title: CSF and plasma cytokines at delivery and postpartum mood disturbances.
abstract: BACKGROUND
  Immune activation has been shown to be involved in the pathophysiology of anxiety states and major depression and pregnancy is associated with a characteristic immune activation to sustain the fetus. Despite the possibility of a relation between immune parameters and postpartum mood disturbance, few studies have explored this association. Further, no study to-date has examined CSF.
  
  
  METHODS
  Fifty-six Greek parturients were recruited and a detailed medical and obstetric history was recorded. All of them completed the Postpartum Blues Questionnaire (on admission and on days 1-4 postpartum) and the Edinburgh Postnatal Depression Scale (at first and sixth week postpartum). At delivery, a blood sample and a CSF sample while puncturing for epidural analgesia were taken from 33 participants; blood samples only were obtained from the rest of the 23 parturients. TNF-a and IL-6 were quantified with an ELISA assay.
  
  
  RESULTS
  A multiple regression analysis of psychometric scores depending on cytokine levels revealed that cytokine levels were positively associated with depressive mood during the first four days postpartum (p=0.035 for CSF IL-6, p=0.025 for CSF TnF-a, p=0.023 for serum TnF-a) and also at sixth week postpartum (p=0.012 for CSF IL-6, p=0.072 for CSF TnF-a). Pregnancy duration had an adverse association to psychometric scores.
  
  
  CONCLUSIONS
  It is suggested that immune mechanisms may play a role in the etiopathology of postpartum depressive mood shifts. The role of a "rebound" reaction of the maternal immune system postnatal should be further investigated.
authors: Laboratory of Biopathology and Immunology, University of Athens, Eginition Hospital, Greece. f_boufidou@hotmail.com
authors: Fotini
authors: F
authors: Boufidou
authors: Irini
authors: I
authors: Lambrinoudaki
authors: John
authors: J
authors: Argeitis
authors: Ioannis M
authors: IM
authors: Zervas
authors: Paraskevi
authors: P
authors: Pliatsika
authors: Aggeliki A
authors: AA
authors: Leonardou
authors: Georgios
authors: G
authors: Petropoulos
authors: Dimitrios
authors: D
authors: Hasiakos
authors: Konstantinos
authors: K
authors: Papadias
authors: Chryssoula
authors: C
authors: Nikolaou
mesh_terms: D000328:Adult; D000339:Affect / Q000502:physiology; D036861:Delivery, Obstetric; D019052:Depression, Postpartum / Q000276:immunology*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000378:metabolism*; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011247:Pregnancy; D011594:Psychometrics; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D055815:Young Adult
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha