HPA轴与围产期抑郁症状的研究进展
Research Progress of HPA Axis and Perinatal Depressive Symptoms
DOI: 10.12677/ns.2024.135077, PDF,    科研立项经费支持
作者: 李星星, 张 瑜, 陈正英*：吉首大学医学院，湖南 吉首；周梦佳, 刘 李, 肖 归：中南大学湘雅医学院，湖南 长沙；张婷婷, 秦春香*：中南大学湘雅三医院，湖南 长沙
关键词: HPA轴；围产期抑郁症状；产前抑郁；产后抑郁；HPA Axis； Perinatal Depressive Symptoms； Prenatal Depression； Postpartum Depression
摘要: 孕妇在围产期经历了一系列的生理和心理变化，这些变化可能导致下丘脑–垂体–肾上腺轴的激活和功能紊乱；皮质醇因能反映下丘脑–垂体–肾上腺轴功能，成为探索围产期抑郁症与下丘脑–垂体–肾上腺轴关系的重要生物标记物，因此，可通过探索皮质醇在围产期抑郁症状病因和病理生理学中的具体作用为其早期识别和疗效预测提供依据。本文就下丘脑–垂体–肾上腺轴与围产期抑郁症状的研究进展进行综述，旨在为国内相关研究设计和实施提供帮助。
Abstract: Pregnant women undergo a series of physiological and psychological changes during the perinatal period, which may lead to the activation and dysfunction of the hypothalamic-pituitary-adrenal axis. Since cortisol can reflect the function of the hypothalamic-pituitary-adrenal axis, it has become an important biomarker to explore the relationship between perinatal depression and the hypothalamic-pituitary-adrenal axis. Therefore, exploring the specific role of cortisol in the etiology and pathophysiology of perinatal depression symptoms can provide a basis for its early recognition and curative effect prediction. This article reviews the research progress of hypothalamic-pituitary-adrenal axis and perinatal depressive symptoms, in order to provide help for domestic research design and implementation.
文章引用：李星星, 周梦佳, 刘李, 肖归, 张婷婷, 张瑜, 秦春香, 陈正英. HPA轴与围产期抑郁症状的研究进展[J]. 护理学, 2024, 13(5): 534-539. https://doi.org/10.12677/ns.2024.135077

参考文献

[1] Spiga, F., Walker, J.J., Terry, J.R., et al. (2014) HPA Axis-Rhythms. Comprehensive Physiology, 4, 1273-1298. [Google Scholar] [CrossRef] [PubMed]
[2] Kalafatakis, K., Russell, G.M., Ferguson, S.G., et al. (2021) Glucocorticoid Ultradian Rhythmicity Differentially Regulates Mood and Resting State Networks in the Human Brain: A Randomised Controlled Clinical Trial. Psychoneuroendocrinology, 124, Article 105096. [Google Scholar] [CrossRef] [PubMed]
[3] Hamidovic, A., Karapetyan, K., Serdarevic, F., et al. (2020) Higher Circulating Cortisol in the Follicular vs. Luteal Phase of the Menstrual Cycle: A Meta-Analysis. Frontiers in Endocrinology, 11, Article 311. [Google Scholar] [CrossRef] [PubMed]
[4] Glynn, L.M., Davis, E.P. and Sandman, C.A. (2013) New Insights into the Role of Perinatal HPA-Axis Dysregulation in Postpartum Depression. Neuropeptides, 47, 363-370. [Google Scholar] [CrossRef] [PubMed]
[5] Mlili, N.E., Ahabrach, H. and Cauli, O. (2023) Hair Cortisol Concentration as a Biomarker of Symptoms of Depression in the Perinatal Period. CNS & Neurological Disorders Drug Targets, 22, 71-83. [Google Scholar] [CrossRef] [PubMed]
[6] Baranov, V., Frost, A., Hagaman, A., et al. (2022) Effects of a Maternal Psychosocial Intervention on Hair Derived Biomarkers of HPA Axis Function in Mothers and Children in Rural Pakistan. SSM-Mental Health, 2, Article 100082. [Google Scholar] [CrossRef] [PubMed]
[7] Focke, C.M.B. and Iremonger, K.J. (2020) Rhythmicity Matters: Circadian and Ultradian Patterns of HPA Axis Activity. Molecular and Cellular Endocrinology, 501, Article 110652. [Google Scholar] [CrossRef] [PubMed]
[8] Gjerstad, J.K., Lightman, S.L. and Spiga, F. (2018) Role of Glucocorticoid Negative Feedback in the Regulation of HPA Axis Pulsatility. Stress, 21, 403-416. [Google Scholar] [CrossRef] [PubMed]
[9] Beech, A., Edelman, A., Yatziv, T., et al. (2023) Cortisol Reactivity to a Laboratory Stressor Predicts Increases in Depressive Symptoms in Perinatal and Nulliparous Women during Population-Level Stress. Journal of Affective Disorders, 340, 33-41. [Google Scholar] [CrossRef] [PubMed]
[10] Russell, G. and Lightman, S. (2019) The Human Stress Response. Nature Reviews Endocrinology, 15, 525-534. [Google Scholar] [CrossRef] [PubMed]
[11] Keller-Wood, M. (2015) Hypothalamic-Pituitary-Adrenal Axis—Feedback Control. Comprehensive Physiology, 5, 1161-1182. [Google Scholar] [CrossRef] [PubMed]
