• Samantha Meltzer-Brody, Alison Stuebe, Nancy Dole, David Savitz, David Rubinow, and John Thorp.
• Department of Psychiatry, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA. meltzerb@med.unc.edu
• J. Clin. Endocrinol. Metab. 2011 Jan 1; 96 (1): E40-7.

ContextPerinatal depression has a prevalence of 10% with devastating consequences for mother and baby. The prospective identification of those at risk for postpartum (PPD) or prenatal (PND) depression has led to biomarker searches in pregnancy. There are conflicting reports of associations between midpregnancy placental CRH (pCRH) and PPD or PND.ObjectiveThe objective of the study was to quantify the association of maternal pCRH with PPD and PND.DesignThis was a prospective cohort study (the Pregnancy, Infection, and Nutrition Study).SettingThe study was conducted at a prenatal clinics at the University of North Carolina at Chapel Hill.PatientsPatients included 1230 pregnant women.Main Outcome MeasuresThe relationship between pCRH at less than 20 wk and 24-29 wk and maternal depression assessed in pregnancy [Center for Epidemiologic Studies Depression Scale (CES-D)] and postpartum (12 wk and 1 yr) with the Edinburgh Postnatal Depression Scale (EPDS).ResultsAt 24-29 wk, 24.8% of women had CES-D score of 17 or greater, and 9.7% had a CES-D score of 25 or greater. At 12 wk postpartum, 18.2% of women had an EPDS score of 10 or greater and 7.6% had an EPDS score of 13 or greater. CRH measures at less than 20 wk and 24-29 wk were inversely correlated with a CES-D score at 24-29 wk (n = 1080, P < 0.05 and P < 0.01, respectively). Pregnancy pCRH was not correlated with the EPDS score at 12 wk (n = 484) or 1 yr postpartum (n = 391). In covariate-adjusted models, higher pCRH was not associated with a CES-D of 17 or greater at 24-29 wk (odds ratio 0.88 per sd change in pCRH at 24-29 wk, 95% confidence interval 0.76-1.03). There was no association between log CRH at 24-29 wk and PPD (covariate-adjusted odds ratio per sd 0.99, 95% confidence interval 0.69-1.42).ConclusionHigher midpregnancy pCRH was not associated with an increased risk of PND or PPD.

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