as a marker of a monoamine-lowering process that contributes to the mood change of postpartum blues,” Dr. Meyer and colleagues write. […] Rather than a purely psychosocial model, they propose a „neurobiological model of estrogen decline, followed by elevated MAO-A binding, low mood, and subsequently a period of high risk for major depressive episodes.” […] A spike in MAO-A right after delivery, fueled by rapidly declining estrogen levels, could be one such change.

• #65 Neurobiological Mechanism for Postpartum Depression Identified

  https://www.medscape.com/viewarticle/721584

  During the first postpartum week, when postpartum blues tend to occur, women experience a „dramatic” increase in monoamine oxidase A (MAO-A) binding in key areas of the brain that affect mood, according to results of a study in the May issue of the Archives of General Psychiatry. […] „Elevated MAO-A levels in the early postpartum period can be interpreted as a marker of a monoamine-lowering process that contributes to the mood change of postpartum blues,” Dr. Meyer and colleagues write. […] Rather than a purely psychosocial model, they propose a „neurobiological model of estrogen decline, followed by elevated MAO-A binding, low mood, and subsequently a period of high risk for major depressive episodes.” […] A spike in MAO-A right after delivery, fueled by rapidly declining estrogen levels, could be one such change.

• #66 Neurobiological Mechanism for Postpartum Depression Identified

  https://www.medscape.com/viewarticle/721584

  During the first postpartum week, when postpartum blues tend to occur, women experience a „dramatic” increase in monoamine oxidase A (MAO-A) binding in key areas of the brain that affect mood, according to results of a study in the May issue of the Archives of General Psychiatry. […] „Elevated MAO-A levels in the early postpartum period can be interpreted as a marker of a monoamine-lowering process that contributes to the mood change of postpartum blues,” Dr. Meyer and colleagues write. […] Rather than a purely psychosocial model, they propose a „neurobiological model of estrogen decline, followed by elevated MAO-A binding, low mood, and subsequently a period of high risk for major depressive episodes.” […] A spike in MAO-A right after delivery, fueled by rapidly declining estrogen levels, could be one such change.

• #67 Linking the reversal of gestational insulin resistance to postpartum depression | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03659-7

  Postpartum depression (PPD) constitutes a significant mental health disorder affecting almost one fifth of pregnancies globally. Despite extensive research, the precise etiological mechanisms underlying PPD remain elusive. However, several risk factors like genetic predisposition, hormonal fluctuations, and stress-related environmental and psychosocial triggers have been found to be implicated in its development. […] Recently, an increased risk of PPD has been reported to be associated with gestational diabetes mellitus (GDM), which is characterized by the disruption of glucose metabolism, primarily attributed to the emergence of insulin resistance (IR). […] Considering the pivotal roles of energy metabolism, particularly glucose metabolism, in CNS functions, we propose a novel model that such pronounced changes in IR and the associated glucose metabolism seen postpartum might account for PPD development.

• #68 Linking the reversal of gestational insulin resistance to postpartum depression | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03659-7

  Postpartum depression (PPD) constitutes a significant mental health disorder affecting almost one fifth of pregnancies globally. Despite extensive research, the precise etiological mechanisms underlying PPD remain elusive. However, several risk factors like genetic predisposition, hormonal fluctuations, and stress-related environmental and psychosocial triggers have been found to be implicated in its development. […] Recently, an increased risk of PPD has been reported to be associated with gestational diabetes mellitus (GDM), which is characterized by the disruption of glucose metabolism, primarily attributed to the emergence of insulin resistance (IR). […] Considering the pivotal roles of energy metabolism, particularly glucose metabolism, in CNS functions, we propose a novel model that such pronounced changes in IR and the associated glucose metabolism seen postpartum might account for PPD development.

• #69 Linking the reversal of gestational insulin resistance to postpartum depression | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03659-7

  The detailed pathogenesis of PPD might be multifactorial and still remains to be fully elucidated. Nevertheless, our hypothesis might account in part for an additional etiological factor to PPD development. […] With accumulating evidence suggesting the role of insulin and glucose metabolism in mood control in the brain, we here propose a novel concept, positing that the abrupt reversal of gestational IR following childbirth and the concomitant alterations in central nervous system (CNS) insulin and glucose metabolism play a role in the development of PPD. […] Mechanistically, reversal of IR post-delivery rewires the glucose metabolism in the periphery; these changes are likely to extend towards the brain as well. […] These alterations are critical to maternal mood control, and when they surpass a defined threshold, they can profoundly interrupt maternal brain functions, ultimately detrimentally affecting mood regulation and leading to PPD. […] Our concept, drawing upon the state-of-the-art advances in metabolism and neuroscience, proposes a novel mechanism for the development of PPD. We suggest that PPD may arise as an exacerbated consequence following the reversal of gestational IR.

