Melanie H Jacobson1, Cheryl R Stein2, Mengling Liu3, Marra G Ackerman4, Jennifer K Blakemore5, Sara E Long1, Graziano Pinna6, Raquel Romay-Tallon6, Kurunthachalam Kannan1, Hongkai Zhu1, Leonardo Trasande1,3,7,8. 1. Department of Pediatrics, Division of Environmental Pediatrics, NYU Langone Medical Center, New York, NY 10016, USA. 2. Hassenfeld Children's Hospital at NYU Langone; Department of Child and Adolescent Psychiatry, New York, NY 10016, USA. 3. Departments of Population Health and Environmental Medicine, NYU Langone Medical Center, New York, NY 10016, USA. 4. Department of Psychiatry, NYU Langone Medical Center, New York, NY 10016, USA. 5. Department of Obstetrics and Gynecology, NYU Langone Medical Center, New York, NY 10016, USA. 6. The Psychiatric Institute, Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, IL 60612, USA. 7. NYU Wagner School of Public Service, New York, NY 10012, USA. 8. NYU College of Global Public Health, New York, NY 10012, USA.
Abstract
CONTEXT: Postpartum depression (PPD) is a serious psychiatric disorder. While causes remain poorly understood, perinatal sex hormone fluctuations are an important factor, and allopregnanolone in particular has emerged as a key determinant. Although synthetic environmental chemicals such as bisphenols and phthalates are known to affect sex hormones, no studies have measured allopregnanolone and the consequences of these hormonal changes on PPD have not been interrogated. OBJECTIVE: To investigate associations of repeated measures of urinary bisphenols and phthalates in early and midpregnancy with serum pregnenolone, progesterone, allopregnanolone, and pregnanolone concentrations in midpregnancy and PPD symptoms at 4 months postpartum. METHODS: Prospective cohort study of 139 pregnant women recruited between 2016 and 2018. Bisphenols and phthalates were measured in early and midpregnancy urine samples. Serum sex steroid hormone concentrations were measured in midpregnancy. PPD was assessed at 4 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Multiple informant models were fit using generalized estimating equations. Serum levels of allopregnanolone, progesterone, pregnanolone, and pregnenolone were examined as log-transformed continuous variables. PPD symptoms were examined as continuous EPDS scores and dichotomously with scores ≥10 defined as PPD. RESULTS: Di-n-octyl phthalate (DnOP) and diisononyl phthalate (DiNP) metabolites were associated with reduced progesterone concentrations. Log-unit increases in ∑DnOP and ∑DiNP predicted 8.1% (95% CI -15.2%, -0.4%) and 7.7% (95% CI -13.3%, -1.7%) lower progesterone, respectively. ∑DnOP was associated with increased odds of PPD (odds ratio 1.48; 95% CI 1.04, 2.11). CONCLUSION: Endocrine disrupting chemicals may influence hormonal shifts during pregnancy as well as contribute to PPD.
CONTEXT: Postpartum depression (PPD) is a serious psychiatric disorder. While causes remain poorly understood, perinatal sex hormone fluctuations are an important factor, and allopregnanolone in particular has emerged as a key determinant. Although synthetic environmental chemicals such as bisphenols and phthalates are known to affect sex hormones, no studies have measured allopregnanolone and the consequences of these hormonal changes on PPD have not been interrogated. OBJECTIVE: To investigate associations of repeated measures of urinary bisphenols and phthalates in early and midpregnancy with serum pregnenolone, progesterone, allopregnanolone, and pregnanolone concentrations in midpregnancy and PPD symptoms at 4 months postpartum. METHODS: Prospective cohort study of 139 pregnant women recruited between 2016 and 2018. Bisphenols and phthalates were measured in early and midpregnancy urine samples. Serum sex steroid hormone concentrations were measured in midpregnancy. PPD was assessed at 4 months postpartum using the Edinburgh Postnatal Depression Scale (EPDS). Multiple informant models were fit using generalized estimating equations. Serum levels of allopregnanolone, progesterone, pregnanolone, and pregnenolone were examined as log-transformed continuous variables. PPD symptoms were examined as continuous EPDS scores and dichotomously with scores ≥10 defined as PPD. RESULTS: Di-n-octyl phthalate (DnOP) and diisononyl phthalate (DiNP) metabolites were associated with reduced progesterone concentrations. Log-unit increases in ∑DnOP and ∑DiNP predicted 8.1% (95% CI -15.2%, -0.4%) and 7.7% (95% CI -13.3%, -1.7%) lower progesterone, respectively. ∑DnOP was associated with increased odds of PPD (odds ratio 1.48; 95% CI 1.04, 2.11). CONCLUSION: Endocrine disrupting chemicals may influence hormonal shifts during pregnancy as well as contribute to PPD.
Authors: Laura E Dichtel; Elizabeth A Lawson; Melanie Schorr; Erinne Meenaghan; Margaret Lederfine Paskal; Kamryn T Eddy; Graziano Pinna; Marianela Nelson; Ann M Rasmusson; Anne Klibanski; Karen K Miller Journal: Neuropsychopharmacology Date: 2017-11-01 Impact factor: 7.853
Authors: G A van Wingen; F van Broekhoven; R J Verkes; K M Petersson; T Bäckström; J K Buitelaar; G Fernández Journal: Mol Psychiatry Date: 2007-06-19 Impact factor: 15.992
Authors: Lauren E Johns; Kelly K Ferguson; Offie P Soldin; David E Cantonwine; Luis O Rivera-González; Liza V Anzalota Del Toro; Antonia M Calafat; Xiaoyun Ye; Akram N Alshawabkeh; José F Cordero; John D Meeker Journal: Reprod Biol Endocrinol Date: 2015-01-17 Impact factor: 5.211