Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Archives of Women's Mental Health
Published in: Archives of Women's Mental Health 4/2016

01-08-2016 | Original Article

Do changes in subjective sleep and biological rhythms predict worsening in postpartum depressive symptoms? A prospective study across the perinatal period

Authors: Elizabeth M. Krawczak, Luciano Minuzzi, Maria Paz Hidalgo, Benicio N. Frey

Published in: Archives of Women's Mental Health | Issue 4/2016

Login to get access

Abstract

Abnormalities of sleep and biological rhythms have been widely implicated in the pathophysiology of major depressive disorder (MDD) and bipolar disorder (BD). However, less is known about the influence of biological rhythm disruptions across the perinatal period on postpartum depression (PPD). The objective of this study was to prospectively evaluate the relationship between subjective changes in both sleep and biological rhythms and worsening of depressive symptoms from pregnancy to the postpartum period in women with and without mood disorders. Eighty-three participants (38 euthymic women with a history of a mood disorder and 45 healthy controls) were studied. Participants completed subjective assessments of sleep (Pittsburgh Sleep Quality Index), biological rhythm disturbances (Biological Rhythms Interview of Assessment in Neuropsychiatry), and depressive symptoms (Edinburgh Postnatal Depression Scale) prospectively at two time points: third trimester of pregnancy and at 6–12 weeks postpartum. Multivariate regression analyses showed that changes in biological rhythms across the perinatal period predicted worsening of depressive symptoms in both groups. Moreover, women with a history of a mood disorder showed higher levels of sleep and biological rhythm disruption during both pregnancy and the postpartum period. These findings suggest that disruptions in biological rhythms during the perinatal period increase the risk for postpartum mood worsening in healthy pregnant as well as in pregnant women with a history of mood disorders.
Literature
Albacar G, Sans T, Martin-Santos R et al (2010) Thyroid function 48h after delivery as a marker for subsequent postpartum depression. Psychoneuroendocrinology 35:738–742CrossRefPubMed
Barr JA, Beck CT (2008) Infanticide secrets: qualitative study on postpartum depression. Can Fam Physician 54:1716–1717 e1715PubMedPubMedCentral
Bei B, Milgrom J, Ericksen J et al (2010) Subjective perception of sleep, but not its objective quality, is associated with immediate postpartum mood disturbances in healthy women. Sleep 33:531–538PubMedPubMedCentral
Bennett S, Alpert M, Kubulins V et al (2009) Use of modified spectacles and light bulbs to block blue light at night may prevent postpartum depression. Med Hypotheses 73:251–253CrossRefPubMed
Brummelte S, Galea LA (2010) Depression during pregnancy and postpartum: contribution of stress and ovarian hormones. Prog Neuropsychopharmacol Biol Psychiatry 34:766–776CrossRefPubMed
Buysse DJ, Reynolds CF 3rd, Monk TH et al (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213CrossRefPubMed
Coble PA, Reynolds CF 3rd, Kupfer DJ et al (1994) Childbearing in women with and without a history of affective disorder. II. Electroencephalographic sleep. Compr Psychiatry 35:215–224CrossRefPubMed
Coo Calcagni S, Bei B, Milgrom J et al (2012) The relationship between sleep and mood in first-time and experienced mothers. Behav Sleep Med 10:167–179CrossRefPubMed
Coo Calcagni S, Milgrom J, Trinder J (2014) Mood and objective and subjective measures of sleep during late pregnancy and the postpartum period. Behav Sleep Med 12:317–330CrossRef
Corral M, Wardrop AA, Zhang H et al (2007) Morning light therapy for postpartum depression. Arch Womens Ment Health 10:221–224CrossRefPubMed
Cox JL, Holden JM, Sagovsky R (1987) Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 150:782–786CrossRefPubMed
Di Florio A, Jones L, Forty L et al (2014) Mood disorders and parity—a clue to the aetiology of the postpartum trigger. J Affect Disord 152–154:334–339CrossRefPubMedPubMedCentral
Dorheim SK, Bondevik GT, Eberhard-Gran M et al (2009) Sleep and depression in postpartum women: a population-based study. Sleep 32:847–855PubMedPubMedCentral
Epperson CN, Terman M, Terman JS et al (2004) Randomized clinical trial of bright light therapy for antepartum depression: preliminary findings. J Clin Psychiatry 65:421–425CrossRefPubMed