• #70 Linking the reversal of gestational insulin resistance to postpartum depression | BMC Medicine | Full Text

  https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-024-03659-7

  The detailed pathogenesis of PPD might be multifactorial and still remains to be fully elucidated. Nevertheless, our hypothesis might account in part for an additional etiological factor to PPD development. […] With accumulating evidence suggesting the role of insulin and glucose metabolism in mood control in the brain, we here propose a novel concept, positing that the abrupt reversal of gestational IR following childbirth and the concomitant alterations in central nervous system (CNS) insulin and glucose metabolism play a role in the development of PPD. […] Mechanistically, reversal of IR post-delivery rewires the glucose metabolism in the periphery; these changes are likely to extend towards the brain as well. […] These alterations are critical to maternal mood control, and when they surpass a defined threshold, they can profoundly interrupt maternal brain functions, ultimately detrimentally affecting mood regulation and leading to PPD. […] Our concept, drawing upon the state-of-the-art advances in metabolism and neuroscience, proposes a novel mechanism for the development of PPD. We suggest that PPD may arise as an exacerbated consequence following the reversal of gestational IR.

• #71 Maternal childhood trauma, postpartum depression, and infant outcomes: Avoidant affective processing as a potential mechanism – SEARCH

  https://primo.qatar-weill.cornell.edu/discovery/fulldisplay/cdi_proquest_miscellaneous_1861590889/974WCMCIQ_INST:VU1

  Abstract Background Women who have experienced childhood trauma may be at risk for postpartum depression, increasing the likelihood of negative outcomes among their children. […] Structural equation models tested postpartum depression as a mediator between maternal experiences of childhood trauma and children’s outcomes. […] Women with childhood trauma experienced greater depressive symptoms through six months postpartum, which then predicted negative child outcomes at one year. […] Mediating effects of postpartum depression were significant, and persisted for maternal-infant bonding and infant growth after controlling for covariates and antenatal distress. […] Maternal avoidance of fearful stimuli emerged as a potential affective mechanism. […] Findings suggest a mediating role of postpartum depression in the intergenerational transmission of negative outcomes.

• #72 Maternal childhood trauma, postpartum depression, and infant outcomes: Avoidant affective processing as a potential mechanism – SEARCH

  https://primo.qatar-weill.cornell.edu/discovery/fulldisplay/cdi_proquest_miscellaneous_1861590889/974WCMCIQ_INST:VU1

  Abstract Background Women who have experienced childhood trauma may be at risk for postpartum depression, increasing the likelihood of negative outcomes among their children. […] Structural equation models tested postpartum depression as a mediator between maternal experiences of childhood trauma and children’s outcomes. […] Women with childhood trauma experienced greater depressive symptoms through six months postpartum, which then predicted negative child outcomes at one year. […] Mediating effects of postpartum depression were significant, and persisted for maternal-infant bonding and infant growth after controlling for covariates and antenatal distress. […] Maternal avoidance of fearful stimuli emerged as a potential affective mechanism. […] Findings suggest a mediating role of postpartum depression in the intergenerational transmission of negative outcomes.

• #73 Maternal childhood trauma, postpartum depression, and infant outcomes: Avoidant affective processing as a potential mechanism – SEARCH

  https://primo.qatar-weill.cornell.edu/discovery/fulldisplay/cdi_proquest_miscellaneous_1861590889/974WCMCIQ_INST:VU1

  Abstract Background Women who have experienced childhood trauma may be at risk for postpartum depression, increasing the likelihood of negative outcomes among their children. […] Structural equation models tested postpartum depression as a mediator between maternal experiences of childhood trauma and children’s outcomes. […] Women with childhood trauma experienced greater depressive symptoms through six months postpartum, which then predicted negative child outcomes at one year. […] Mediating effects of postpartum depression were significant, and persisted for maternal-infant bonding and infant growth after controlling for covariates and antenatal distress. […] Maternal avoidance of fearful stimuli emerged as a potential affective mechanism. […] Findings suggest a mediating role of postpartum depression in the intergenerational transmission of negative outcomes.

