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Low Serum Allopregnanolone Is Associated with Symptoms of Depression in Late Pregnancy
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology. (Reproduktiv Hälsa)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Obstetrics and Gynaecology.ORCID iD: 0000-0002-4935-7532
Umeå Neurosteroid Research Center, Department of Clinical Science, Obstetrics and Gynecology, Umeå University, Umeå, Sweden.
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2014 (English)In: Neuropsychobiology, ISSN 0302-282X, E-ISSN 1423-0224, Vol. 69, no 3, 147-153 p.Article in journal (Refereed) Published
Abstract [en]

Allopregnanolone (3α-hydroxy-5α-pregnan-20-one) is a neurosteroid which has inhibitory function through interaction with the GABAA receptor. This progesterone metabolite has strong sedative and anxiolytic properties, and low endogenous levels have been associated with depressed mood. This study aimed to investigate whether the very high serum allopregnanolone levels in late pregnancy co-vary with concurrent self-rated symptoms of depression and anxiety.

Ninety-six women in pregnancy weeks 37 - 40 rated symptoms of depression and anxiety with the Montgomery-Åsberg Depression Rating Scale (MADRS-S) and Spielberger State-Trait Anxiety Inventory (STAI-S and STAI–T). Their serum allopregnanolone was analyzed by celite chromatography and radioimmunoassay.

Ten women had elevated depression scores (MADRS-S ≥ 13), and this group had significantly lower allopregnanolone levels compared to women with MADRS-S scores in the lower range (39.0 ± 17.9 nmol/l vs. 54.6 ± 18.7 nmol/l, p = 0.014). A significant negative correlation was found between self-rated depression scores and allopregnanolone concentrations (Pearson’s correlation coefficient = -0.220, p = 0.031). The linear association between self-rated depression scores and allopregnanolone serum concentrations remained significant when adjusted for gestational length, progesterone levels, and parity. Self-rated anxiety, however, was not associated with allopregnanolone serum concentrations during pregnancy. In conclusion, high allopregnanolone serum concentrations may protect against depressed mood during pregnancy.

Place, publisher, year, edition, pages
2014. Vol. 69, no 3, 147-153 p.
Keyword [en]
allopregnanolone, anxiety, depression, MADRS-S, neurosteroid, pregnancy, STAI
National Category
Neurosciences Physiology Obstetrics, Gynecology and Reproductive Medicine
Research subject
Obstetrics and Gynaecology; Medical Science; Neuroscience
URN: urn:nbn:se:uu:diva-197611DOI: 10.1159/000358838ISI: 000337267300003OAI: oai:DiVA.org:uu-197611DiVA: diva2:613935
Available from: 2013-04-02 Created: 2013-04-01 Last updated: 2016-06-21Bibliographically approved
In thesis
1. Physiological Stress Reactivity in Late Pregnancy
Open this publication in new window or tab >>Physiological Stress Reactivity in Late Pregnancy
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

During pregnancy, the basal activity is increased in both of our major stress response systems: the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis. At the same time, the reactivity towards stressors is reduced. These alterations sustain maternal and fetal homeostasis, and are involved in the regulation of gestational length. Although the feto-placental hormone synthesis produces the main endocrinological changes, also the central nervous system undergoes adaptation. Together, these profound adjustments have been suggested to make women’s mental health more vulnerable during pregnancy and postpartum period. The aim of this thesis was to examine factors connected to physiological stress responses during the late pregnancy in relation to pain, labour onset, emotional reactivity, and mental health.

The first study examined the pain and sympathetic response during cold stress, in relation to time to delivery. Women with fewer days to spontaneous delivery had lower sympathetic reactivity, while no pain measure was associated with time to delivery.

In the second study, acoustic startle response modulation was employed to study emotional reactivity during late gestation, and at four to six weeks postpartum. The startle response was measured by eye-blink electromyography, while the participants watched pleasant and unpleasant pictures, and positive and negative anticipation stimuli. A significant reduction in startle modulation by anticipation was found during the postpartum assessment. However, no startle modulation by pleasant, or unpleasant, pictures was detected at either time-point.

The serum level of allopregnanolone, a neurosteroid implied in pregnancy-induced hyporeactivity, was analysed in relation to self-reported symptoms of anxiety and depression. Although the participants reported low levels of depression, the women with the highest depression scores had significantly lower levels of serum allopregnanolone. There was no correlation between allopregnanolone and anxiety scores.

In the fourth study, the cortisol awakening response was compared between women with depression during pregnancy, women with depression prior to pregnancy, and women who had never suffered from depression. No group differences in cortisol awakening response during late pregnancy were found.

The results are in line with the previously described pregnancy-induced hyporesponsiveness, and add to the knowledge on maternal stress hyporeactivity, gestational length, and maternal mental health.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2013. 70 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 887
acoustic startle response, allopregnanolone, antenatal, anxiety, cold pressor test, cortisol, cortisol awakening response, depression, electrodermal, estradiol, hypothalamic-pituitary-adrenal axis, postpartum, pregnancy, progesterone, skin conductance, stress, sympathetic nervous system
National Category
Physiology Neurosciences Obstetrics, Gynecology and Reproductive Medicine
Research subject
Medical Science
urn:nbn:se:uu:diva-197441 (URN)978-91-554-8636-5 (ISBN)
Public defence
2013-05-17, Sal X, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15 (English)
Available from: 2013-04-26 Created: 2013-03-25 Last updated: 2013-08-30Bibliographically approved

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Hellgren, CharlotteÅkerud, HelenaSkalkidou, AlkistisSundström-Poromaa, Inger
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