The functioning of the hypothalamic-pituitary-adrenal (HPA) axis in postpartum depressive states: a systematic review
| Autor: | Cybele Garcia-Leal, Cristina Marta Del-Ben, Marcos Gonçalves de Rezende, Margaret de Castro, Fabiana Corsi-Zuelli |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Postpartum depression
medicine.medical_specialty business.industry Baby blues Obstetrics Endocrinology Diabetes and Metabolism medicine.disease 030227 psychiatry 03 medical and health sciences 0302 clinical medicine HORMÔNIOS GLICOCORTICOIDES Medicine business Psychiatry 030217 neurology & neurosurgery Postpartum period Morning |
| Zdroj: | Repositório Institucional da USP (Biblioteca Digital da Produção Intelectual) Universidade de São Paulo (USP) instacron:USP |
| ISSN: | 1744-8417 1744-6651 |
| DOI: | 10.1080/17446651.2017.1347500 |
| Popis: | A large body of literature suggests the role of the hypothalamic-pituitary-adrenal (HPA) axis in postpartum depression (PPD). Nonetheless, these studies present discrepant methodology and results; thus, this hypothesis deserves further exploration. Areas covered: This review included studies investigating the HPA axis in PPD or postpartum blues published until November 2016. In total, 48 studies met the inclusion criteria. The HPA axis was mostly investigated in the immediate postpartum period (62.5%), and the majority of studies collected samples in the morning (43.8%), with one measure in a single day (43.8%), and blood was the fluid more often collected (58.4%). Seven out of 21 studies evaluating postpartum blues, and 15 out of 28 studies evaluating PPD detected abnormalities in the HPA axis functioning. Expert commentary: We found a significant heterogeneity in the methodology adopted by studies and consequently, in the results. Despite that, the majority of studies reported HPA changes in women with PPD during the remote period. Notably, reactivity tests pointed to attenuated HPA axis response. Ideally, future investigations should use validated reactivity tests, include larger sample sizes, consider many measures of cortisol throughout the day, and more than one day of collection. We also recommend that studies continue to use validated scales for mood assessment. |
| Databáze: | OpenAIRE |
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