Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2017-0032
Trends in Psychiatry and Psychotherapy
Brief Communication

Salivary cortisol during memory encoding in pregnancy predicts postpartum depressive symptoms: a longitudinal study

Cortisol salivar durante aquisição de memória na gravidez prediz sintomas depressivos no período pós-parto: um estudo longitudinal

Marissa E. Williams; Benicio N. Frey

Downloads: 0
Views: 492

Abstract

Abstract Introduction Postpartum depression (PPD) is a common disorder that substantially decreases quality of life for both mother and child. In this longitudinal study, we investigated whether emotional memory, salivary cortisol (sCORT) or alpha-amylase during pregnancy predict postpartum depressive symptoms. Methods Forty-four pregnant women (14 euthymic women with a diagnosis of major depressive disorder [MDD] and 30 healthy women) between the ages of 19 and 37 years (mean age = 29.5±4.1 years) were longitudinally assessed in the 2nd trimester of pregnancy (12-22 weeks of gestational age) and again at 14-17 weeks postpartum. Depressive symptoms were assessed using the Edinburgh Postnatal Depression Scale (EPDS). Results Follow-ups were completed for 41 women (7% attrition). Postpartum EPDS scores were predicted by sCORT collected immediately after an incidental encoding memory task during pregnancy (b=-0.78, t -2.14, p=0.04). Postpartum EPDS scores were not predicted by positive (p=0.27) or negative (p=0.85) emotional memory. Conclusions The results of this study indicate that higher levels of sCORT during a memory encoding task in the 2nd trimester of pregnancy are associated with lower postpartum EPDS scores. While the hypothalamus-pituitary-adrenal (HPA) axis has long been associated with the neurobiology of MDD, the role of the HPA axis in perinatal depression deserves more attention.

Keywords

Pregnancy, postpartum depression, major depressive disorder, salivary cortisol, emotional memory

Resumo

Resumo Introdução A depressão pós-parto é um transtorno prevalente que afeta negativamente a qualidade de vida da mãe e da criança. Neste estudo longitudinal, nós investigamos se a memória emocional, o cortisol salivar (salivary cortisol, sCORT) ou alfa-amilase durante a gravidez predizem sintomas depressivos no período pós-parto. Métodos Um total de 44 mulheres grávidas [14 eutímicas com diagnóstico de transtorno depressivo maior (TDM) e 30 voluntárias sadias] entre 19 e 37 anos de idade (idade média = 29.5±4.1 anos) foram avaliadas longitudinalmente no 2° trimestre da gravidez (12-22 semanas de gestação) e na 1417ª semana pós-parto. Sintomas depressivos foram avaliados com a Escala de Depressão Pós-Natal de Edimburgo (Edinburgh Postnatal Depression Scale, EPDS). Resultados Quarenta e uma mulheres completaram o seguimento (7% de perda). sCORT coletado imediatamente antes de um teste de aquisição memória durante a gravidez foi preditor dos escores da escala EPDS no período pós-parto (b=-0.78, t -2.14, p=0.04). Memória emocional positiva (p=0.27) ou negativa (p=0.85) não foram preditores dos escores da escala EPDS no período pós-parto. Conclusão Os resultados deste estudo indicam que altos níveis de sCORT durante um teste de aquisição de memória no 2° trimestre da gravidez foram associados com baixos escores na escala EPDS no período pós-parto. Uma vez que o eixo hipotálamo-hipófise-adrenal (HHA) tenha sido envolvido na neurobiologia do TDM, o papel do eixo HHA na depressão perinatal merece mais atenção.

Palavras-chave

Gravidez, depressão pós-parto, transtorno depressivo maior, cortisol salivar, memória emocional

References

Dennis CL, Heaman M, Vigod S. Epidemiology of postpartum depressive symptoms among Canadian women: regional and national results from a cross-sectional survey. Can J Psychiatry. 2012;57:537-46.

