Perinatal depression is a major cause of disability for individuals giving birth worldwide, with detrimental effects on short- and long-term parental and child outcomes. There is emerging evidence that the neuroactive steroid hormone allopregnanolone is implicated in the pathophysiology and course of perinatal mood symptoms. However, no study thus far has examined allopregnanolone levels whilst making use of longitudinal data on depressive symptom trajectories throughout the perinatal period. The present study investigated levels of allopregnanolone at gestational week 17 of 252 participants in relation to perinatal depressive symptom trajectories, with a secondary aim of exploring the role of history of depression as an effect modifier. Four perinatal depressive symptom trajectories were investigated: controls (no depressive symptoms throughout perinatal period) (N=161), antepartum (depressive symptoms prenatally with postpartum remission) (N=31), postpartum-onset (no depressive symptoms during pregnancy, development of depressive symptoms postpartum) (N=23), and persistent (depressive symptoms throughout the perinatal period) (N=37). Results show that for every one nmol/l increase in allopregnanolone, there was 7% higher odds for persistent depressive symptoms (OR 1.07, 95% CI 1.01–1.14) compared to controls. No association was seen for antepartum and postpartum-onset depressive symptoms. History of depression did not modify the association between allopregnanolone and perinatal depressive symptom trajectories. These results show the role of allopregnanolone for persistent depressive symptoms and strengthen the hypothesis of differences in pathophysiology among the trajectories.

中文翻译：

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妊娠中期别孕酮水平和围产期抑郁症状的轨迹

围产期抑郁症是全世界分娩者残疾的主要原因，对短期和长期的父母和儿童结局产生不利影响。越来越多的证据表明，神经活性类固醇激素四氢孕酮与围产期情绪症状的病理生理学和过程有关。然而，迄今为止，还没有研究利用整个围产期抑郁症状轨迹的纵向数据来检查异孕酮水平。本研究调查了 252 名参与者在妊娠第 17 周时的四氢孕酮水平与围产期抑郁症状轨迹的关系，第二个目的是探索抑郁病史作为效应调节剂的作用。研究了四种围产期抑郁症状轨迹：对照（整个围产期没有抑郁症状）（N = 161），产前（产前抑郁症状，产后缓解）（N = 31），产后发作（怀孕期间没有抑郁症状，发展为抑郁症）。产后抑郁症状）（N=23），以及持续性（整个围产期抑郁症状）（N=37）。结果显示，与对照组相比，四氢孕酮每增加 1 nmol/l，持续抑郁症状的几率就会增加 7%（OR 1.07，95% CI 1.01–1.14）。未发现产前和产后抑郁症状之间存在关联。抑郁症史并没有改变四氢孕酮与围产期抑郁症状轨迹之间的关联。这些结果显示了四氢孕酮对持续性抑郁症状的作用，并加强了轨迹之间病理生理学差异的假设。