Context: Elevated hypothalamic corticotropin-releasing hormone (CRH) has been implicated in melancholic major depression in non-pregnant individuals, but the role of placental CRH in maternal prenatal and postpartum depression is largely unexplored.

Objective: To examine the association of maternal mid-pregnancy plasma CRH levels with prenatal and postpartum depression.

Participants: 800 participants in Project Viva, a pregnancy and childhood cohort

Methods: CRH levels were analyzed from blood samples obtained at mean 27.9 weeks gestation (+/- 1.3 s.d.; range 24.6 to 37.4 weeks) and were normalized on the logarithmic scale. Depression was assessed with the Edinburgh Postpartum Depression Scale (EPDS, range 0–30 points) in mid-pregnancy and at six months postpartum. We employed logistic regression to estimate the odds of scoring 13 or more points on the EPDS as an 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, a standard deviation increase in log CRH was associated with nearly 50% higher odds of prenatal depression symptoms (Odds ratio (OR) = 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 (OR = 0.82 (0.58 – 1.15).

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