HORMONAL ASPECTS OF POSTPARTUM DEPRESSION

Plasma cortisol, prolactin, oestrogen, progesterone, thyroxine, thyrot rophin (TSH) were collected from 23 pregnant, 70 postpartum women at 7 days postpartum, and 38 non-gravid controls. Sixty two postpartum wom en were screened for depression by the Edinburgh Postnatal Depression Scale (EPDS) on day 7 after delivery and 34 of them were assessed by t he Present Stale Examination (PSE) at 8 +/- 2 weeks after delivery. Po stpartum women had a significantly greater level of cortisol, prolacti n, thyroxine and oestrogen than non-puerperal women. Postpartum women with current depression (EPDS 2 Il)had significantly lower plasma prol actin levels than those without depression and those who developed dep ression within 6-10 weeks after delivery (PSE level greater than or eq ual to 5) had significantly lower plasma prolactin and significantly g reater progesterone levels than those who were not depressed. There we re significant correlations between age and plasma cortisol and prolac tin levels. Higher thyroxine levels predicted greater severity of conc urrent symptoms of depression (total EPDS score) whilst higher progest erone and lower prolactin levels predicted the occurrence of depressio n (total PSE score) 6-10 weeks after delivery. Women who breastfed had significantly lower EPDS and total PSE scores and higher plasma prola ctin levels than those who did not breastfed their infants whilst wome n who had previous episodes of depression had significantly greater EP DS and PSE scores, lower prolactin and higher TSH levels than those wh o had not suffered from previous episodes of depression. (C) 1998 Else vier Science Ltd. All rights reserved.