Glynn LM, Davis EP, Sandman CA. New insights into the role of perinatal HPA-axis dysregulation in postpartum depression. Neuropeptides. 2013;47:363-70.

McEwen BS. Physiology and neurobiology of stress and adaptation: central role of the brain. Physiol Rev. 2007;87:873-904.

Meinlschmidt G, Martin C, Neumann ID, Heinrichs M. Maternal cortisol in late pregnancy and hypothalamic-pituitary-adrenal reactivity to psychosocial stress postpartum in women. Stress. 2010;13:163-71.

Petrakova L, Doering BK, Vits S, Engler H, Rief W, Schedlowski M, Grigoleit J. Psychosocial stress increases salivary alpha-amylase activity independently from plasma noradrenaline levels. PLoS One. 2015;10.

Nierop A, Bratsikas A, Klinkenberg A, Nater UM, Zimmermann R, Ehlert U. Prolonged salivary cortisol recovery in second-trimester pregnant women and attenuated salivary α-amylase responses to psychosocial stress in human pregnancy. J Clin Endocrinol Metab. 2006;91:1329-35.

Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008;108:147-57.

O'Hara MW. Postpartum depression: what we know. J. Clin. Psychol. 2009;65:1258-69.

Norhayati MN, Hazlina NH, Asrenee AR, Emilin WM. Magnitude and risk factors for postpartum symptoms: a literature review. J Affect Disord. 2015;175:34-52.

Williams ME, Becker S, McKinnon MC, Wong Q, Cudney LE, Steiner M. Emotional memory in pregnant women at risk for postpartum depression. Psychiatry Res. 2015;229:777-83.

Buchanan TW, Lovallo WR. Enhance memory for emotional material following stress-level cortisol treatment in humans. Psychoneuroendocrinology. 2001;26:307-17.

Hamilton JP, Gotlib IH. Neural substrates of increased memory sensitivity for negative stimuli in major depression. Biol Psychiatry. 2008;63:1155-62.

First MB, Spitzer RL, Gibbon M, Williams JBW. Structured Clinical Interview for DSM-IV-TR Axis-I Disorders, Research Version, Patient Edition (SCID-I/P). 2002.

Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987;150:782-6.

Spielberger CDG, Lushene RE. Manual for the state-trait anxiety inventory. 1970.

Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28:193-213.

Expanded range high sensitivity salivary cortisol enzyme immunoassay kit. State College: Salimetrics. 2016.

Salivary α-amylase kinetic enzyme assay kit. State College: Salimetrics. 2016.

Iliadis SI, Comasco E, Sylven S, Hellgren C, Sundstrom Poromaa I, Skalkidou A. Prenatal and postpartum evening salivary cortisol levels in association with peripartum depressive symptoms. PLoS One. 2015;10.

Glynn LM, Sandman CA. Evaluation of the association between placental corticotrophin-releasing hormone and postpartum depressive symptoms. Psychosom Med. 2014;76:355-62.

Kammerer M, Taylor A, Glover V. The HPA axis and perinatal depression: A hypothesis. Arch Womens Ment Health. 2006;9:187-96.

de Rezende MG, Garcia-Leal C, de Figueiredo FP, de Carvalho Cavalli R, Spanghero MS, Barbieri MA. Altered functioning of the HPA axis in depressed postpartum women. J Affect Disord. 2015;193:249-56.

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). 2013.

Moses-Kolko EL, Perlman SB, Wisner KL, James J, Saul AT, Phillips ML. Abnormally reduced dorsomedial prefrontal cortical activity and effective connectivity with amygdala in response to negative emotional faces in postpartum depression. Am J Psychiatry. 2010;167:1373-80.

Silverman ME, Loudon H, Liu X, Mauro C, Leiter G, Goldstein MA. The neural processing of negative emotion postpartum: a preliminary study of amygdala function in postpartum depression. Arch Womens Ment Health. 2011;14:355-9.

6169de79a953955b070efb84 trends Articles
Links & Downloads

Trends Psychiatry Psychother

Share this page
Page Sections