The see-saw effect of neuroactive steroids and endocrine disrupting compounds on maternal mental health status

Abstract

Background

Antepartum depression, a non-psychotic mood disturbance occurring during pregnancy, is influenced by hormonal fluctuations and environmental endocrine disruptors. Despite its association with adverse postpartum outcomes, it has been studied to a limited extent. Hence, this study aims to investigate the association of neuroactive steroids, endocrine-disrupting compounds, and nutritional status of pregnant women with the manifestations of antepartum depressive symptoms.

Materials and methods

This cross-sectional study assessed 400 pregnant women in their third trimester for depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS) and evaluated for severity using the Beck Depression Inventory-II. The concentrations of allopregnanolone, DHEA-S, bisphenol A, methyl paraben, estradiol, progesterone, oxytocin, vitamin B₁₂, folic acid, vitamin D, iron, magnesium and zinc were analysed. Statistical analysis included Mann Whitney U test, Chi-square test, Spearman Correlation, and Logistic regression.

Results

The prevalence of antepartum depressive symptoms was 23 %. Allopregnanolone, DHEA-S, bisphenol A, methyl paraben, estradiol, oxytocin, and TSH levels were associated with depressive symptoms. Reduced levels of allopregnanolone, DHEA-S, and estradiol, along with elevated bisphenol A levels, were identified as significant independent risk factors for antepartum depressive symptoms. Selective micronutrient deficiency was also noted. Risk cutoff for antepartum depressive symptoms was established for allopregnanolone (≤17.9 ng/ml), DHEA-S (≤0.20 µg/ml), bisphenol A (≥2027.1 pg/ml), and methyl paraben (≥1.15 µg/ml).

Conclusion

Our study on 400 antepartum women showed a 23 % prevalence of depressive symptoms, with significant association reported with reduced neuroactive steroids, elevated endocrine disruptors, lower reproductive hormones, and micronutrient deficiency. These findings emphasize the need for comprehensive screening, monitored nutritional supplementation, and hormonal assessments in effectively managing pregnancy-related depressive symptoms.