Abstract
Postpartum depression (PPD) is a psychiatric complication of childbirth affecting 10–20% of new mothers and has negative impact on both mother and infant. Serum lipid levels have been related to depressive disorders, but very limited literatures are available regarding the lipid levels in women with postpartum depression. The present study is aimed to examine the association of serum lipids with the development of postpartum depressive symptoms. This is a cross sectional study conducted at a tertiary care hospital in South India. Women who came for postpartum check-up at 6th week post-delivery were screened for PPD (September 2014-October 2015). Women with depressive symptoms were assessed using EPDS (Edinburgh Postnatal Depression Scale). The study involved 186 cases and 250 controls matched for age and BMI. Serum levels of lipid parameters were estimated through spectrophotometry and the atherogenic indices were calculated in all the subjects. Low serum levels of Total Cholesterol (TC) and High Density Lipoprotein cholesterol (HDL-c) were significantly low in PPD women with severe depressive symptoms. The study recorded a significant negative correlation between HDL-c and the EPDS score in PPD women (r = -0.140, p = 0.05). Interestingly, the study also observed a significant negative correlation between Body Mass Index (BMI) and EPDS scores in case group (r = -0.146, p = 0.047), whereas a positive correlation between the same in controls (r = 0.187, p = 0.004). Our study demonstrated that low levels of serum HDL-c is correlated with the development of severe depressive symptoms in postpartum women. Study highlights the role of lipids in the development of postpartum depressive symptoms.
Highlights
In women, pregnancy and postpartum period are regarded as the crucial periods of time for the occurrence of psychiatric disorders
Postpartum depression (PPD) can persist for a short period and remit abruptly and about 50% of women with postpartum depressive symptoms continue to have major depression throughout beyond the first year post-delivery [3].Varying rate of occurrence of postpartum depressive symptoms have been reported in and across countries, which ranges from 10–42%, with higher rates in developing countries [4]
The serum High-Density Lipoprotein cholesterol (HDL-c) levels were observed to be lower in PPD women with Edinburgh Postnatal Depression Scale (EPDS) score greater than 12 compared to PPD women with EPDS score less than or equal to 12 without any statistical significance
Summary
Pregnancy and postpartum period are regarded as the crucial periods of time for the occurrence of psychiatric disorders. Postpartum depression (PPD) is a psychological complication following child birth. PPD differs from ‘postpartum blues’ which is a brief period of mood disturbance that begins three to five days after childbirth and may last up to two weeks [1] and ‘postpartum psychosis’ which is a rare psychiatric episode that develops within the first two weeks after delivery and requires hospitalization [2]. PPD can persist for a short period and remit abruptly and about 50% of women with postpartum depressive symptoms continue to have major depression throughout beyond the first year post-delivery [3].Varying rate of occurrence of postpartum depressive symptoms have been reported in and across countries, which ranges from 10–42%, with higher rates in developing countries [4]. If untreated and left undiagnosed, it leads to detrimental outcomes: affects the mother- child bonding, increases risk of infanticide and maternal suicide and adversely affects the child’s cognitive and behavioural development [5]
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