A new study by UVA and Weill Cornell Medicine reveals the potential for a simple blood test to identify women at risk of postpartum depression. This innovation could transform early intervention and treatment, profoundly impacting maternal health.
A new study from the University of Virginia (UVA) School of Medicine and Weill Cornell Medicine, co-led by Jennifer Payne and Lauren Osborne, suggests that certain molecules in the blood of pregnant women might predict who is at risk of developing postpartum depression (PPD), opening avenues for preventive treatments.
Published in the journal Neuropsychopharmacology, the research focused on neuroactive steroids, molecules derived from the hormone progesterone, which plays essential roles in pregnancy.
Detecting specific levels of these steroids through a simple blood test could enable health care providers to intervene sooner, possibly even before any symptoms arise.
“Studying postpartum depression gives us a way to identify biological changes that occur before someone becomes depressed because the timing of postpartum depression is predictable,” Payne, an expert in reproductive psychiatry at UVA Health and the University of Virginia School of Medicine, said in a news release.
Understanding Postpartum Depression
Approximately 10% to 15% of new mothers experience PPD, a debilitating condition marked by prolonged sadness, severe anxiety, a persistent sense of hopelessness and difficulties bonding with the newborn.
Unlike the transient “baby blues,” PPD can severely affect both the mother and child for years.
“Postpartum is the only time in people’s lifespans when we know there is a biological trigger which guarantees that a certain percentage of people will become ill,” Osborne, an associate professor of obstetrics and gynecology at Weill Cornell, said in the news release. “If we can untangle this biology and find predictors for it, not only will we be helping women, but it may give us a step up in trying to find predictors for other psychiatric illnesses also.”
The study highlights an imbalance in the metabolism of progesterone as a potential factor for PPD.
About the Study
The researchers delved into the hormonal regulation and metabolic pathways of progesterone by examining blood samples from 136 women during their second and third trimesters. Among these participants, 33 developed PPD post-delivery.
Particularly, two neuroactive steroids, pregnanolone and isoallopregnanolone, were implicated in PPD risk. Pregnanolone helps reduce stress by acting on specific cellular receptors, while isoallopregnanolone increases stress.
The study identified that women who later developed PPD had lower pregnanolone-to-progesterone ratios and higher isoallopregnanolone-to-pregnanolone ratios in their third trimester compared to those who did not develop PPD.
Elevated progesterone levels during late pregnancy were also linked to higher PPD risk.
Next Steps
The research team aims to replicate their findings in a larger and more diverse cohort, with the goal of developing a clinical test for predicting PPD risk.
Looking ahead, they see potential in existing prescription drugs, brexanolone and zuranolone, as preventive treatments.
“We don’t know if these drugs would work as a preventive measure for people who are at risk of developing postpartum depression, but based on our findings, they have the potential to prevent [its] development,” added Osborne.