Serum allopregnanolone in women with postpartum "blues"

Objective: To relate serum allopregnanolone and progesterone levels postpar tum to maternity "blues." Methods: Forty primiparous, healthy, married women (24-39 years of age; at least 13 years of education) who delivered healthy neonates in the Departme nt of Obstetrics at the University of Pavia entered the present study. Bloo d samples were drawn at 8:30 AM On postpartum day 3 for measurements of ser um allopregnanolone, progesterone, cortisol, prolactin, and estradiol. On t he same day, every woman was interviewed using the Hamilton Rating Scale fo r Depression for psychometric testing and completed a self-administered ver sion of the Stein Questionnaire for symptoms of the "blues." Results: Eighteen of 40 women (45%) experienced maternity "blues" (12 who d elivered vaginally and six who delivered by cesarean). Serum allopregnanolo ne levels were significantly lower in those women experiencing postpartum " blues" with respect to euthymic women (1.1 +/- 0.4 versus 2.3 +/- 1.0 nmol/ L; P < .001), whereas progesterone levels did not differ significantly (11. 6 +/- 5.6 versus 19.1 +/- 15.6 nmol/L; P > .058). Allopregnanolone and prog esterone levels correlated significantly in euthymic women (r = .648; P = . 001) but not in those with postpartum "blues" (r = .317; P = .199). There w as a significant negative correlation between the Hamilton score and levels of serum allopregnanolone (r = - .62; P = .001) and progesterone (r = - .3 6; P = .024). Conclusion: Serum allopregnanolone levels were detectable postpartum and we re significantly decreased in women with maternity "blues." (Obstet Gynecol 2001;97:77-80. (C) 2001 by The American College of Obstetricians and Gynec ologists.)