Postpartum Depression and Role of Serum Trace Elements
Etebary, Sahabeh, Nikseresht, Sara, Sadeghipour, Hamid Reza, Zarrindast, Mohammad Reza, Iranian Journal of Psychiatry
Postpartum depression (PPD) is a major depressive disorder that most often emerges within 6 to 12 weeks of delivery, but can happen any time up to 1 year after birth. In developed countries, the incidence of postnatal depression is about 10-15% in adult women depending upon the diagnostic criteria, timing of screening and screening instruments used. Mothers with depressive symptoms have been found to have more complex behavioral contacts with their children; this situation can damage family relationships, and even leads to infanticide. Various pathophysiologies are proposed for postpartum depression: Nutritional deficiencies, iron deficiency anemia, rapid decrease in the levels of reproductive hormones following delivery, alterations in hypothalamic-pituitary-adernocortical mechanism and alterations in neurotransmitter levels. Among pathophysiologies of postpartum depression, the role of trace elements is highlighted. The purpose of this review is to assess the role of trace elements including zinc, magnesium, iron and copper in PPD. Zinc as a trace element has the second highest concentration of all transition metals in the brain, and its deficiency is associated with behavioral disturbances. Lower zinc blood concentration was found in women with postpartum depression. Another trace element, magnesium, also influences the nervous system via its actions on the release and metabolism of neurotransmitters. Various studies have focused on antidepressant-like effects of magnesium and its deficiency has been reported in depression. Depletion of magnesium stores during pregnancy is hypothesized to be the cause of postpartum depression. Iron deficiency is the most common single nutrient deficiency in the world. There is an association between anemia and depressive disorders. Copper has been recognized as an essential element for many years. Iron also plays a vital role in neurological disorders and its levels are relevant to postpartum depression. Involvement of trace elements can be seen in pathophysiologies of PPD in different ways. Therefore, trace element supplementation can be an alternative treatment for patients with PPD.
Keywords: Copper, Iron, Magnesium, Postpartum depression, Trace element, Zinc
Iran J Psychiatry 2010; 5:2:40-46
Major depression is now accepted as one of the most frequent, chronic, recurrent and life-debilitating illnesses with severe morbidity and mortality, and the World Health Organization suggests that depression and heart disease will be the most ordinary diseases on Earth by 2020 (1, 2).
Depression is about twice as common in women than in men ; and women of childbearing age are at high risk for major depressive disorder (MDD) (3, 4).
Women at risk for depression experience more symptoms in menopause, the premenstrual period and the postpartum (5-7).
Postpartum depression (PPD) is diagnosed as a major depressive episode with postpartum beginning (8). Major depression can be experienced at different times of life, but PPD happens after childbirth, and therefore, it is unique. PPD involves both the mother and the child and sometimes an entire family (9). It is recognized as a major depressive disorder with postpartum onset, accompanied by depressive symptoms. According to another definition, PPD is a mild mental and behavioral disorder (10). In developed countries, the incidence of postnatal depression is about 10-15% in adult women depending on the diagnostic criteria, timing of screening and screening instruments used (11). PPD emerges most often within 6 to 12 weeks of delivery, but can happen any time up to 1 year after birth. Studies have established that depression in the postpartum time can last for months or even years after child birth (12). Clinical symptoms of PPD may recruit depressed mood, markedly reduced pleasure in almost all activities, impairment in everyday functioning, insomnia or hyper insomnia, significant weight loss or weight gain, psychomotor agitation or retardation, loss of energy, feelings of worthlessness and excessive fault, reduced self-esteem and self-confidence, difficulty in concentration and suicidal ideation (8, 10). …