Faisal-Cury A, Huang H, Chan YF et al (2013) The relationship between depressive/anxiety symptoms during pregnancy/postpartum and sexual life decline after delivery. J Sex Med 10:1343–1349CrossRefPubMedPubMedCentral
Gavin NI, Gaynes BN, Lohr KN et al (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106:1071–1083CrossRefPubMed
Giglio LM, Magalhaes PV, Andreazza AC et al (2009) Development and use of a biological rhythm interview. J Affect Disord 118:161–165CrossRefPubMed
Giglio LM, Magalhaes PV, Kapczinski NS et al (2010) Functional impact of biological rhythm disturbance in bipolar disorder. J Psychiatr Res 44:220–223CrossRefPubMed
Glynn LM, Davis EP, Sandman CA (2013) New insights into the role of perinatal HPA-axis dysregulation in postpartum depression. Neuropeptides 47:363–370CrossRefPubMed
Gonzalez R (2014) The relationship between bipolar disorder and biological rhythms. J Clin Psychiatry 75:e323–e331CrossRefPubMed
Goyal D, Gay C, Lee K (2009) Fragmented maternal sleep is more strongly correlated with depressive symptoms than infant temperament at three months postpartum. Arch Womens Ment Health 12:229–237CrossRefPubMedPubMedCentral
Harvey AG (2011) Sleep and circadian functioning: critical mechanisms in the mood disorders? Annu Rev Clin Psychol 7:297–319CrossRefPubMed
Kammerer M, Taylor A, Glover V (2006) The HPA axis and perinatal depression: a hypothesis. Arch Womens Ment Health 9:187–196CrossRefPubMed
Kim JJ, Silver RK, La Porte LM et al (2014) Clinical correlates of maternal suicidal ideation detected by perinatal depression screening. Obstet Gynecol 123:60SCrossRef
Kivlighan KT, DiPietro JA, Costigan KA et al (2008) Diurnal rhythm of cortisol during late pregnancy: associations with maternal psychological well-being and fetal growth. Psychoneuroendocrinology 33:1225–1235CrossRefPubMedPubMedCentral
Klier CM, Muzik M, Dervic K et al (2007) The role of estrogen and progesterone in depression after birth. J Psychiatr Res 41:273–279CrossRefPubMed
Leahy-Warren P, McCarthy G (2007) Postnatal depression: prevalence, mothers’ perspectives, and treatments. Arch Psychiatr Nurs 21:91–100CrossRefPubMed
Lee SY, Kimble LP (2009) Impaired sleep and well-being in mothers with low-birth-weight infants. J Obstet Gynecol Neonatal Nurs 38:676–685CrossRefPubMed
Lee KA, Zaffke ME, McEnany G (2000) Parity and sleep patterns during and after pregnancy. Obstet Gynecol 95:14–18PubMed
Lindahl V, Pearson JL, Colpe L (2005) Prevalence of suicidality during pregnancy and the postpartum. Arch Womens Ment Health 8:77–87CrossRefPubMed
Meltzer-Brody S, Boschloo L, Jones I et al (2013) The EPDS-Lifetime: assessment of lifetime prevalence and risk factors for perinatal depression in a large cohort of depressed women. Arch Womens Ment Health 16:465–473CrossRefPubMed
Murray D, Cox JL (1990) Screening for depression during pregnancy with the edinburgh depression scale (EPDS). J Reprod Infant Psychol 8:99–107CrossRef
Ng TH, Chung KF, Ho FY et al (2015) Sleep-wake disturbance in interepisode bipolar disorder and high-risk individuals: a systematic review and meta-analysis. Sleep Med Rev 20:46–58CrossRefPubMed
O’Hara MW, McCabe JE (2013) Postpartum depression: current status and future directions. Annu Rev Clin Psychol 9:379–407CrossRefPubMed
Okun ML, Luther J, Prather AA et al (2011b) Changes in sleep quality, but not hormones predict time to postpartum depression recurrence. J Affect Disord 130:378–384CrossRefPubMed
Palagini L, Baglioni C, Ciapparelli A et al (2013) REM sleep dysregulation in depression: state of the art. Sleep Med Rev 17:377–390CrossRefPubMed
Park EM, Meltzer-Brody S, Stickgold R (2013) Poor sleep maintenance and subjective sleep quality are associated with postpartum maternal depression symptom severity. Arch Womens Ment Health 16:539–547CrossRefPubMed
Parry BL, Curran ML, Stuenkel CA et al (2000) Can critically timed sleep deprivation be useful in pregnancy and postpartum depressions? J Affect Disord 60:201–212CrossRefPubMed
Piteo AM, Roberts RM, Nettelbeck T et al (2013) Postnatal depression mediates the relationship between infant and maternal sleep disruption and family dysfunction. Early Hum Dev 89:69–74CrossRefPubMed
Pope CJ, Xie B, Sharma V et al (2013) A prospective study of thoughts of self-harm and suicidal ideation during the postpartum period in women with mood disorders. Arch Womens Ment Health 16:483–488CrossRefPubMed
