This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Rich-Edwards, J. W. Articles by Gillman, M. W. Search for Related Content PubMed PubMed Citation Articles by Rich-Edwards, J. W. Articles by Gillman, M. W. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Depression High Risk Pregnancy Postpartum Care Postpartum Depression Related Collections Adrenal and Hypertension Neuroendocrinology and Pituitary

Elevated Midpregnancy Corticotropin-Releasing Hormone Is Associated with Prenatal, But Not Postpartum, Maternal Depression

Connors Center for Women's Health and Gender Biology (J.W.R.-E.), Brigham and Women's Hospital, Departments of Epidemiology (J.W.R.-E., A.P.M.), Society, Human Development, and Health (R.J.W.), and Nutrition (M.W.G.), Harvard School of Public Health, Department of Obstetrics and Gynecology (M.R.H.), Beth Israel Deaconess Medical Center, Harvard Medical School, Division of Endocrinology (J.M.), Children's Hospital Boston, and Channing Laboratory (R.J.W.), Brigham & Women's Hospital, Harvard Medical School, Boston, Massachusetts 02215; and Department of Ambulatory Care and Prevention (J.W.R.-E., K.K., M.W.G.), Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts 02115

Address all correspondence and requests for reprints to: Dr. Janet Rich-Edwards, Brigham and Women's Hospital, Connors Center for Women's Health, 1620 Tremont Street, Boston, Massachusetts 02215. E-mail: jr33{at}partners.org.

Context: Elevated hypothalamic CRH has been implicated in melancholic major depression in nonpregnant individuals, but the role of placental CRH in maternal prenatal and postpartum depression is largely unexplored.

Objective: The objective of the study was to examine the association of maternal midpregnancy plasma CRH levels with prenatal and postpartum depression.

Participants: The study included 800 participants in Project Viva, a pregnancy and childhood cohort.

Methods: CRH levels were analyzed from blood samples obtained at mean 27.9 wk gestation (± 1.3 SD; range 24.6–37.4 wk) and were normalized on the logarithmic scale. Depression was assessed with the Edinburgh Postpartum Depression Scale (range 0–30 points) in midpregnancy and at 6 months postpartum. We used logistic regression to estimate the odds of scoring 13 or more points on the Edinburgh Postpartum Depression Scale as indicative of major or minor depression.

Results: Seventy (8.8%) and 46 (7.5%) women had prenatal and postpartum depression symptoms, respectively. Mean log CRH was 4.93 (± 0.62 SD). After adjusting for confounders, an SD increase in log CRH was associated with nearly 50% higher odds of prenatal depression symptoms (odds ratio 1.48, 95% confidence interval 1.14–1.93). Higher CRH levels during pregnancy were unassociated with greater risk of postpartum depressive symptoms. In fact, there was a suggestion that prenatal CRH levels might be inversely associated with risk of postpartum depressive symptoms (odds ratio 0.82, 95% confidence interval 0.58–1.15).

Conclusions: Elevated placental CRH levels in midpregnancy are positively associated with risk of prenatal depression symptoms but not postpartum depression symptoms.

This article has been cited by other articles:

				J. Rich-Edwards, M. Hacker, and M. Gillman Premature Recommendation of Corticotropin-Releasing Hormone as Screen for Postpartum Depression Arch Gen Psychiatry, August 1, 2009; 66(8): 917 - 917. [Full Text] [PDF]

				M. H. Fasting, E. Oken, C. S. Mantzoros, J. W. Rich-Edwards, J. A. Majzoub, K. Kleinman, S. L. Rifas-Shiman, T. Vik, and M. W. Gillman Maternal Levels of Corticotropin-Releasing Hormone during Pregnancy in Relation to Adiponectin and Leptin in Early Childhood J. Clin. Endocrinol. Metab., April 1, 2009; 94(4): 1409 - 1415. [Abstract] [Full Text] [PDF]

				I. S. Yim, L. M. Glynn, C. Dunkel Schetter, C. J. Hobel, A. Chicz-DeMet, and C. A. Sandman Risk of Postpartum Depressive Symptoms With Elevated Corticotropin-Releasing Hormone in Human Pregnancy Arch Gen Psychiatry, February 1, 2009; 66(2): 162 - 169. [Abstract] [Full Text] [PDF]