title: Lower serotonin level and higher rate of fibromyalgia syndrome with advancing pregnancy.
abstract: OBJECTIVE
  The aim of the study is to investigate the relationship between changes in serotonin levels during pregnancy and fibromyalgia syndrome (FS) and the relationships between FS and the physical/psychological state, biochemical and hormonal parameters, which may be related to the musculoskeletal system.
  
  
  METHODS
  This study is a prospective case-control study conducted with 277 pregnant women at the obstetric unit of Ankara University Faculty of Medicine, in the period between January and June 2015. FS was determined based on the presence or absence of the 2010 ACR diagnostic criteria and all the volunteers were asked to answer the questionnaires as Fibromyalgia Impact Criteria (FIQ), Widespread Pain Index (WPI), Symptom Severity Scale (SS), Beck Depression Inventory and Visual Analog Scale (VAS). Biochemical and hormonal markers (glucose, TSH, T4, Ca (calcium), P (phosphate), PTH (parathyroid hormone) and serotonin levels) relating to muscle and bone metabolism were measured.
  
  
  RESULTS
  In the presence of fibromyalgia, the physical and psychological parameters are negatively affected (p < 0.001). There was no significant difference between the fibromyalgia and control groups in terms of glucose, Ca (calcium), P (phosphorus), PTH (parathyroid hormone), TSH (thyroid stimulant hormone), fT4 (free T4) levels (p = 0.060, 0.799, 0.074, 0.104, 0.797, 0.929, respectively). A reduction in serotonin levels may contribute to the development of fibromyalgia but this was not statistically significant. The Beck Depression Inventory scale statistically showed that increasing scores also increase the risk of fibromyalgia (p <0.001).
  
  
  CONCLUSIONS
  Our study has shown that serotonin levels in women with FS are lower than the control group and that serotonin levels reduce as pregnancy progresses. Anxiety and depression in pregnant women with FS are higher than the control group. The presence of depression increases the likelihood of developing FS at a statistically significant level. Serotonin impairment also increases the chance of developing FS, but this correlation has not been shown to be statistically significant.
authors.affiliation: a Department of Gynecology and Obstetrics , Giresun University Faculty of Medicine , Giresun , Turkey.
authors.forename: Melahat
authors.initials: M
authors.lastname: Atasever
authors.affiliation: b Department of Gynecology and Obstetrics , Turgut Ozal University Faculty of Medicine , Ankara , Turkey.
authors.forename: Muberra
authors.initials: M
authors.lastname: Namlı Kalem
authors.affiliation: c Department of Clinical Biochemistry , Dr Abdurrahman Yurtarslan Oncology Education and Research Hospital , Ankara , Turkey.
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Sönmez
authors.affiliation: d Department of Gynecology and Obstetrics , Ankara University Faculty of Medicine , Ankara , Turkey.
authors.forename: Mehmet Murat
authors.initials: MM
authors.lastname: Seval
authors.affiliation: d Department of Gynecology and Obstetrics , Ankara University Faculty of Medicine , Ankara , Turkey.
authors.forename: Tuncay
authors.initials: T
authors.lastname: Yüce
authors.affiliation: e Department of Obstetrics and Gynecology , Dr. Sami Ulus Children and Woman Health Training and Research Hospital , Ankara , Turkey and.
authors.forename: Seda
authors.initials: S
authors.lastname: Sahin Aker
authors.affiliation: d Department of Gynecology and Obstetrics , Ankara University Faculty of Medicine , Ankara , Turkey.
authors.forename: Acar
authors.initials: A
authors.lastname: Koç
authors.affiliation: f Department of Physical Medicine and Rehabilitation , University of Health Sciences, Ankara Traning and Research Hospital , Ankara , Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Genc
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000150:complications / Q000523:psychology; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003863:Depression / Q000150:complications / Q000523:psychology*; D005260:Female; D005356:Fibromyalgia / Q000097:blood* / Q000209:etiology / Q000503:physiopathology / Q000523:psychology; D006801:Humans; D016015:Logistic Models; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000503:physiopathology / Q000523:psychology; D011446:Prospective Studies; D012307:Risk Factors; D012701:Serotonin / Q000097:blood*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D015415:Biomarkers; D012701:Serotonin
keywords: Pregnancy; fibromyalgia syndrome; serotonin