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. 2020 Apr 1:11:251.
doi: 10.3389/fpsyt.2020.00251. eCollection 2020.

Postpartal Affective and Endocrine Differences Between Parents of Preterm and Full-Term Infants

Tobias Weigl  1   2 , Nora Schneider  1   3 , Anja Stein  3 , Ursula Felderhoff-Müser  3 , Manfred Schedlowski  1 , Harald Engler  1
Affiliations

Postpartal Affective and Endocrine Differences Between Parents of Preterm and Full-Term Infants

Tobias Weigl et al. Front Psychiatry. .

Abstract

Background: During the postpartum period, new parents frequently experience emotional stress and exhibit symptoms of depression and anxiety, accompanied by substantial endocrine changes. However, evidence predominantly exists from parents of full-term infants, while data on parents of preterm infants are scarce. In this exploratory, cross-sectional study, we compared psychological well-being and endocrine parameters in parents of very preterm and term born infants.

Methods: Mothers (N = 28) and fathers (N = 30) of full-term infants as well as mothers (N = 18) and fathers (N = 21) of very or extreme preterm infants (< 32nd gestational week) were recruited in the days following birth. Anxiety, depression, and perceived stress were assessed with the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI), and the Perceived Stress Questionnaire (PSQ), respectively. Physiological measures included serum levels of estradiol, progesterone, prolactin, and thyroid-stimulating hormone (mothers only), as well as the salivary cortisol awakening response (mothers and fathers).

Results: New mothers and fathers of very preterm infants exhibited higher scores of depression, anxiety and stress than parents of term infants. Besides, mothers of very preterm infants showed lower levels of estradiol, progesterone, and prolactin, as well as a heightened post-awakening cortisol response compared to mothers of term infants. Furthermore, in mothers of preterm infants we found significant negative associations between serum prolactin levels and BDI and STAI scores, respectively.

Conclusions: Parents of very preterm infants suffered from a higher burden of psychological distress than parents of full-term infants. The affective symptoms in preterm mothers were accompanied by altered endocrine profiles that, at least to some extent, may contribute to the psychological changes. The profound psychological and physiological disturbances in mothers of preterm infants may have an impact on long-term mental health and early pharmacological and psychological interventions may help to ameliorate postpartum affective symptoms.

Keywords: anxiety; cortisol; depression; ovarian hormones; postpartum; preterm birth.

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Figures

Figure 1
Figure 1
Scores of BDI (A) and STAI-S (B) in mothers of infants born at term or preterm. ***p < 0.001; **p < 0.01. Data are shown as mean values ± SEM.
Figure 2
Figure 2
Serum concentrations of estradiol (A), progesterone (B), prolactin (C), and TSH (D) in in mothers of infants born at term or preterm. ***p < 0.001. Data are shown as mean values ± SEM.
Figure 3
Figure 3
Cortisol awakening response in mothers of infants born at term or preterm. **p < 0.01; *p < 0.05. Data are shown as mean values ± SEM.
Figure 4
Figure 4
Spearman correlation between serum levels of prolactin and scores of BDI (A) and STAI-S (B) in mothers of infants born preterm.
Figure 5
Figure 5
Scores of BDI (A) and STAI-S (B) in fathers of infants born at term or preterm. ***p < 0.001. Data are shown as mean values ± SEM.
See this image and copyright information in PMC

References

    1. Grekin R, O’Hara MW. Prevalence and risk factors of postpartum posttraumatic stress disorder: a meta-analysis. Clin Psychol Rev (2014) 34(5):389–401. 10.1016/j.cpr.2014.05.003 - DOI - PubMed
    1. Lonstein JS. Regulation of anxiety during the postpartum period. Front Neuroendocrinol (2007) 28(2-3):115–41. 10.1016/j.yfrne.2007.05.002 - DOI - PubMed
    1. Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol (2005) 106(5 Pt 1):1071–83. 10.1097/01.AOG.0000183597.31630.db - DOI - PubMed
    1. Loughnan SA, Wallace M, Joubert AE, Haskelberg H, Andrews G, Newby JM. A systematic review of psychological treatments for clinical anxiety during the perinatal period. Arch Womens Ment Health (2018) 21(5):481–90. 10.1007/s00737-018-0812-7 - DOI - PubMed
    1. Skalkidou A, Hellgren C, Comasco E, Sylven S, Sundstrom Poromaa I. Biological aspects of postpartum depression. Womens Health (Lond Engl) (2012) 8(6):659–72. 10.2217/whe.12.55 - DOI - PubMed