title: Cerebrospinal Fluid CRH Levels in Late Pregnancy Are Not Associated With New-Onset Postpartum Depressive Symptoms.
abstract: BACKGROUND
  CRH participates in the hypothalamic-pituitary-adrenal axis and in neural circuits involved in the pathophysiology of depression. During pregnancy, the placenta produces large amounts of CRH, and production ceases abruptly after delivery. The relationship between CRH in the cerebrospinal fluid (CSF) during pregnancy and peripartum mood disorders has not been investigated.
  
  
  OBJECTIVE
  The objectives were to determine whether there are differences in CSF CRH concentrations of pregnant and nonpregnant women and whether CSF CRH concentrations in late pregnancy are associated with the presence of depressive symptoms during pregnancy and in the early postpartum period.
  
  
  METHODS
  This was a prospective cohort study conducted from January to April, 2011.
  
  
  METHODS
  The study was conducted in one public and two private hospitals in Brasilia, Brazil.
  
  
  METHODS
  Patients included 107 healthy pregnant women who underwent elective cesarean delivery and 22 nonpregnant healthy women who underwent spinal anesthesia for elective surgical sterilization.
  
  
  METHODS
  CRH in CSF was measured in pregnant and nonpregnant women by ELISA.
  
  
  METHODS
  The association between CSF CRH concentration at delivery and maternal depression assessed before cesarean section and postpartum (4 to 8 wk) with the Edinburgh Postnatal Depression Scale (EPDS), with a cutoff of ≥ 13.
  
  
  RESULTS
  CRH concentration in the CSF was significantly higher in pregnant (4.1 ± 0.51 log CRH) than in nonpregnant women (3.6 ± 0.26 log CRH) (P < .001). Depressive symptoms starting after delivery occurred in 5.6% of women. CRH concentration in CSF was not different between women without depressive symptoms and women showing such symptoms during pregnancy or in the postpartum period.
  
  
  CONCLUSIONS
  CRH concentration in the CSF was higher in pregnant women than in nonpregnant women. However, in this sample, CSF CRH in late pregnancy was not associated with new-onset depressive symptoms in the early postpartum period.
authors.affiliation: Section of Obstetrics and Gynecology (A.M.Z., L.D.C.d.M.), Department of Pharmaceutical Sciences (A.A.A.), Sabin Laboratory of Clinical Analysis and Post-Graduation in Health Sciences (G.B.B.), Medical Sciences Graduate Program (V.C.d.S.), Faculty of Ceilandia (M.G.d.O.K.), and Section of Endocrinology (L.A.C.), University of Brasília, 70840-901 Brasília, Brazil.
authors.forename: Alberto Moreno
authors.initials: AM
authors.lastname: Zaconeta
authors.affiliation: Section of Obstetrics and Gynecology (A.M.Z., L.D.C.d.M.), Department of Pharmaceutical Sciences (A.A.A.), Sabin Laboratory of Clinical Analysis and Post-Graduation in Health Sciences (G.B.B.), Medical Sciences Graduate Program (V.C.d.S.), Faculty of Ceilandia (M.G.d.O.K.), and Section of Endocrinology (L.A.C.), University of Brasília, 70840-901 Brasília, Brazil.
authors.forename: Angélica Amorim
authors.initials: AA
authors.lastname: Amato
authors.affiliation: Section of Obstetrics and Gynecology (A.M.Z., L.D.C.d.M.), Department of Pharmaceutical Sciences (A.A.A.), Sabin Laboratory of Clinical Analysis and Post-Graduation in Health Sciences (G.B.B.), Medical Sciences Graduate Program (V.C.d.S.), Faculty of Ceilandia (M.G.d.O.K.), and Section of Endocrinology (L.A.C.), University of Brasília, 70840-901 Brasília, Brazil.
authors.forename: Gustavo Barcelos
authors.initials: GB
authors.lastname: Barra
authors.affiliation: Section of Obstetrics and Gynecology (A.M.Z., L.D.C.d.M.), Department of Pharmaceutical Sciences (A.A.A.), Sabin Laboratory of Clinical Analysis and Post-Graduation in Health Sciences (G.B.B.), Medical Sciences Graduate Program (V.C.d.S.), Faculty of Ceilandia (M.G.d.O.K.), and Section of Endocrinology (L.A.C.), University of Brasília, 70840-901 Brasília, Brazil.
authors.forename: Lucília Domingues
authors.initials: LD
authors.lastname: Casulari da Motta
authors.affiliation: Section of Obstetrics and Gynecology (A.M.Z., L.D.C.d.M.), Department of Pharmaceutical Sciences (A.A.A.), Sabin Laboratory of Clinical Analysis and Post-Graduation in Health Sciences (G.B.B.), Medical Sciences Graduate Program (V.C.d.S.), Faculty of Ceilandia (M.G.d.O.K.), and Section of Endocrinology (L.A.C.), University of Brasília, 70840-901 Brasília, Brazil.
authors.forename: Vinícius Carolino
authors.initials: VC
authors.lastname: de Souza
authors.affiliation: Section of Obstetrics and Gynecology (A.M.Z., L.D.C.d.M.), Department of Pharmaceutical Sciences (A.A.A.), Sabin Laboratory of Clinical Analysis and Post-Graduation in Health Sciences (G.B.B.), Medical Sciences Graduate Program (V.C.d.S.), Faculty of Ceilandia (M.G.d.O.K.), and Section of Endocrinology (L.A.C.), University of Brasília, 70840-901 Brasília, Brazil.
authors.forename: Margô Gomes de Oliveira
authors.initials: MG
authors.lastname: Karnikowski
authors.affiliation: Section of Obstetrics and Gynecology (A.M.Z., L.D.C.d.M.), Department of Pharmaceutical Sciences (A.A.A.), Sabin Laboratory of Clinical Analysis and Post-Graduation in Health Sciences (G.B.B.), Medical Sciences Graduate Program (V.C.d.S.), Faculty of Ceilandia (M.G.d.O.K.), and Section of Endocrinology (L.A.C.), University of Brasília, 70840-901 Brasília, Brazil.
authors.forename: Luiz Augusto
authors.initials: LA
authors.lastname: Casulari
mesh_terms: D000328:Adult; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D015331:Cohort Studies; D003346:Corticotropin-Releasing Hormone / Q000134:cerebrospinal fluid*; D003863:Depression / Q000134:cerebrospinal fluid / Q000453:epidemiology; D019052:Depression, Postpartum / Q000134:cerebrospinal fluid* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000134:cerebrospinal fluid / Q000453:epidemiology; D011263:Pregnancy Trimester, Third / Q000134:cerebrospinal fluid*; D055815:Young Adult
chemical_list: D003346:Corticotropin-Releasing Hormone