The Role of Allopregnanolone in Pregnancy in Predicting Postpartum Anxiety Symptoms.

Lauren M Osborne,Gayane Yenokyan,Joshua F Betz,Lindsay R Standeven,Jennifer L Payne

doi:10.3389/fpsyg.2019.01033

Lauren M Osborne, Gayane Yenokyan + Show 3 more

Open Access

https://doi.org/10.3389/fpsyg.2019.01033

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Abstract

Postpartum depression is a serious illness affecting up to 15% of women worldwide after childbirth, and our understanding of its biology is limited. Postpartum anxiety is perhaps more prevalent and less understood. Prior studies indicate that allopregnanolone, a metabolite of progesterone, may play a role in reproductive mood disorders, including postpartum depression, but the exact nature of that role is unclear. Our own prior study in a group of psychiatrically ill women found that low allopregnanolone in the second trimester predicted the development of postpartum depression. In the present study, in both healthy and mood- and anxiety-disordered women who remained well throughout the perinatal period, we found that second trimester allopregnanolone predicted postpartum anxiety symptoms, with a similar trend toward the prediction of postpartum depressive symptoms (though without statistical significance). Both concurrent sleep and prior histories of mood and anxiety disorders contributed to the variance in mood and anxiety scores at 6 weeks postpartum. These findings confirm the importance of pregnancy allopregnanolone in postpartum psychiatric symptoms and point to future directions that may determine other important contributing factors.

Highlights

Postpartum depression (PPD) is a serious illness affecting up to 15% of women worldwide after childbirth (Yonkers et al, 2011), with higher rates in populations with significant psychosocial stressors
We showed that lower levels of ALLO at the second trimester of pregnancy (T2) predicted the development of a postpartum depression, with each additional ng/ml of ALLO reducing the odds of PPD by 62% (Osborne et al, 2017)
In a population of women with and without mood and anxiety disorders, almost all of whom remained psychiatrically well throughout the study, we found an association between lower T2 ALLO and higher anxiety scores at 6 weeks postpartum, as well as a similar relationship between T2 ALLO and higher W6 depressive symptoms, which did not reach statistical significance in the adjusted model

Summary

INTRODUCTION

Postpartum depression (PPD) is a serious illness affecting up to 15% of women worldwide after childbirth (Yonkers et al, 2011), with higher rates in populations with significant psychosocial stressors. Some studies (Hellgren et al, 2014; Crowley et al, 2016) have found associations between lower levels of ALLO and mood in the perinatal period, but others have not found a relationship (Deligiannidis et al, 2013). We were not certain whether our results would be generalizable to a less ill population and sought to examine a similar question [whether T2 ALLO can predict depressive or anxious symptoms at 6 weeks postpartum (W6)] in a different population – one that is roughly divided among women with and without histories of mood and/or anxiety disorders, with almost all women (regardless of history) remaining psychiatrically well throughout the perinatal period

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