To determine associations between postpartum depression (PPD) and plasma neurotransmitters. Methods: We conducted a case-control study nested to a prospective cohort established in 3 comprehensive tertiary hospitals in Changsha, Hunan, China from February to September 2007. The Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was used at 2 weeks postpartum to screen PPD, with a score of 13 or higher as the cut-off for PPD. The women with matched age but without PPD and delivery within 5 years were selected as controls. The levels of plasma monoamine neurotransmitters including serotonin (5-hydroxytryptamine, 5-HT), dopamine (DA), and norepinephrine (NE), and peptide neurotransmitters including neuropeptide Y (NPY) and substance P (SP) in maternal blood samples taken at 2 weeks postpartum were measured and compared between PPD women (n=42) and controls (n=42). Results: Plasma levels of 5-HT and NPY were significantly lower while plasma levels of NE and SP were significantly higher in PPD women than those in the controls. For women with PPD, a negative correlation between NPY and NE (r=-0.36, P﹤0.05) was observed. Conclusion: There are changes in plasma levels of neurotransmitters in women with PPD, and there are potential interactions between different neurotransmitters.
目的：探讨血浆神经递质与产后抑郁症(postpartum depression，PPD)的关联。方法：于2007年2至9月在湖南长沙3家三甲医院开展一项前瞻性巢式病例对照研究。运用爱丁堡产后抑郁量表(Edinburgh Postnatal Depression Scale，EPDS)中文版对产后2周产妇进行PPD筛查，得分≥13分者确定为PPD患者(n=42)。每个PPD患者按1:1抽取正常产妇为对照组(n=42)，两组按照分娩医院(同一医院)与年龄(±5岁)进行匹配。在产后2周抽取血液样本，比较PPD组和对照组产妇的血浆单胺类递质及肽类神经递质水平，其中血浆单胺类递质包括5-羟色胺(5-hydroxytryptamine，5-HT)、多巴胺(dopamine，DA)、去甲肾上腺素(norepinephrine，NE)，肽类神经递质包括神经肽Y(neuropeptide Y，NPY)和P物质(substance P，SP)。结果：PPD组5-HT和NPY血浆水平明显低于对照组，而NE和SP血浆水平明显高于对照组(均P<0.05)。PPD组NPY和NE血浆水平之间呈负相关(r=–0.36，P<0.05)。结论：PPD产妇存在多种神经递质水平的改变，不同神经递质之间具有潜在相互作用。.