• #74 Maternal childhood trauma, postpartum depression, and infant outcomes: Avoidant affective processing as a potential mechanism – SEARCH

  https://primo.qatar-weill.cornell.edu/discovery/fulldisplay/cdi_proquest_miscellaneous_1861590889/974WCMCIQ_INST:VU1

  Abstract Background Women who have experienced childhood trauma may be at risk for postpartum depression, increasing the likelihood of negative outcomes among their children. […] Structural equation models tested postpartum depression as a mediator between maternal experiences of childhood trauma and children’s outcomes. […] Women with childhood trauma experienced greater depressive symptoms through six months postpartum, which then predicted negative child outcomes at one year. […] Mediating effects of postpartum depression were significant, and persisted for maternal-infant bonding and infant growth after controlling for covariates and antenatal distress. […] Maternal avoidance of fearful stimuli emerged as a potential affective mechanism. […] Findings suggest a mediating role of postpartum depression in the intergenerational transmission of negative outcomes.

• #75 Maternal childhood trauma, postpartum depression, and infant outcomes: Avoidant affective processing as a potential mechanism – SEARCH

  https://primo.qatar-weill.cornell.edu/discovery/fulldisplay/cdi_proquest_miscellaneous_1861590889/974WCMCIQ_INST:VU1

  Abstract Background Women who have experienced childhood trauma may be at risk for postpartum depression, increasing the likelihood of negative outcomes among their children. […] Structural equation models tested postpartum depression as a mediator between maternal experiences of childhood trauma and children’s outcomes. […] Women with childhood trauma experienced greater depressive symptoms through six months postpartum, which then predicted negative child outcomes at one year. […] Mediating effects of postpartum depression were significant, and persisted for maternal-infant bonding and infant growth after controlling for covariates and antenatal distress. […] Maternal avoidance of fearful stimuli emerged as a potential affective mechanism. […] Findings suggest a mediating role of postpartum depression in the intergenerational transmission of negative outcomes.

• #76 Postpartum Depression – Gynecology and Obstetrics – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/gynecology-and-obstetrics/postpartum-care-and-associated-disorders/postpartum-depression

  Postpartum depression occurs in 7% of women during the first year after delivery. […] The exact etiology of postpartum depression is unknown; however, prior depression is the major risk, and hormonal changes during the puerperium, sleep deprivation, and genetic susceptibility may contribute. […] Treatment of postpartum depression includes antidepressants and psychotherapy. Two medications have been approved by the U.S. Food and Drug Administration specifically for postpartum depression: brexanolone given intravenously, and zuranolone given orally. Both are neurosteroids that modulate GABA-A receptors in the brain.

• #77 FDA Approves New Postpartum Depression Treatment – NewYork-Presbyterian – Psychiatry, Women’s Health

  https://healthmatters.nyp.org/fda-approves-new-postpartum-depression-treatment/

  Postpartum depression is a serious but common condition, affecting about 1 in 8 women, according to the Centers for Disease Control and Prevention. […] Zuranolone is a synthetic form of allopregnanolone, a metabolite of progesterone, that rises greatly across pregnancy and has a calming effect on the brain. […] Numerous studies have identified that dysregulation in this system both shifts in the levels of allopregnanolone and changes in the conformation of the receptor may play an important role in postpartum depression. […] While zuranolone itself is a new medication, it mimics a hormone that is natural in the body and works through a mechanism that we know to be implicated in postpartum depression from many years of basic scientific research. […] There is tremendous excitement about the possibility of zuranolone because it is working off this mechanism that is so specific to the postpartum period and to this distinct condition. It has a lot of potential as a treatment that could, if it continues to prove to be effective, transform the way we practice and treat patients in this postpartum period.

