Postnatal depression (PND) affects about one out of seven new mothers. Not to be confused with the ‘baby blues,’ PND can lead to a lack of engagement and bonding with their infant, which can have long-term effects, like learning disabilities in children, emotional difficulties later in life and lack of maternal-child bond. In severe cases, the mother may have thoughts of suicide or of harming their child or have other symptoms like crying episodes, isolation, changes in sleeping and eating patterns, anxiety, reduced libido, and severe irritability.
Too many cases of PND are overlooked or undiagnosed. Often, the mother is too afraid, depressed or ashamed to talk to their doctor about their symptoms. This, of course, leads to an even deeper depression and symptoms that are more severe. Being able to screen mothers ahead of time may be helpful in reducing the number of undiagnosed cases and in having a support system or treatment plan in place ahead of time, before they symptoms start. But how do you go about screening ahead of time? A recent study just might have the answer.
Presented at the International Congress of Endocrinology/European Congress of Endocrinology by Professor Dimitris Grammatopoulos, Professor of Molecular Medicine at Warwick’s University, the study found that detecting a risk for postnatal depression may be as simple as a blood test during pregnancy.
“Current screening policies rely on the opportunities finding of PND cases using tools such as the Edinburgh Postnatal Depression Score (EPDS), but such tests cannot identify women at risk, ahead of them developing the condition,” said Grammatopoulos. But they hope to change all that with their most recent work.
During their study, researchers conducted the EPDS on 200 pregnant women during their first antenatal visit. Two to eight weeks after delivery, the same test was performed. After evaluating their blood work before and after pregnancy, researchers found that the women who had developed PND had a higher likelihood of having specific genetic variants, particularly the bcl1 and rs242939 single nucleotide polymorphisms (SNPs) of the glucocorticoid receptor and the corticotrophin-releasing hormone receptor-1 genes.
The receptors found in women with PND play a part in controlling the hypothalamo-pituitary adrenal (HPA) axis. It’s job is to link the nervous system to the endocrine system through the pituitary gland. A variety of hormones are released into the blood, including hormones that relate to stress. It seems, according to the findings, that PND may actually be a subgroup of depression and that a distinct genetic element is responsible. Essentially, this means that some women may react stronger to environmental factors that cause depression and that genetics may be responsible for that reaction.
More research will be needed for the PND-HPA axis link, but researchers strongly believe that they have found a hormonal imbalance responsible for PND and that they have taken the first big step in moving towards better, more effective treatments for women at high risk for postnatal depression.
“Although we knew already that there was an association of the HPA axis with depression, ours is the first study to show a link between specific genetic elements of this pathway and the particular case of PND,” Grammatopoulos stated. “We now intend to conduct further research on other genetic variants of the HPA axis in a larger, multi-centre study involving women from Coventry, Birmingham and London. We think that we have made an important step forward in characterizing the prospective risks and are, therefore, paving the way for timely, appropriate medical treatment for women who are likely to develop PND. We believe that we have made a discovery with important clinical and social implications. If we can identify women likely to suffer from PND in advance so that they can be treated appropriately and at an early stage, we will have improved the lives, not just of the parents, but also of their children.”
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