Doctors May Soon Be Able To Predict A Woman's Chances Of Postpartum Depression With A Blood Test

Postpartum depression (PPD) affects 10% to 20% of parents who give birth all around the world. It can cause severe mood swings, depression, isolation from friends and family, and an inability to bond with their baby.

Those who have been previously diagnosed with major depressive disorder are at a higher risk, but many people with PPD have never had depression symptoms before.

New research shows that a blood test could help predict who is most likely to experience PPD so that they can seek treatment and support before the onset of symptoms.

"Postpartum is the only time in people's lifespans when we know there is a biological trigger which guarantees that a certain percentage of people will become ill," said Dr. Lauren Osborne, a co-author of the study and an associate professor of obstetrics, gynecology and psychiatry at Weill Cornell Medicine.

"If we can untangle this biology and find predictors for it, not only will we be helping women, but it may give us a step up in trying to find predictors for other psychiatric illnesses also."

Researchers drew blood from 136 people between 34 and 36 weeks of pregnancy. An analysis of the blood samples confirmed that women who were later diagnosed with PPD metabolized the hormone progesterone differently during their third trimester of pregnancy.

Progesterone is derived from cholesterol and is primarily produced in the ovaries, adrenal glands, and placenta. One of its key roles involves influencing a neurotransmitter called gamma-aminobutyric acid (GAMA), which affects the nervous system and enhances the feeling of wellbeing.

When progesterone breaks down into metabolites, known as neurosteroids, the balance between them can either aid or hinder GABA's natural calming effects.

Study participants who developed PPD had more progesterone in their blood because it did not break down or had more metabolites that block GABA receptors.

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It's unclear exactly why some individuals develop PPD and others don't, but it might have something to do with this imbalance in the metabolism of progesterone.

According to Dr. Osborne, PPD is severely underdiagnosed in the United States. Only about 3% of people with PPD are diagnosed, treated, and achieve recovery. That's why it's so important to be able to predict PPD symptoms.

"If we had a blood test that could predict postpartum depression, it would alert clinicians and patients so they could start treatment immediately postpartum in the hospital to prevent the onset of postpartum depression," Dr. Osborne said.

The next step would be to replicate the study with a larger and more diverse group of participants. Researchers are still far from producing a blood test that could be used regularly in prenatal care.

Maybe one day, the blood test could be used alongside newer treatments that are already available: brexanolone and zuranolone. These drugs can be prescribed to someone once they've been diagnosed with PPD.

The recent findings were published in Neuropsychopharmacology.