Altered functioning of the HPA axis in depressed postpartum women

Journal of Affective Disorders
Marcos Gonçalves de RezendeCristina Marta Del-Ben

Abstract

The present study aimed to evaluate the relationship between the functioning of the hypothalamic-pituitary-adrenal (HPA) axis and major depressive episodes in the remote postpartum period. The sample (mean age, 28.0±5.3 years) consisted of 37 depressed postpartum women (DPP), 42 euthymic postpartum women (EPP) and 25 non-postpartum healthy women (HC). Salivary cortisol samples were collected immediately after awakening and 30min, 3 and 12h later, at approximately the sixth month postpartum (mean, 169.6±60.3 days). Differences in cortisol levels were observed at awakening (DPP<EPP=HC), at 30min (DPP<EPP<HC), at 3h (DPP=EPP<HC) and at 12h (DPP>EPP=HC). The relative increment in the cortisol awakening response (CARi%) was significantly higher in HC (113.5±94.3) than in EPP (63.1±69.8) and DPP (32.2±49.6). The relative reduction in diurnal variation (DVr%) was lower in DPP (56.5±41.8) than in EPP (75.6±22.4) and HC (75.1±13.0). The main limitation was cortisol collection on a single day and without measurement at midnight. Our findings suggest that the remote postpartum period involves attenuation of HPA axis reactivity; this dysregulation is more pronounced in the presence of DPP, which is associated with a reduction in cortisol d...Continue Reading

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