The role of central serotonergic markers and estradiol changes in perinatal mental health
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The role of central serotonergic markers and estradiol changes in perinatal mental health. / Borgsted, Camilla; Høgh, Stinne; Høgsted, Emma Sofie; Fonnesbech-Sandberg, Laura; Ekelund, Kim; Albrechtsen, Charlotte Krebs; Wiis, Julie Therese; Hegaard, Hanne; Cvetanovska, Eleonora; Juul, Anders; Frederiksen, Hanne; Pinborg, Anja; Weikop, Pia; Frokjaer, Vibe.
In: Acta Psychiatrica Scandinavica, Vol. 146, No. 4, 2022, p. 357-369.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - The role of central serotonergic markers and estradiol changes in perinatal mental health
AU - Borgsted, Camilla
AU - Høgh, Stinne
AU - Høgsted, Emma Sofie
AU - Fonnesbech-Sandberg, Laura
AU - Ekelund, Kim
AU - Albrechtsen, Charlotte Krebs
AU - Wiis, Julie Therese
AU - Hegaard, Hanne
AU - Cvetanovska, Eleonora
AU - Juul, Anders
AU - Frederiksen, Hanne
AU - Pinborg, Anja
AU - Weikop, Pia
AU - Frokjaer, Vibe
N1 - Publisher Copyright: © 2022 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.
PY - 2022
Y1 - 2022
N2 - Objective: Women have an increased risk for mental distress and depressive symptoms in relation to pregnancy and birth. The serotonin transporter (SERT) may be involved in the emergence of depressive symptoms postpartum and during other sex-hormone transitions. It may be associated with cerebrospinal fluid (CSF) levels of the main serotonin metabolite 5-hydroxyindolacetic acid (5-HIAA). In 100 healthy pregnant women, who were scheduled to deliver by cesarean section (C-section), we evaluated 5-HIAA and estradiol contributions to mental distress 5 weeks postpartum. Methods: Eighty-two women completed the study. CSF collected at C-section was analyzed for 5-HIAA, with high performance liquid chromatography. Serum estradiol concentrations were quantified by liquid chromatography tandem mass spectrometry before C-section and postpartum. Postpartum mental distress was evaluated with the Edinburgh Postnatal Depression Scale (EPDS). Associations between EPDS, 5-HIAA, and Δestradiol were evaluated in linear regression models adjusted for age, parity and SERT genotype. Results: Higher levels of postpartum mental distress symptoms were negatively associated with a large decrease in estradiol concentrations (βΔE2 = 0.73, p = 0.007) and, on a trend level, positively associated with high antepartum 5-HIAA levels (β5-HIAA = 0.002, p = 0.06). Conclusion: In a cohort of healthy pregnant women, postpartum mental distress was higher in women with high antepartum 5-HIAA (trend) and lower in women with a large perinatal estradiol decrease. We speculate that high antepartum 5-HIAA is a proxy of SERT levels, that carry over to the postpartum period and convey susceptibility to mental distress. In healthy women, the postpartum return to lower estradiol concentrations may promote mental well-being.
AB - Objective: Women have an increased risk for mental distress and depressive symptoms in relation to pregnancy and birth. The serotonin transporter (SERT) may be involved in the emergence of depressive symptoms postpartum and during other sex-hormone transitions. It may be associated with cerebrospinal fluid (CSF) levels of the main serotonin metabolite 5-hydroxyindolacetic acid (5-HIAA). In 100 healthy pregnant women, who were scheduled to deliver by cesarean section (C-section), we evaluated 5-HIAA and estradiol contributions to mental distress 5 weeks postpartum. Methods: Eighty-two women completed the study. CSF collected at C-section was analyzed for 5-HIAA, with high performance liquid chromatography. Serum estradiol concentrations were quantified by liquid chromatography tandem mass spectrometry before C-section and postpartum. Postpartum mental distress was evaluated with the Edinburgh Postnatal Depression Scale (EPDS). Associations between EPDS, 5-HIAA, and Δestradiol were evaluated in linear regression models adjusted for age, parity and SERT genotype. Results: Higher levels of postpartum mental distress symptoms were negatively associated with a large decrease in estradiol concentrations (βΔE2 = 0.73, p = 0.007) and, on a trend level, positively associated with high antepartum 5-HIAA levels (β5-HIAA = 0.002, p = 0.06). Conclusion: In a cohort of healthy pregnant women, postpartum mental distress was higher in women with high antepartum 5-HIAA (trend) and lower in women with a large perinatal estradiol decrease. We speculate that high antepartum 5-HIAA is a proxy of SERT levels, that carry over to the postpartum period and convey susceptibility to mental distress. In healthy women, the postpartum return to lower estradiol concentrations may promote mental well-being.
KW - estradiol
KW - mental health
KW - postpartum
KW - pregnancy
KW - serotonin
U2 - 10.1111/acps.13461
DO - 10.1111/acps.13461
M3 - Journal article
C2 - 35729864
AN - SCOPUS:85133490920
VL - 146
SP - 357
EP - 369
JO - Acta Psychiatrica Scandinavica
JF - Acta Psychiatrica Scandinavica
SN - 0001-690X
IS - 4
ER -
ID: 320652581