A Study Of The Correlation Between Postpartal Depression And Levels Of Female Sex Hormone And Neurotransmitter

Objective To comprehensively analyze the correlation betweenpostpartum depression and the levels of estrogen, progesterone, andneurotransmitters, and to provide scientific evidence for prevention andtreatment of postpartum depression.Methods All articles on case-control study about postpartumdepression and its relationship with the changes of female sex hormoneand neurotransmitters were collected by literature search methods andbased on the selection criteria.①The compare of both south and northdistrict incidence of postpartal depression was analyzed through one-way.②A meta-analysis of all studies about Chinese women from 1994 to 2004was performed to evaluate the magnitude of the relationships betweenpostpartum depression and the changes of female sex hormone andneurotransmitters.Results 1. Nine studies selected, 1648 women within one weekof postpartum were observed and 217 women of them suffered frompostpartum depression.685 women within six weeks of postpartum wereobserved and 110 women of them suffered from postpartum depression. 2.The incidence of postpartal depression was 13.17% during the 1 week ofpostpartum. The combined P-valve was 0.1749, 95%CI=0.11～0.15. Theincidence of postpartal depression was 16.6% in the 6 weeks of postpartum. The combined P-valve was 0.1872, 95% CI=0.14～0.18. 3.The south district incidence of postpartal depression was 15.63%. Thecombined P-valve was 0.0874, 95% CI=0.14～0.17. The north districtincidence of postpartal depression was 7.66%. The combined P-valve was0.0252, 95% CI=0.05～0.08. The P-valve of Chi-square test, which bothsouth and north district incidence of postpartal depression was calculated,was less than 0.005. 4. The random effect model of meta-analysis wasselected to calculate the pooled effect size for estrogen of the 1 week afterchildbirth. The combined effect size was -150.8,95%CI=-150.64～-150.87. The combined effect size for the deviance ofestrogen between the 1 week of postpartum and antepartum was 162.18,95%CI=160.43～163.93. The combine effect size for the deviance ofestrogen between the 6 weeks of postpartum and antepartum was 112.38,95%CI=92.27～132.49. The combined effect size for progesterone of the 1week after childbirth was 2.61, 95%CI=2.27～2.99. The combined effectsize for the deviance of progesterone between the 1 week of postpartumand antepartum was -3.9, 95%CI=-4.17～-3.63. The combined effect sizefor Orphanin FQ of the 1 week after childbirth was 14.86,95%CI=12.72～16.70. The combined effect size for dopamine of the 1week after childbirth was -1.23, 95%CI=-1.29～-1.77. The fixed effectmodel of Meta-analysis was selected to calculate the pooled effect sizefor 5-HT of the 1 week after childbirth. The combined effect size was -0.36, 95%CI=-0.49～-0.32. The combined effect size for noradrenaline ofthe 1 week after childbirth was -12.88, 95%CI=-12.99～-12.21.Conclusion 1. The incidence of postpartal depression was13.17% during the 1 week of postpartum and 16.6% in the 6 weeks ofpostpartum. 2. The south district incidence of postpartal depression washigher than north, P＜0.005. 3. The incidence of postpartum depressionrelated to the decreased levels of plasmatic estrogen, 5-HT, dopamine,and noradrenaline, and to the increased levels of plasmatic progesteroneand Orphanin FQ. 4. The measurement of estrogen, progesterone, 5-HT,dopamine, and noradrenaline, Orphanin FQ in the plasma may help todiagnose the postpartum depression. 5. The patients with postpartumdepression may be treated by giving estrogen, the exciting drugs of 5-HT,dopamine and noradrenaline, the drugs against Orphanin FQ. 6. Weshould pay more attention to postpartum depression in order to takemeasures of prevention and treatment earlier.