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Prepartal Stress, Prepartal and Postpartal Hair Glucocorticoid Concentrations, and Symptoms of Postpartum Depression 3 Days and 12 Weeks After Delivery Publisher



Sadeghibahmani D1, 2 ; Brand S3, 4, 5, 6, 7, 8 ; Meinlschmidt G9, 10 ; Tegethoff M11 ; Kurath J3 ; Burki N12, 13 ; Hosli I13 ; Mikoteit T3, 14
Authors
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Authors Affiliations
  1. 1. Department of Psychology, Stanford University, Stanford, California, United States
  2. 2. Department of Epidemiology and Population Health, Stanford University, Stanford, California, United States
  3. 3. Psychiatric Clinics of the University of Basel, Centre for Affective, Stress and Sleep Disorders, Basel, Switzerland
  4. 4. Department of Sport and Health Science, Faculty of Medicine, University of Basel, Sport Science Section, Basel, Switzerland
  5. 5. Kermanshah University of Medical Sciences, Department of Psychiatry, Substance Abuse Prevention Research Center, Health Institute, Kermanshah, Iran
  6. 6. Kermanshah University of Medical Sciences, Department of Psychiatry, Sleep Disorders Research Center, Kermanshah, Iran
  7. 7. Tehran University of Medical Sciences, School of Medicine, Tehran, Iran
  8. 8. Center for Disaster Psychiatry and Disaster Psychology, Center of Competence of Disaster Medicine of the Swiss Armed Forces, Basel, Switzerland
  9. 9. Clinical Psychology and Psychotherapy, Methods and Approaches, Department of Psychology, Trier University, Trier, Germany
  10. 10. Department of Digital and Blended Psychosomatics and Psychotherapy, Psychosomatic Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
  11. 11. Institute of Psychology, RWTH Aachen University, Aachen, Germany
  12. 12. Department for Gynecology and Obstetrics, Hospital of Baselland, Liestal, Switzerland
  13. 13. Clinic for Gynecology and Obstetrics, Hospital of the University of Basel, Basel, Switzerland
  14. 14. Psychiatric Services of Solothurn and University of Basel, Solothurn, Switzerland

Source: Biological Psychiatry Global Open Science Published:2025


Abstract

Background: Postpartum depression (PPD) is a serious mental health problem that affects about 17% of mothers. The aims of the current study were to observe the associations between prenatal stress, self- and expert-rated PPD, and prepartal and postpartal hair cortisol and cortisone concentrations as proxies for altered hypothalamic-pituitary-adrenal axis activity (HPA-AA). Methods: A total of 129 mothers (mean age 33.1 years) completed the Edinburgh Postnatal Depression Scale 3 days (baseline) and 12 weeks (study end) postpartum. At the end of the study, participants reported on prepartum stressful life events, experts rated participants’ symptoms of depression, and participants provided 6 cm of hair strands for analysis of hair glucosteroid levels 12 weeks before and 12 weeks after delivery. Results: Prepartal stress was associated with higher scores for self- and expert-rated PPD and with lower hair cortisone concentrations as a proxy for less adaptive HPA-AA. Higher prepartal and postpartal hair cortisol/cortisone ratios (i.e., higher cortisol/lower cortisone concentrations) were associated with higher PPD symptom scores. Conclusions: Women with prepartal stress were at increased risk of experiencing PPD 12 weeks after delivery. Altered hair steroid levels (lower cortisone concentrations) as a proxy for altered HPA-AA further substantiated this association. Results suggest that 1) both prepartal stress and the suppression of HPA-AA appear to be involved in the development of PPD; 2) hair steroid analysis can be used to predict PPD; and 3) women with prepartal stressful life events may benefit from timely support and relief to decrease their risk of developing PPD. © 2025 The Authors
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