• #78 FDA Approves New Postpartum Depression Treatment – NewYork-Presbyterian – Psychiatry, Women’s Health

  https://healthmatters.nyp.org/fda-approves-new-postpartum-depression-treatment/

  Postpartum depression is a serious but common condition, affecting about 1 in 8 women, according to the Centers for Disease Control and Prevention. […] Zuranolone is a synthetic form of allopregnanolone, a metabolite of progesterone, that rises greatly across pregnancy and has a calming effect on the brain. […] Numerous studies have identified that dysregulation in this system both shifts in the levels of allopregnanolone and changes in the conformation of the receptor may play an important role in postpartum depression. […] While zuranolone itself is a new medication, it mimics a hormone that is natural in the body and works through a mechanism that we know to be implicated in postpartum depression from many years of basic scientific research. […] There is tremendous excitement about the possibility of zuranolone because it is working off this mechanism that is so specific to the postpartum period and to this distinct condition. It has a lot of potential as a treatment that could, if it continues to prove to be effective, transform the way we practice and treat patients in this postpartum period.

• #79 FDA Approves New Postpartum Depression Treatment – NewYork-Presbyterian – Psychiatry, Women’s Health

  https://healthmatters.nyp.org/fda-approves-new-postpartum-depression-treatment/

  Postpartum depression is a serious but common condition, affecting about 1 in 8 women, according to the Centers for Disease Control and Prevention. […] Zuranolone is a synthetic form of allopregnanolone, a metabolite of progesterone, that rises greatly across pregnancy and has a calming effect on the brain. […] Numerous studies have identified that dysregulation in this system both shifts in the levels of allopregnanolone and changes in the conformation of the receptor may play an important role in postpartum depression. […] While zuranolone itself is a new medication, it mimics a hormone that is natural in the body and works through a mechanism that we know to be implicated in postpartum depression from many years of basic scientific research. […] There is tremendous excitement about the possibility of zuranolone because it is working off this mechanism that is so specific to the postpartum period and to this distinct condition. It has a lot of potential as a treatment that could, if it continues to prove to be effective, transform the way we practice and treat patients in this postpartum period.

• #80 Neurobiological Mechanism for Postpartum Depression Identified

  https://www.medscape.com/viewarticle/721584

  If confirmed in future studies, the finding could have potentially important clinical implications in terms of preventing postpartum depression, Dr. Meyer noted. […] „Because MAO-A is elevated in this 4- to 6-day postpartum time period, it might be important to try to give nutrients that will replace what MAO-A moves during this time period,” he told Medscape Psychiatry. „We are going to do a study to see if there might be a health supplement that can do this and possibly reduce the risk of postpartum depression.” […] „MAO-A inhibitors might end up being particularly useful for postpartum depression in the future,” Dr. Meyer said.

• #81 Treating Postpartum Depression – Whole Health Library

  https://www.va.gov/WHOLEHEALTHLIBRARY/tools/treating-postpartum-depression.asp

  Dietary supplementation with omega-3 fats prenatally may decrease the risk of developing postpartum depression, as well as reduce some depressive symptoms in the postpartum period. […] Studies suggest a link between low serum vitamin D levels and an increased risk of postpartum depression. […] Correction of vitamin D deficiency may play a significant role in the recovery from postpartum depression. […] Social connection is necessary during the postpartum time.

• #82 Causal mechanisms of postnatal depression among women in Gondar town, Ethiopia: application of a stress-process model with generalized structural equation modeling | Reproductive Health | Full Text

  https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-020-00912-z

  A CMD before pregnancy and low birth weight (LBW) increased PND scores, and these effects were in part mediated via antenatal depression and labor complications. Early detection and treatment of depression before or during pregnancy could either directly or indirectly reduce the risk of labor complications and PND. Interventions that reduce LBW or improve the uptake of postnatal care might reduce PND incidence. […] Understanding the potential mechanisms by which stresses can lead to depression is now considered essential to enable the development of preventative PND interventions. […] This study, therefore, considered the stress process model developed by Pearlin to better understand potential causal pathways to postnatal depression among postnatal women in Gondar Town. […] Symptoms of common mental disorders (CMDs) before pregnancy were both directly (standardized =0.06) and indirectly (standardized =0.05) associated with the EPDS (total standardized =0.11). Thus, a history of CMDs was associated with an overall 0.11 SD higher EPDS. The two significant indirect pathways through which CMDs led to postnatal depression were through antenatal depression and self-reported labor complications. Low birth weight (standardized =0.32) and self-reported labor complications (standardized =0.09) also had direct positive associations with postnatal depression.

