title: Observational study on the stability of the psychological status during normal pregnancy and increased blood levels of neuroactive steroids with GABA-A receptor agonist activity.
abstract: We investigated whether pregnancy could modify psychological symptoms and whether neuroactive steroids which exert an anti-anxiety effect by acting on the gamma-aminobutyric acid (GABA)-A receptors, are modified during pregnancy in young healthy women. Healthy volunteer women in the Department of Obstetrics and Gynecology at Cagliari University participated in the study. They were divided into women with low (group 1, seven subjects) and high (group 2, seven subjects) psychological score by SCL-90 psychometric scale. Age, body mass index and physiological status of pregnancy did not differ between the groups. The subjects were studied before pregnancy during the follicular phase (FP), and the luteal phase (LP) of the menstrual cycle (MC) and four times during pregnancy (at 14th, 22nd, 30th, and 38th week). SCL-90 psychometric scale, circulating levels of progesterone (P4), 3alpha-hydroxy-5alpha-pregnan-20-one (allopregnanolone, AP), 3alpha,21-dihydroxy-5alpha-pregnan-20-one (allotetrahydrodeoxy-corticosterone, THDOC), cortisol and DHEAS were assayed at each visit. The SCL-90 global score and the intensity of psychological symptoms differ between the groups, but within each group they did not change both during MC and during pregnancy. The DHEAS and cortisol levels did not differ between the groups. DHEAS did not change during the study, whereas cortisol levels increased during pregnancy in both groups. Progesterone, AP, and THDOC levels were higher during LP than during FP and further increased during pregnancy, without any difference between the groups. In conclusion, pregnancy does not seem to interfere with the psychological status of healthy women independently of the psychological basal score. Some neuroactive steroids with anxiolytic activity seem to increase during pregnancy depending on placental function. Their increase could represent some kind of protection against maternal anxiety and stress due to concerns about the pregnancy outcome.
authors.affiliation: Dipartimento Chirurgico Materno Infantile e di Scienze delle Immagini, Sezione di Clinica Ginecologica Ostetrica e di Fisiopatologia della Riproduzione Umana, Università di Cagliari, Via Ospedale 46, I-09124 Cagliari, Italy. gineca.annapaoletti@tiscali.it
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Paoletti
authors.forename: Sandra
authors.initials: S
authors.lastname: Romagnino
authors.forename: Rossana
authors.initials: R
authors.lastname: Contu
authors.forename: Marisa Margherita
authors.initials: MM
authors.lastname: Orrù
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Marotto
authors.forename: Pierina
authors.initials: P
authors.lastname: Zedda
authors.forename: Stefano
authors.initials: S
authors.lastname: Lello
authors.forename: Giovanni
authors.initials: G
authors.lastname: Biggio
authors.forename: Alessandra
authors.initials: A
authors.lastname: Concas
authors.forename: Gian Benedetto
authors.initials: GB
authors.lastname: Melis
mesh_terms: D000328:Adult; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D003900:Desoxycorticosterone / Q000031:analogs & derivatives / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D058785:GABA-A Receptor Agonists; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008597:Menstrual Cycle / Q000097:blood / Q000523:psychology*; D009483:Neuropsychological Tests; D011247:Pregnancy / Q000097:blood / Q000523:psychology*; D011278:Pregnanes / Q000097:blood*; D011280:Pregnanolone / Q000097:blood; D011374:Progesterone / Q000097:blood; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011963:Receptors, GABA-A / Q000378:metabolism; D012016:Reference Values; D013315:Stress, Psychological / Q000097:blood*
chemical_list: D058785:GABA-A Receptor Agonists; D011278:Pregnanes; D011963:Receptors, GABA-A; D003900:Desoxycorticosterone; C009413:tetrahydrodeoxycorticosterone; D011374:Progesterone; D019314:Dehydroepiandrosterone Sulfate; D011280:Pregnanolone; D006854:Hydrocortisone