beta-endorphin and Puerperal-Disorders

1. There are major changes in progesterone, oestrogen, cortisol and beta-endorphin level associated with parturition, and as all these can be psychoactive it is likely that they contribute to the mood changes that can occur at this time. However evidence for their involvement is, at present, indirect. 2. Postnatal depression itself appears to be a heterogeneous condition with different times of onset, and it is probable that various biological and social factors play a role to a differing degree in different individuals. 3. About half of postnatal depression appears to arise in the first two weeks after childbirth. Some cases follow a period of early euphoria. 4. A different subgroup is associated with thyroid dysfunction, which peaks two to five months postpartum. 5. The tyramine test does not predict vulnerability to postnatal depression. 6. It is suggested that in future research the time course of onset of the depression, and the nature of the mood changes that occur in the first postpartum week, are investigated as possibly relevant variables.

Topics: Affect; beta-Endorphin; Depressive Disorder; Estrogens; Female; Humans; Hydrocortisone; Progesterone; Puerperal Disorders; Time Factors

The relationships between mood change, obstetric experience and alterations in plasma cortisol, beta-endorphin (beta-EP) and corticotrophin-releasing hormone (CRH) were examined in a prospective study of 97 primiparous Australian women. Psychological measures were administered between the 28th week of pregnancy and the 3rd postnatal month, including the Profile of Mood States (POMS) and the Montgomery Asberg Depressive Rating Scale (MADRS). Blood samples were collected for cortisol, beta-EP and CRH assay on most of these occasions and during labour. Factor analysis was used to identify key subsets of psychological variables for use in the subsequent analyses. 'Mood disturbance' and 'tiredness' factors peaked at 38 weeks' gestation, while 'difficulty falling asleep' was greatest around the time of birth. Cortisol, beta-EP and CRH concentrations rose significantly as pregnancy advanced and peaked at birth; plasma CRH correlated with plasma cortisol (r = 0.54) and beta-EP (r = 0.32). Women with the highest 'mood disturbance' and MADRS depression scores at 28 weeks' gestation received significantly more pain relief during labour. Those women whose mood deteriorated from 38 weeks' gestation to postnatal day 2 had larger falls in plasma beta-EP after delivery (p less than 0.01) than those women whose mood improved or remained constant. Women in this mood-deteriorated subgroup also had significantly higher MADRS depression scores at 3 months (p less than 0.01). Mild antenatal depression (MADRS greater than 13) occurred in 5.2% of women and mild postnatal depression in 4.7%. Overall, these data suggest a role for circulating CRH in the regulation of maternal cortisol secretion and significant relationships between maternal postnatal mood states and beta-EP and between antenatal mood states and obstetric events.

Topics: Adult; beta-Endorphin; Corticotropin-Releasing Hormone; Depressive Disorder; Female; Follow-Up Studies; Humans; Hydrocortisone; Infant, Newborn; Mother-Child Relations; Personality Tests; Pilot Projects; Pregnancy; Pregnancy Complications; Prospective Studies; Puerperal Disorders

Nineteen women were studied before, during and after labour by assessment of their mood using a variety of psychological tests and by measurement of their plasma concentrations of beta-endorphin and cortisol. Beta-endorphin and cortisol concentrations rose markedly during labour and were influenced by the type of analgesia used. A deterioration in cognitive performance between days 2 and 4 postpartum correlated positively with the fall in beta-endorphin concentrations from those in labour to those on the fourth day postpartum. The women were more anxious and depressed at 38 weeks' gestation than on days 1-4 postpartum and the elevation of mood on day 2 postpartum correlated with a measure of depression 8 weeks later. It is postulated that the phenomenon of postpartum blues is a reaction to the euphoria of delivery which in turn is a response to endorphin release during labour. Whilst these changes may have a role in promoting maternal-infant attachment it is at the expense of maternal depression some weeks later.

Topics: Anxiety; beta-Endorphin; Cognition; Depression; Emotions; Endorphins; Female; Humans; Hydrocortisone; Labor, Obstetric; Postpartum Period; Pregnancy; Psychological Tests; Puerperal Disorders

Topics: beta-Endorphin; Endorphins; Female; Humans; Monoamine Oxidase; Mood Disorders; Pregnancy; Prolactin; Puerperal Disorders

Topics: beta-Endorphin; Endorphins; Female; Hormones; Humans; Mental Disorders; Pregnancy; Puerperal Disorders

Plasma beta-endorphin-like immunoreactivity was studied in 43 pregnant women at 36 weeks gestation and in 23 of these at delivery and 24 h post-partum; an attempt made to correlate changes with various social, psychological and obstetric factors, including the 'post-natal blues'. Beta-endorphin levels were elevated at 36 weeks gestation and term, increased to very high levels during labour and fell rapidly within 1 h of delivery. A negative correlation was observed between the woman's estimate of her pain in labour and the beta-endorphin levels post-partum, suggesting an analgesic role for beta-endorphin in labour. A positive correlation was also observed between the levels of beta-endorphin at delivery and the woman's attitude to her pregnancy at 36 weeks and a negative correlation between the 'post-natal blues score' and the beta-endorphin level at 36 weeks. However, the 'blues' did not correlate either with the beta-endorphin level at delivery or 24 h post-partum nor with its rate of fall in the first 24 h. Our general finding that there was no consistent social, psychological or obstetric factor which predisposes women to develop 'post-natal blues' still supports the hypothesis that humoral factors, of which beta-endorphin may be one, rather than psychological factors are important in the genesis of this syndrome.

Topics: beta-Endorphin; Endorphins; Female; Humans; Labor, Obstetric; Postpartum Period; Pregnancy; Psychotic Disorders; Puerperal Disorders