[12] Duthie, L and Reynolds, R.M. (2013) Changes in the Maternal Hypothalamic-Pituitary-Adrenal Axis in Pregnancy and Postpartum: Influences on Maternal and Fetal Outcomes. Neuroendocrinology, 98, 106-115. [Google Scholar] [CrossRef] [PubMed]
[13] Caparros-Gonzalez, R.A., Romero-Gonzalez, B., Gonzalez-Perez, R., et al. (2019) Maternal and Neonatal Hair Cortisol Levels and Psychological Stress Are Associated with Onset of Secretory Activation of Human Milk Production. Advances in Neonatal Care, 19, E11-E20. [Google Scholar] [CrossRef] 
[14] Dickens, M.J. and Pawluski, J.L. (2018) The HPA Axis during the Perinatal Period: Implications for Perinatal Depression. Endocrinology, 159, 3737-3746. [Google Scholar] [CrossRef] [PubMed]
[15] Vrijkotte, T., De Rooij, S.R., Roseboom, T.J., et al. (2023) Maternal Serum Cortisol Levels during Pregnancy Differ by Fetal Sex. Psychoneuroendocrinology, 149, Article 105999. [Google Scholar] [CrossRef] [PubMed]
[16] Jung, C., Ho, J.T., Torpy, D.J., et al. (2011) A Longitudinal Study of Plasma and Urinary Cortisol in Pregnancy and Postpartum. The Journal of Clinical Endocrinology and Metabolism, 96, 1533-1540. [Google Scholar] [CrossRef] [PubMed]
[17] Mastorakos, G. and Ilias, I. (2003) Maternal and Fetal Hypothalamic-Pituitary-Adrenal Axes during Pregnancy and Postpartum. Annals of the New York Academy of Sciences, 997, 136-149. [Google Scholar] [CrossRef] [PubMed]
[18] Petraglia, F., Imperatore, A. and Challis, J.R.G. (2010) Neuroendocrine Mechanisms in Pregnancy and Parturition. Endocrine Reviews, 31, 783-816. [Google Scholar] [CrossRef] [PubMed]
[19] Penalver Bernabe, B., Maki, P.M., Dowty, S.M., et al. (2020) Precision Medicine in Perinatal Depression in Light of the Human Microbiome. Psychopharmacology, 237, 915-941. [Google Scholar] [CrossRef] [PubMed]
[20] 余艳红, 陈叙. 助产学[M]. 北京: 人民卫生出版社, 2017.
[21] 肖霄, 朱社宁, 张旱愉, 刘慧. 产前抑郁概念分析[J]. 护理学报, 2017, 24(19): 18-23.
[22] 蔡毅媛, 吴颖岚, 刘华, 龚雯洁, 余徐. 围产期女性不同时点抑郁症状检出率及影响因素[J]. 中国心理卫生杂志, 2021, 35(1): 19-25.
[23] Nazzari, S., Fearon, P., Rice, F., et al. (2020) The Biological Underpinnings of Perinatal Depressive Symptoms: A Multi-Systems Approach. Journal of Affective Disorders, 274, 1004-1012. [Google Scholar] [CrossRef] [PubMed]
[24] De Rezende, M.G., Garcia-Leal, C., De Figueiredo, F.P., et al. (2016) Altered Functioning of the HPA Axis in Depressed Postpartum Women. Journal of Affective Disorders, 193, 249-256. [Google Scholar] [CrossRef] [PubMed]
[25] Weiss, S.J. and Xu, L. (2024) Postpartum Symptoms of Anxiety, Depression and Stress: Differential Relationships to Women’s Cortisol Profiles. Archives of Women’s Mental Health. [Google Scholar] [CrossRef] [PubMed]
[26] Kammerer, M., Adams, D., Castelberg, B.V., et al. (2002) Pregnant Women Become Insensitive to Cold Stress. BMC Pregnancy and Childbirth, 2, Article No. 8. [Google Scholar] [CrossRef] [PubMed]
[27] Heinrichs, M., Meinlschmidt, G., Wippich, W., et al. (2004) Selective Amnesic Effects of Oxytocin on Human Memory. Physiology & Behavior, 83, 31-38. [Google Scholar] [CrossRef] 
[28] Walter, M.H., Abele, H. and Plappert, C.F. (2021) The Role of Oxytocin and the Effect of Stress during Childbirth: Neurobiological Basics and Implications for Mother and Child. Frontiers in Endocrinology, 12, Article 742236. [Google Scholar] [CrossRef] [PubMed]
[29] Workman, J.L., Barha, C.K. and Galea, L.A.M. (2012) Endocrine Substrates of Cognitive and Affective Changes during Pregnancy and Postpartum. Behavioral Neuroscience, 126, 54-72. [Google Scholar] [CrossRef] [PubMed]
[30] Hochberg, Z.E., Pacak, K. and Chrousos, G.P. (2003) Endocrine Withdrawal Syndromes. Endocrine Reviews, 24, 523-538. [Google Scholar] [CrossRef] [PubMed]
