BACKGROUND: Unfavorable post-partum changes to mental well-being affect more than half of all women, and are a risk to the health of both mother and baby. Their effects place strains on health and social systems. Currently, no generally accepted theory exists of the causes and mechanisms of post-partum mental disorders. METHODS: Literature search up to 2012, using PubMed and search words: neuroactive steroids, post-partum mental disorders, depression, corticotropin-releasing hormone and estrogens. RESULTS: There are several theories for post-partum depression. One is that autoimmune diseases are involved. Others revolve around genes responsible or that lead to increased disposition to the disorder. It is likely however that the process is associated with the separation of the placenta and the fetal zone of fetal adrenal gland, the main sources of corticotropin-releasing hormone and sexual and neuroactive steroids during pregnancy, and the ability of the receptor system to adapt to these changes. The central nervous system is able to produce neurosteroids, but the drop in levels of peripheral steroids likely leads to a sudden deficit in neuroinhibitory steroids modulating ionotropic receptors in the brain. CONCLUSIONS: Post-partum depression is a multifactorial disease with unknown etiology. It is probably associated with sudden changes in the production of hormones influencing the nervous system, and on the other hand the ability of the receptor system to adapt to these changes. When the relative changes in concentrations of hormones, rather than their absolute levels, is likely more important.
- MeSH
- dospělí MeSH
- lidé MeSH
- metabolomika metody MeSH
- pohlavní steroidní hormony krev MeSH
- poporodní deprese krev MeSH
- těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
Steroids are important markers in pregnancy. Although estimating their levels separately in umbilical arterial (UA) and venous blood (UV) enable more precise insights into the functioning fetoplacental unit compared to using mixed umbilical blood (UM), selective aspiration of UA and UV is technically more demanding than collecting UM. We measured the levels of 67 unconjugated steroids and steroid polar conjugates in UA and UV using GC-MS in 80 women giving birth within weeks 28 to 42 of gestation. The samples were sorted into three groups: women entering labor within weeks 28-32 (group A, n=19), weeks 33-37 (group B, n=19), and weeks 38-42 (group C, n=42) of gestation, respectively. The preterm labors were due to pathologies unrelated to steroid status. Most unconjugated steroids exhibited pronounced arteriovenous differences (AVD). The AVD were less distinct in more stable steroid conjugates. Most steroids positively correlate with gestational age, but unconjugated 5beta-reduced pregnanes show negative correlations, as do testosterone and androstenediol, substrates for the placental synthesis of estrogens. Tight correlations between steroids in UA and UV indicate that steroid measurements in UA, UV and UM can be accurately derived from each other, which is important for the diagnostics of steroid related diseases in newborns.
- MeSH
- arteriae umbilicales metabolismus MeSH
- dospělí MeSH
- fetální krev metabolismus MeSH
- lidé MeSH
- metabolom fyziologie MeSH
- mladý dospělý MeSH
- novorozenec MeSH
- předčasný porod krev MeSH
- pupečník metabolismus MeSH
- steroidy krev MeSH
- těhotenství MeSH
- venae umbilicales metabolismus MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- srovnávací studie MeSH
- MeSH
- diagnostické techniky porodnicko-gynekologické klasifikace MeSH
- gestační stáří MeSH
- lidé MeSH
- měření nuchální translucence metody využití MeSH
- první trimestr těhotenství MeSH
- těhotenství mnohočetné MeSH
- těhotenství MeSH
- ultrasonografie využití MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Klíčová slova
- TRACTORIT,
- MeSH
- antagonisté prostaglandinu farmakologie škodlivé účinky terapeutické užití MeSH
- blokátory kalciových kanálů farmakologie škodlivé účinky terapeutické užití MeSH
- oxytocin antagonisté a inhibitory farmakologie škodlivé účinky MeSH
- předčasný porod etiologie terapie MeSH
- sympatomimetika aplikace a dávkování farmakologie škodlivé účinky MeSH
- tokolytika aplikace a dávkování farmakologie kontraindikace MeSH
- vápník antagonisté a inhibitory farmakologie škodlivé účinky MeSH
- Publikační typ
- přehledy MeSH
