The role of central serotonergic markers and estradiol changes in perinatal mental health.

"in line with this other studies have also found that anxiety in pregnancy increase the risk for postpartum depression as detailed in dataset s1 this underlying vulnerability was not likely to depend on antepartum e2 or 5-httlpr as neither mapped on to 5-hiaa levels in pregnancy.; human studies suggests that brain mao-a distribution is higher early postpartum where sex-steroid levels are low and normalize in healthy postpartum women but not in women with postpartum mood symptoms however as detailed in dataset s1 antepartum e2 potentially mapped on to norepinephrine but not 5-hiaa or 5-ht suggesting that 5-hiaa levels not mainly were driven by e2 induction of mao-a.; similarly we show in dataset s1 that none of the other monoamines are associated with epds score suggesting that neither mao-a or -b are responsible for the association between e2 and 5-hiaa.; as detailed in dataset s1 there were no absolute differences between multiparous or primiparous women to explain this but parity-associated differences in e2 dynamics or steroid metabolism may have played a role.; we do not know if the 14 women who left the study before follow-up may have developed a depression but as shown in dataset s1 they suffered more from sleep disturbances in pregnancy which is a known risk factor for depression further we have no information on the longitudinal changes in 5-hiaa and epds for ethical and practical reasons."

"CONFLICT OF INTEREST VGF declares that she has received honorarium as a consultant for Sage Therapeutics and lectures for Lundbeck Pharma A/S. None of the other authors declare any potential conflicts of interest."

"Funding information Niels and Desiree Yde foundation; The Independent Research Fund Denmark; The Mental Health Services in the Capital Region of Denmark; The Research Council at Rigshospitalet"