[31] O’connor, T.G., Tang, W., Gilchrist, M.A., et al. (2014) Diurnal Cortisol Patterns and Psychiatric Symptoms in Pregnancy: Short-Term Longitudinal Study. Biological Psychology, 96, 35-41. [Google Scholar] [CrossRef] [PubMed]
[32] O’keane, V., Lightman, S., Marsh, M., et al. (2011) Increased Pituitary-Adrenal Activation and Shortened Gestation in a Sample of Depressed Pregnant Women: A Pilot Study. Journal of Affective Disorders, 130, 300-305. [Google Scholar] [CrossRef] [PubMed]
[33] Orta, O.R., Gelaye, B., Bain, P.A., et al. (2018) The Association between Maternal Cortisol and Depression during Pregnancy, a Systematic Review. Archives of Women’s Mental Health, 21, 43-53. [Google Scholar] [CrossRef] [PubMed]
[34] Epstein, C.M., Houfek, J.F., Rice, M.J., et al. (2020) Early Life Adversity and Depressive Symptoms Predict Cortisol in Pregnancy. Archives of Women’s Mental Health, 23, 379-389. [Google Scholar] [CrossRef] [PubMed]
[35] Elrefaay, S.M. and Weiss, S.J. (2023) Cortisol Regulation among Women Who Experience Suicidal Ideation during Pregnancy. Journal of Affective Disorders Reports, 14, Article 100642. [Google Scholar] [CrossRef] [PubMed]
[36] Seth, S., Lewis, A.J. and Galbally, M. (2016) Perinatal Maternal Depression and Cortisol Function in Pregnancy and the Postpartum Period: A Systematic Literature Review. BMC Pregnancy Childbirth, 16, Article No. 124. [Google Scholar] [CrossRef] [PubMed]
[37] Iliadis, S.I., Comasco, E., Sylvén, S., et al. (2015) Prenatal and Postpartum Evening Salivary Cortisol Levels in Association with Peripartum Depressive Symptoms. PLOS ONE, 10, e0135471. [Google Scholar] [CrossRef] [PubMed]
[38] Corwin, E.J., Pajer, K., Paul, S., et al. (2015) Bidirectional Psychoneuroimmune Interactions in the Early Postpartum Period Influence Risk of Postpartum Depression. Brain, Behavior, and Immunity, 49, 86-93. [Google Scholar] [CrossRef] [PubMed]
[39] Cho, J., Chien, L.C. and Holditch-Davis, D. (2022) Sociodemographic and Biological Factors of Health Disparities of Mothers and Their Very Low Birth-Weight Infants. Advances in Neonatal Care, 22, E169-E181. [Google Scholar] [CrossRef] 
[40] Lommatzsch, M., Hornych, K., Zingler, C., et al. (2006) Maternal Serum Concentrations of BDNF and Depression in the Perinatal Period. Psychoneuroendocrinology, 31, 388-394. [Google Scholar] [CrossRef] [PubMed]
[41] Conde, A., Costa, R. and Figueiredo, B. (2021) Anxiety and Depressive Symptoms Effects on Cortisol Trajectories from Pregnancy to Postpartum: Differences and Similarities between Women and Men. Hormones and Behavior, 128, Article 104917. [Google Scholar] [CrossRef] [PubMed]
[42] Ahn, S. and Corwin, E.J. (2015) The Association between Breastfeeding, the Stress Response, Inflammation, and Postpartum Depression during the Postpartum Period: Prospective Cohort Study. International Journal of Nursing Studies, 52, 1582-1590. [Google Scholar] [CrossRef] [PubMed]
[43] Scheyer, K. and Urizar, G.G. (2016) Altered Stress Patterns and Increased Risk for Postpartum Depression among Low-Income Pregnant Women. Archives of Women’s Mental Health, 19, 317-328. [Google Scholar] [CrossRef] [PubMed]
[44] Maguire, J. (2019) Neuroactive Steroids and GABAergic Involvement in the Neuroendocrine Dysfunction Associated with Major Depressive Disorder and Postpartum Depression. Frontiers in Cellular Neuroscience, 13, Article 83. [Google Scholar] [CrossRef] [PubMed]
[45] Gelman, P.L., Flores-Ramos, M., López-Martínez, M., et al. (2015) Hypothalamic-Pituitary-Adrenal Axis Function during Perinatal Depression. Neuroscience Bulletin, 31, 338-350. [Google Scholar] [CrossRef] [PubMed]
[46] Garcia-Leal, C., De Rezende, M.G., De Castro, M., et al. (2017) The Functioning of the Hypothalamic-Pituitary-Adrenal (HPA) Axis in Postpartum Depressive States: A Systematic Review. Expert Review of Endocrinology & Metabolism, 12, 341-353. [Google Scholar] [CrossRef] [PubMed]

为你推荐