• #83 Causal mechanisms of postnatal depression among women in Gondar town, Ethiopia: application of a stress-process model with generalized structural equation modeling | Reproductive Health | Full Text

  https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-020-00912-z

  A CMD before pregnancy and low birth weight (LBW) increased PND scores, and these effects were in part mediated via antenatal depression and labor complications. Early detection and treatment of depression before or during pregnancy could either directly or indirectly reduce the risk of labor complications and PND. Interventions that reduce LBW or improve the uptake of postnatal care might reduce PND incidence. […] Understanding the potential mechanisms by which stresses can lead to depression is now considered essential to enable the development of preventative PND interventions. […] This study, therefore, considered the stress process model developed by Pearlin to better understand potential causal pathways to postnatal depression among postnatal women in Gondar Town. […] Symptoms of common mental disorders (CMDs) before pregnancy were both directly (standardized =0.06) and indirectly (standardized =0.05) associated with the EPDS (total standardized =0.11). Thus, a history of CMDs was associated with an overall 0.11 SD higher EPDS. The two significant indirect pathways through which CMDs led to postnatal depression were through antenatal depression and self-reported labor complications. Low birth weight (standardized =0.32) and self-reported labor complications (standardized =0.09) also had direct positive associations with postnatal depression.

• #84 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Signs and symptoms of postpartum depression are clinically indistinguishable from major depression that occurs in women at other times. […] Symptoms of major depression may include depressed mood, tearfulness, anhedonia, insomnia, fatigue, appetite disturbance, suicidal thoughts, and recurrent thoughts of death. […] This interferes with the mothers ability to function, causing risk of harm to the mother or infant. […] Earlier initiation of treatment is associated with a better prognosis, and the severity of the illness should guide treatment. […] Nonpharmacologic treatment strategies are useful for women with mild to moderate depressive symptoms. […] Pharmacologic strategies are indicated for moderate to severe depressive symptoms or when a woman’s condition does not respond to nonpharmacologic treatment.

• #85 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Signs and symptoms of postpartum depression are clinically indistinguishable from major depression that occurs in women at other times. […] Symptoms of major depression may include depressed mood, tearfulness, anhedonia, insomnia, fatigue, appetite disturbance, suicidal thoughts, and recurrent thoughts of death. […] This interferes with the mothers ability to function, causing risk of harm to the mother or infant. […] Earlier initiation of treatment is associated with a better prognosis, and the severity of the illness should guide treatment. […] Nonpharmacologic treatment strategies are useful for women with mild to moderate depressive symptoms. […] Pharmacologic strategies are indicated for moderate to severe depressive symptoms or when a woman’s condition does not respond to nonpharmacologic treatment.

• #86 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Signs and symptoms of postpartum depression are clinically indistinguishable from major depression that occurs in women at other times. […] Symptoms of major depression may include depressed mood, tearfulness, anhedonia, insomnia, fatigue, appetite disturbance, suicidal thoughts, and recurrent thoughts of death. […] This interferes with the mothers ability to function, causing risk of harm to the mother or infant. […] Earlier initiation of treatment is associated with a better prognosis, and the severity of the illness should guide treatment. […] Nonpharmacologic treatment strategies are useful for women with mild to moderate depressive symptoms. […] Pharmacologic strategies are indicated for moderate to severe depressive symptoms or when a woman’s condition does not respond to nonpharmacologic treatment.

• #87 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Antidepressants remain the first line of treatment. […] However, there are preliminary data to suggest that estrogen, alone or in combination with an antidepressant, may be beneficial. […] The GABA system is the major inhibitory signaling pathway of the brain and CNS and contributes to regulating brain function (eg, mood, arousal, behavior, cognition). The mechanism of action for the treatment of PPD is not fully understood, but is believed to be related to positive allosteric modulation of both synaptic and extrasynaptic GABA-A receptors.

• #88 Postpartum Depression: Overview, Risk Factors for Postpartum Mood Disorders, Screening for Postpartum Mood Disorders

  https://emedicine.medscape.com/article/271662-overview

  Antidepressants remain the first line of treatment. […] However, there are preliminary data to suggest that estrogen, alone or in combination with an antidepressant, may be beneficial. […] The GABA system is the major inhibitory signaling pathway of the brain and CNS and contributes to regulating brain function (eg, mood, arousal, behavior, cognition). The mechanism of action for the treatment of PPD is not fully understood, but is believed to be related to positive allosteric modulation of both synaptic and extrasynaptic GABA-A receptors.