Razurel C, Kaiser B, Sellenet C et al (2013) Relation between perceived stress, social support, and coping strategies and maternal well-being: a review of the literature. Women Health 53:74–99CrossRefPubMed
Rich-Edwards JW, Kleinman K, Abrams A et al (2006) Sociodemographic predictors of antenatal and postpartum depressive symptoms among women in a medical group practice. J Epidemiol Community Health 60:221–227CrossRefPubMedPubMedCentral
Robertson E, Grace S, Wallington T et al (2004) Antenatal risk factors for postpartum depression: a synthesis of recent literature. Gen Hosp Psychiatry 26:289–295CrossRefPubMed
Scott J (2011) Clinical parameters of circadian rhythms in affective disorders. Eur Neuropsychopharmacol 21:S671–S675CrossRefPubMed
Sellers R, Collishaw S, Rice F et al (2013) Risk of psychopathology in adolescent offspring of mothers with psychopathology and recurrent depression. Br J Psychiatry 202:108–114CrossRefPubMed
Serhan N, Ege E, Ayranci U et al (2013) Prevalence of postpartum depression in mothers and fathers and its correlates. J Clin Nurs 22:279–284CrossRefPubMed
Sharkey KM, Pearlstein TB, Carskadon MA (2013) Circadian phase shifts and mood across the perinatal period in women with a history of major depressive disorder: a preliminary communication. J Affect Disord 150:1103–1108CrossRefPubMedPubMedCentral
Sheehan DV, Lecrubier Y, Sheehan KH et al (1998) The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry 59:S22–S33, quiz 34–57
Sibolboro Mezzacappa E, Endicott J (2007) Parity mediates the association between infant feeding method and maternal depressive symptoms in the postpartum. Arch Womens Ment Health 10(6):259–266CrossRefPubMed
Simpson W, Frey BN, Steiner M (2016) Mild depressive symptoms during the third trimester of pregnancy are associated with disruptions in daily rhythms but not subjective sleep quality. J Womens Health (Larchmt). doi:10.​1089/​jwh.​2015.​540)
Sylven SM, Elenis E, Michelakos T et al (2013) Thyroid function tests at delivery and risk for postpartum depressive symptoms. Psychoneuroendocrinology 38:1007–1013CrossRefPubMed
Tabb KM, Gavin AR, Guo Y et al (2013) Views and experiences of suicidal ideation during pregnancy and the postpartum: findings from interviews with maternal care clinic patients. Women Health 53:519–535CrossRefPubMedPubMedCentral
Verbeek T, Bockting CL, van Pampus MG et al (2012) Postpartum depression predicts offspring mental health problems in adolescence independently of parental lifetime psychopathology. J Affect Disord 136:948–954CrossRefPubMed
Williamson JA, O’Hara MW, Stuart S et al (2015) Assessment of postpartum depressive symptoms: the importance of somatic symptoms and irritability. Assessment 22:309–318CrossRefPubMed
Wirz-Justice A (2006) Biological rhythm disturbances in mood disorders. Int Clin Psychopharmacol 21:S11–S15CrossRefPubMed
Wisner KL, Parry BL, Piontek CM (2002) Clinical practice. Postpartum depression. N Engl J Med 347:194–199CrossRefPubMed
Xie RH, Yang J, Liao S et al (2010) Prenatal family support, postnatal family support and postpartum depression. Aust N Z J Obstet Gynaecol 50:340–345CrossRefPubMed
Metadata
Title
Do changes in subjective sleep and biological rhythms predict worsening in postpartum depressive symptoms? A prospective study across the perinatal period
Authors
Elizabeth M. Krawczak
Luciano Minuzzi
Maria Paz Hidalgo
Benicio N. Frey
Publication date
01-08-2016
Publisher
Springer Vienna
Published in
Archives of Women's Mental Health / Issue 4/2016
Print ISSN: 1434-1816
Electronic ISSN: 1435-1102
DOI
https://doi.org/10.1007/s00737-016-0612-x

Other articles of this Issue 4/2016

Archives of Women's Mental Health 4/2016 Go to the issue

Original Article

Oxytocin course over pregnancy and postpartum period and the association with postpartum depressive symptoms

Original Article

Individual differences in self-reported difficulty sleeping across the menstrual cycle

Original Article

Predictors of postnatal mother-infant bonding: the role of antenatal bonding, maternal substance use and mental health

Original Article

Eating disorder symptoms pre- and postpartum

Original Article

The course and interrelationship of maternal and paternal perinatal depression

Short Communication

Role of self-compassion in psychological well-being among perinatal women