Postpartum depression affects about one in seven women who give birth, but it is known little about what happens in the brain of pregnant women who experience it. A new study begins to shed light.
The researchers scanned the dozen brain of women in the previous weeks and after childbirth and found that two brain areas involved in the elaboration and control of emotions increased in size in women who have developed symptoms of postpartum depression.
The results, published on Wednesday in the journal Science Advances, constitute some of the first tests that postpartum depression is associated with changes in the brain during pregnancy.
The researchers discovered that women with symptoms of depression in the first month after childbirth also had increases in the volume of their amygdala, a brain area that plays a key role in emotional elaboration. Women who have evaluated their childbirth experience are difficult or stressful – a perception that is often associated with postpartum depression – have also shown increases in the volume of the hippocampus, a brain area that helps regulate emotions.
“This is truly the first step in an attempt to understand how the brain changes in people who have a normal pregnancy course and then those who experience perinatal depression, and what we can do about it,” said Dr. Sheila Shanmugan, assistant professor of psychiatry, midwife-gynecology and radiology at the University of Pennsylvania who was not involved in the study.
“The great takeaways concern the way there are these really profound brain changes during pregnancy and as we now see it in the circuits of depression in particular,” he said.
The study was conducted in Madrid by a team that brought efforts to document the effects of pregnancy on the brain. It is part of a growing corpus of research that has discovered that some brain networks, in particular those involved in social and emotional elaboration, narrow during pregnancy, probably suffer a process of developing in preparation for parenting. These changes correspond to the hormones of pregnancy, in particular to estrogen, and some last two years after childbirth, they discovered researchers.
The new study seems to be the first to scan and compare the brain areas during pregnancy and after childbirth and connect the changes to the postpartum depression, said Elseline Hoekzema, a neuroscientist who directs the pregnancy and the cerebral laboratory of the Amesterdam University Medical Center and has not been involved in the study.
The authors of the study and other researchers said they were not clear whether the increase in volume in the amygdala and the hippocampus pushed the depressive symptoms and perceptions of stress during childbirth or if brain changes were verified in response to symptoms and stress. It was also not clear from the scan of the brain so some women seemed more vulnerable to these symptoms of others.
“It could be that those people whose amygdala is more susceptible to change are also at a greater risk of suffering from postpartum depression,” said the senior author of the study, Susana Carmona, a neuroscientist who guides the neuromternal laboratory at the Institute of Investigación Health Gregory Marañn in Madrid. “It can also be the opposite,” he said, “that somehow these symptoms of depression produce an increase in the volume of the amygdala”.
The researchers studied 88 pregnant women who had not previously given birth and who had no previous stories of depression or other neuropsychiatric conditions. For a control group, they also looked at 30 women who were not pregnant. Pregnant women were subjected to brain scans during their third quarter and about a month after giving birth.
Women completed standard questionnaires to evaluate if they had symptoms of postpartum depression. After childbirth, 15 women showed moderate symptoms of depression and 13 others showed symptoms of depression serious enough to justify the search for medical assistance, said Dr. Carmona.
The women also completed the questionnaires on the fact that they perceived their experience in childbirth. Previous studies have shown that “a negative birth experience is associated with increases in depression scores,” said Dr. Carmona. He said that the difficult experiences of childbirth were not necessarily deliveries from a medical point of view, but they could be simple deliveries that women perceived as stressful due to factors such as rude hospital staff.
Laura Pritschet, a post -psychiatry scholar in Psychiatry at the University of Pennsylvania that was not involved in the study, called the “truly fascinating” results, adding that they indicate the way for further research “trying to understand which areas of the brain are changing the most in relation to a variety of outcomes after childbirth, such as mood, anxiety, depression.”
Dr. Pritschet, who wrote an article with Dr. Shanmugan in the same issue of the magazine that supports the research to determine the individualized brain signatures as the perinatal depression, said that the results of the new study help to identify a road map to improve the forecast, the diagnosis and the treatment of postpartum depression.
“If we habitually show some brain areas are implicated, what do we do? How can we intervene early? “He said.” What is the normal amount of change? Why could that area be vulnerable? Many interesting questions to ask later. “