• #89 Postpartum depression – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617

  Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems. […] Untreated postpartum depression can last for months or longer, sometimes becoming an ongoing depressive disorder. Mothers may stop breastfeeding, have problems bonding with and caring for their infants, and be at increased risk of suicide. Even when treated, postpartum depression increases a woman’s risk of future episodes of major depression. […] Postpartum depression can have a ripple effect, causing emotional strain for everyone close to a new baby. When a new mother is depressed, the risk of depression in the baby’s other parent may also increase. And these other parents may already have an increased risk of depression, whether or not their partner is affected. […] Children of mothers who have untreated postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, crying too much, and delays in language development.

• #90 Postpartum depression – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617

  Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems. […] Untreated postpartum depression can last for months or longer, sometimes becoming an ongoing depressive disorder. Mothers may stop breastfeeding, have problems bonding with and caring for their infants, and be at increased risk of suicide. Even when treated, postpartum depression increases a woman’s risk of future episodes of major depression. […] Postpartum depression can have a ripple effect, causing emotional strain for everyone close to a new baby. When a new mother is depressed, the risk of depression in the baby’s other parent may also increase. And these other parents may already have an increased risk of depression, whether or not their partner is affected. […] Children of mothers who have untreated postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, crying too much, and delays in language development.

• #91 Postpartum depression – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/postpartum-depression/symptoms-causes/syc-20376617

  Left untreated, postpartum depression can interfere with mother-child bonding and cause family problems. […] Untreated postpartum depression can last for months or longer, sometimes becoming an ongoing depressive disorder. Mothers may stop breastfeeding, have problems bonding with and caring for their infants, and be at increased risk of suicide. Even when treated, postpartum depression increases a woman’s risk of future episodes of major depression. […] Postpartum depression can have a ripple effect, causing emotional strain for everyone close to a new baby. When a new mother is depressed, the risk of depression in the baby’s other parent may also increase. And these other parents may already have an increased risk of depression, whether or not their partner is affected. […] Children of mothers who have untreated postpartum depression are more likely to have emotional and behavioral problems, such as sleeping and eating difficulties, crying too much, and delays in language development.

• #92 A new treatment for severe postpartum depression | UCLA Health

  https://www.uclahealth.org/news/publication/new-treatment-severe-postpartum-depression

  Zuranolone may turn out to be effective for other types of depression, too. […] The new drug represents a change in thinking about how depression arises in the brain, says Kimberly A. Yonkers, PhD, a neuroscientist at the University of Massachusetts Chan Medical School. […] According to the neurosteroid hypothesis, fluctuations in allopregnanolone may cause depression and anxiety through the hormones effects not on the body but in the brain. […] This is why 80% of moms experience postpartum blues. Its not mythology. […] The stakes are high if postpartum depression is left untreated, Dr. Burt says. Once identified, we want to address and tackle the problem quickly. […] Research has shown that mothers dampened responses to their babies may contribute to poor infant emotional development, says Michelle G. Craske, PhD, Distinguished Professor of Psychology and of Psychiatry and Biobehavioral Sciences, Kevin Love Fund Centennial Chair and director of the UCLA Anxiety and Depression Research Center.

• #93 Postpartum Depression and Its Long-Term Effects on Children

  https://www.pharmacytimes.com/view/patient-focus-postpartum-depression-and-its-longterm-effects-on-children

  Evidence suggests that both persistent and severe postpartum depression increase the risk of adverse outcomes in children. Research has listed an association between postpartum depression and delayed cognitive and language development, disorganized or insecure attachment, higher rates of behavioral problems, and lower grades. […] Women who met the criteria for moderate and severe postpartum depression at 2 months and at 8 months post delivery made up the most vulnerable group and were found to be more likely to experience depression 11 years later. […] Myrna M. Weissman, PhD, analyzed the study, conducted by Netsi et al, and concluded that children born to women in the most vulnerable group have a 2-fold increased risk of having lower math scores at 16 years, a 4-fold greater risk of having behavioral problems between ages 3 and 4 years, and a 7-fold higher risk of depression at 18 years.

Zobacz więcej