Objective: To explore the relationship of estradiol (E(2)), monoamine neurotransmitters 5-hydroxytryptamine (5-HT), dopamine (DA) and postpartum depression.
Methods: Totally 342 women within 42 days after childbirth were assessed with Edinburgh postnatal depression scale (EPDS), Beck depression inventory (BDI), and general health questionnaire (GHQ). Above or equal to 13 of overall score of EPDS was the diagnosis standard of postpartum depression, and the women tested were divided into depression group and normal group accordingly, using the reagent box of radio immunoassay to test estradiol and 5-HT and DA level in the serum.
Results: (1) Incidence: the incidence of postpartum depression was 16.7% (57/342). The highest incidence occurred in patients above 35 (22.2%); the incidence among women under 23 years old was lowest (12.5%), with a significant difference between them (P < 0.01); the incidence in persons with a bachelor degree and above (21.3%) was higher than that of persons with a lower degree of education (7.9%), with a significant difference between the two groups. (2) Biological indicator: the levels of E(2), and 5-HT in depression group (64.39 +/- 0.22) pmol/L, (1.09 +/- 0.21) micromol/L were significantly lower than those in the normal group (126.18 +/- 0.47) pmol/L, (2.67 +/- 0.36) micromol/L (P < 0.01); whereas the level of DA in depression group (5.21 +/- 0.54) micromol/L was significantly higher than that in the normal group (3.16 +/- 0.98) micromol/L (P < 0.01). (3) The levels of E(2) and 5-HT were negatively correlated with the score of EPDS, BDI, GHQ (P < 0.05); but the level of DA was positively related to the scores of EPDS and BDI (P < 0.05), while it had no relationship with GHQ (P > 0.05).
Conclusions: Evaluation scales such as EPDS, BDI, and GHQ should be used to screen for postpartum depression. The measurement of estradiol and monoamine neurotransmitter (5-HT, DA) level can be used as biological objective indicators for prevention and treatment of postpartum depression.