PSYCHO-EMOTIONAL DISORDERS DURING LACTATION: NEUROENDOCRINE AND HEMODYNAMIC MECHANISMS AND THE EFFECTIVENESS OF COMPREHENSIVE OUTPATIENT REHABILITATION
Keywords:
lactation, postpartum depression, anxiety, cortisol, vitamin D, transcranial Doppler, breastfeeding, rehabilitationAbstract
Abstract. Aim: to determine the clinical-neurological, psychometric, neuroendocrine and hemodynamic features of psycho-emotional disorders during lactation and to evaluate a comprehensive outpatient rehabilitation program. We examined 100 lactating women aged 20–32 years with psycho-emotional disorders and 20 healthy lactating mothers. Patients showed moderate comorbid anxiety-depressive syndrome (EPDS 14.51±0.11; BAI 18.51±0.12 points), hypercortisolemia (649.75±3.94 nmol/L), vitamin D deficiency (14.16±0.49 ng/mL), sympathicotonia and a 59.7% increase in middle cerebral artery Vmean. The program reduced EPDS by 65.2% (vs. 44.4% with standard care) and normalized cortisol, vitamin D and cerebral hemodynamics (p<0.001).
References
Wang Z., Liu J., Shuai H. et al. Mapping global prevalence of depression among postpartum women // Translational Psychiatry. – 2021. – Vol. 11. – Art. 543. – DOI: 10.1038/s41398-021-01692-1.
Xie L., Li J. Association of perinatal depressive symptoms with breastfeeding // Alpha Psychiatry. – 2024. – Vol. 25, №
– P. 277–281. – DOI: 10.5152/alphapsychiatry.2024.231308.
Dennis C.L., McQueen K. The relationship between infant-feeding outcomes and postpartum depression: a qualitative systematic review // Pediatrics. – 2009. – Vol. 123, № 4. – P. e736–e751.
Ahmadinezhad G.S., Karimi F.Z., Abdollahi M., NaviPour E. Association between postpartum depression and breastfeeding self-efficacy in mothers: a systematic review and meta-analysis // BMC Pregnancy and Childbirth. – 2024. – Vol.
– DOI: 10.1186/s12884-024-06465-4.
Chai Y., Li Q., Wang Y. et al. The value of HPA axis hormones as biomarkers for screening and early diagnosis of postpartum depression: updated information about methodology // Frontiers in Endocrinology. – 2022. – Vol. 13. – Art. 916611. – DOI: 10.3389/fendo.2022.916611.
Yuan Y., Qu L., Sun Q. et al. The association between vitamin D deficiency and perinatal depression: a systematic review and meta-analysis // Alpha Psychiatry. – 2024. – Vol. 25, № 6. – P. 669–675. – DOI: 10.5152/alphapsychiatry.2024.241553.
Gong K., Li Y., Rong J. et al. Transcranial Doppler ultrasound in evaluating cerebral blood flow abnormalities in major depressive disorder // Medicine (Baltimore). – 2024. – Vol. 103, № 42. – Art. e39889.
Cox J.L., Holden J.M., Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale // British Journal of Psychiatry. – 1987. – Vol. 150. – P. 782–786.
Buysse D.J., Reynolds C.F., Monk T.H. et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research // Psychiatry Research. – 1989. – Vol. 28, № 2. – P. 193–213.
Krupp L.B., LaRocca N.G., Muir-Nash J., Steinberg A.D. The Fatigue Severity Scale. Application to patients with multiple sclerosis and systemic lupus erythematosus // Archives of Neurology. – 1989. – Vol. 46, № 10. – P. 1121–1123.
Holick M.F. Vitamin D deficiency // New England Journal of Medicine. – 2007. – Vol. 357, № 3. – P. 266–281.
Jensen D., Wallace S., Kelsay P. LATCH: a breastfeeding charting system and documentation tool // Journal of Obstetric, Gynecologic and Neonatal Nursing. – 1994. – Vol. 23, № 1. – P. 27–32.
