title: Evaluation of the association between placental corticotrophin-releasing hormone and postpartum depressive symptoms.
abstract: OBJECTIVE
  Postpartum depression (PPD) represents a significant threat to maternal-child health. Although PPD is common, with an estimated prevalence of 10% to 15%, critical questions concerning its etiology remain unanswered. Existing studies seem to provide conflicting evidence regarding the relation between placental corticotrophin-releasing hormone (pCRH) and the development of PPD. The purpose of the present investigation was to determine whether maternal prepartum hypothalamic-pituitary-adrenal and placental dysregulation, in particular elevated midgestational pCRH, represent markers of risk for the development of PPD symptoms.
  
  
  METHODS
  One hundred seventy adult women with singleton, term pregnancies were recruited during the first trimester and participated in study visits at 15, 19, 25, 31, and 36+ weeks' gestation and at 3 and 6 months postpartum. At each prenatal visit, blood samples were obtained and assayed to determine maternal cortisol, adrenocorticotropic hormone, and pCRH concentrations. Depressive symptoms were assessed at all visits.
  
  
  RESULTS
  Depressive symptoms at 3 months postpartum were associated with elevated midgestational pCRH (partial r = 0.26; p < .01) and also accelerated trajectories of pCRH (B values ranged from 6.9 to 8.3, p < .05). Placental CRH was not predictive of PPD symptoms at 6 months postpartum. Furthermore, prepartum cortisol and corticotrophin profiles were not associated with PPD symptoms.
  
  
  CONCLUSIONS
  The current prospective study provides results that reconcile both the positive and negative findings in the existing literature and identifies elevated pCRH as a marker of risk for the development of PPD symptoms.
authors.affiliation: From the Crean College of Health and Behavioral Sciences (L.M.G.), Chapman University, Orange, California; and Department of Psychiatry and Human Behavior (L.M.G., C.A.S.), University of California, Irvine, Orange, California.
authors.forename: Laura M
authors.initials: LM
authors.lastname: Glynn
authors.forename: Curt A
authors.initials: CA
authors.lastname: Sandman
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D015992:Body Mass Index; D003346:Corticotropin-Releasing Hormone / Q000097:blood*; D003863:Depression / Q000097:blood / Q000503:physiopathology; D019052:Depression, Postpartum / Q000097:blood* / Q000503:physiopathology; D005006:Ethnicity; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D008423:Maternal Age; D008954:Models, Biological; D010298:Parity; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D049590:Postpartum Period / Q000097:blood* / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000503:physiopathology; D011264:Pregnancy Trimesters / Q000097:blood* / Q000523:psychology; D011446:Prospective Studies; D012959:Socioeconomic Factors
chemical_list: D000324:Adrenocorticotropic Hormone; D003346:Corticotropin-Releasing Hormone; D006854:Hydrocortisone