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A new molecular risk pathway for postpartum mood disorders: clues from steroid sulfatase-deficient individuals

Thippeswamy, Harish and Davies, William 2021. A new molecular risk pathway for postpartum mood disorders: clues from steroid sulfatase-deficient individuals. Archives of Women's Mental Health 24 , pp. 391-401. 10.1007/s00737-020-01093-1

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Abstract

Postpartum mood disorders develop shortly after childbirth in a significant proportion of women. These conditions are associated with a range of symptoms including abnormally high or low mood, irritability, cognitive disorganisation, disrupted sleep, hallucinations/delusions, and occasionally suicidal or infanticidal ideation; if not treated promptly, they can substantially impact upon the mother’s health, mother-infant bonding, and family dynamics. The biological precipitants of such disorders remain unclear, although large changes in maternal immune and hormonal physiology following childbirth are likely to play a role. Pharmacological therapies for postpartum mood disorders can be effective, but may be associated with side effects, concerns relating to breastfeeding, and teratogenicity risks when used prophylactically. Furthermore, most of the drugs that are used to treat postpartum mood disorders are the same ones that are used to treat mood episodes during non-postpartum periods. A better understanding of the biological factors predisposing to postpartum mood disorders would allow for rational drug development, and the identification of predictive biomarkers to ensure that ‘at risk’ mothers receive earlier and more effective clinical management. We describe new findings relating to the role of the enzyme steroid sulfatase in maternal postpartum behavioural processes, and discuss how these point to a novel molecular risk pathway underlying postpartum mood disorders. Specifically, we suggest that aberrant steroid hormone–dependent regulation of neuronal calcium influx via extracellular matrix proteins and membrane receptors involved in responding to the cell’s microenvironment might be important. Testing of this hypothesis might identify novel therapeutic targets and predictive biomarkers.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Psychology
Medicine
Neuroscience and Mental Health Research Institute (NMHRI)
Additional Information: This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
Publisher: Springer Verlag (Germany)
ISSN: 1434-1816
Date of First Compliant Deposit: 13 November 2020
Date of Acceptance: 13 November 2020
Last Modified: 28 May 2021 13:12
URI: https://orca.cardiff.ac.uk/id/eprint/136366

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