47075
document
Changes in sleep quality , but not hormones predict time to postpartum depression recurrence . BACKGROUND Poor sleep quality , dysregulation of hormones and increased inflammatory cytokines are all associated with the risk for postpartum major depression ( PPMD ) . We evaluated change over time in sleep quality and hormones during the first 17 weeks postpartum , as well as a single cytokine measure , and their association with PPMD recurrence . METHODS Participants were pregnant women ( N=56 ) , with past histories of MDD/PPMD but not depressed in their current pregnancy . The Pittsburgh Sleep Quality Index ( PSQI ) and blood samples were collected 8 times during the first 17 weeks postpartum . Estradiol , prolactin and cortisol , and a single measure of IL-6 were assayed . Recurrence was determined by two consecutive 21-item Hamilton Rating Scale for Depression ( HRSD ) scores≥15 and clinician interview . RESULTS In the analyses of time to PPMD recurrence , poor sleep quality , but none of the hormones , was associated with PPMD recurrence ( p < .05 ) after controlling for medication assignment . With every one point increase in PSQI scores across time , a woman 's risk for recurrence increased by approximately 25 % There was no significant association between PSQI scores and IL-6 concentrations in early postpartum ( χ ( 2 ) =0.98 , p=.32 ) . CONCLUSIONS Poor sleep quality across the first 17 weeks post-delivery increases the risk for recurrent PPMD among women with a history of MDD . Changes in the hormonal milieu were not associated with recurrence . Further exploration of the degree to which poor sleep contributes to hormonal and cytokine dysregulation and how they are involved in the pathophysiology of PPMD is warranted .
47076
Intervention_Educational
Pittsburgh Sleep Quality Index ( PSQI )
47077
Intervention_Pharmacological
blood samples
47078
Outcome_Physical
sleep quality
47079
Outcome_Physical
hormones
47080
Outcome_Physical
Pittsburgh Sleep Quality Index
47081
Outcome_Physical
Estradiol , prolactin and cortisol , and a single measure of IL-6
47082
Participant_Condition
pregnant
47083
Participant_Sex
women
47084
Participant_Sample-size
( N=56 )
47085
Participant_Condition
MDD/PPMD but not depressed in their current pregnancy
47086
Participant_Sex
women
47087
Participant_Condition
MDD