Antenatal thyroid function and postpartum mood disturbances
Irene Lambrinoudaki1, Demetrios Rizos3, Eleni Armeni1, Paraskevi Pliatsika1, Angeliki Leonardou2, Angeliki Sygelou1, John Argeitis1, Georgia Spentzou1, Dimitrios Hasiakos1, Ioannis Zervas2 & Constantinos Papadias1
Background: Postpartum mood disturbances occur very often in otherwise healthy women, whereas thyroid function is affected during a normal pregnancy. We examined whether thyroid hormone levels in women free from thyroid dysfunction associate with the prevalence of postpartum mood disturbances.
Methods: This cross-sectional study included 57 Greek women. Concentrations of thyroid hormones (free T3, free T4, TSH) and antibodies (anti-thyroglobulin and anti-peroxidase) were assessed before delivery and daily during the first four postpartum days. Mood disturbances were evaluated using the Edinburgh Postnatal Depression Scale and the Maternity Blues Questionnaire on the first and sixth week postpartum. The association between mood scores of both scales and thyroid hormone and antibody levels was evaluated.
Results: Blues scores in the first week postpartum correlated negatively with prepartum serum levels of FT3 and FT4 (blues on day 4: with FT3, ρ=−0.44, P≤0.01; with FT4, ρ=−0.36, P≤0.01). Women with lower FT3 and FT4 levels had higher mood scores in both scales (high scoring group: FT3=1.22 pg/ml, FT4=0.66 ng/dl; low scoring group: FT3=1.64 pg/ml, FT4=0.73 ng/dl). In addition, postpartum blues scores correlated negatively with serum levels of FT3 in the first postpartum days.
Conclusion: The results of this study indicate an association between prepartum thyroid function and the prevalence of postpartum mood disturbances. Within the normal range, lower levels of serum FT3 and FT4 prepartum are associated with increased incidence of mood swings in the first postpartum week.