Early pospartum alexithymia and risk for depression: relationship with serum thyrotropin, free thyroid hormones and thyroid autoantibodies.

Most psychometric evaluations in the postpartum (PP) target depression (PPD) and show an association with thyroid autoantibodies (TAb), not with thyroid function. Three studies evaluated PP alexithymia, but none its relationship with thyroid indices. We tested 74 women aged 31.8±4.64 years, on day 3 PP, by the Edinburgh Postnatal Depression Scale (EPDS), the Montgomery and Asberg Depression Rating Scale (MADRS), and the Toronto Alexithymia Scale (TAS). Concurrently, we measured serum thyrotropin (TSH), free T3 (FT3), free T4 (FT4), thyroperoxidase and thyroglobulin antibodies (TPOAb, TgAb). Using cut-off scores of ≥12 (EPDS), ≥15 (MADRS) and ≥61 (TAS), rates of women with abnormal EPDS and MADRS scores were similar (31%, 30% and 28.4%, respectively). TAS scores were higher and proportions of alexithymics were greater in the abnormal EPDS group or in the abnormal MADRS group than in the normal EPDS or MADRS group. EPDS correlated significantly with TAS. Compared to nonalexithymics, alexythimics had lower FT4, higher FT3, lower FT4:FT3 ratio, and insignificantly higher TPOAb or TgAb levels. Only TPOAb and TgAb were significantly higher in women at risk for PPD compared to women not at risk for PPD, but solely at EPDS cut-off values of ≥13 or ≥14. TAS correlated directly with TPOAb and FT3, and inversely with FT4:FT3 ratio, while EPDS correlated only with TPOAb. Comparing women at risk for depression but nonalexithymics or women alexithymics but not at risk for depression vs. women normal on all scales, the former had lower FT3 and higher FT4:FT3 ratio while the latter had lower both FT4 and FT4:FT3 ratio. We conclude that PPD risk and alexithymia (i) are partly comorbid and directly associated with thyroid autoimmunity; (ii) their association with serum free thyroid hormones and with FT4:FT3 ratio goes in opposite directions.

Le Donne M ，Settineri S ，Benvenga S 《-》

[Thyroid hormone changes in women with pre-eclampsia and its relationship with the presence of pre-eclampsia].

Zhou J ，Du J ，Ma B ，Liu X ，Qiu H ，Li J ，Wang X ... -  《-》

Maternal thyroid function at 11-13 weeks of gestation.

To establish normal ranges of maternal serum thyroid-stimulating hormone (TSH), free thyroxine (FT4) and free triiodothyronine (FT3) at 11-13 weeks of gestation. Maternal serum concentrations of FT3, FT4, TSH, anti-thyroperoxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) antibodies were measured at 11-13 weeks. Normal ranges were constructed from the data of singleton pregnancies with no anti-thyroid antibodies resulting in live births after 34 weeks of phenotypically normal neonates with birth weight above the 5th percentile. Adjustments were made for maternal characteristics found by multiple regression analysis to affect the levels of TSH, FT3 and FT4. 3,592 of the 4,318 pregnancies examined were antibody negative, and in this group serum TSH increased whereas FT3 and FT4 decreased with gestation, and all three were lower in black than in white women. Serum FT3 and FT4 decreased but TSH did not change significantly with maternal age; TSH and FT3 increased whereas FT4 decreased with body mass index; TSH decreased whereas FT3 and FT4 increased with serum free beta-hCG. In the antibody-positive group, compared to the negative group, median TSH was higher and median FT3 and FT4 were lower. The study established normal ranges for maternal thyroid function at 11-13 weeks.

Ashoor G ，Kametas NA ，Akolekar R ，Guisado J ，Nicolaides KH ... -  《-》

Childhood sexual abuse and hypothalamus-pituitary-thyroid axis in postpartum major depression.

The aim of this study was to investigate the association between early life events in women with postpartum major depression and concomitant hypothalamus-pituitary-thyroid axis disturbances (HPTD), thyroid dysfunction or presence of thyroid antibodies. Serum total tri-iodothyronine (TT3), free thyroxin (FT4), Thyroid-stimulating hormone (TSH), Thyroperoxidasa (TPOAb) and Thyroglobulin (TGAb) autoantibodies was measured in 103 major postpartum depressive women. HPTD was defined as TSH and/or T4 abnormal, presence of thyroid autoantibodies and alterations of TT3. All women were assessed with a psychiatry structured interview for DSM-IV. Early Trauma Inventory Self Report, sociodemographic, reproductive, psychosocial and psychopathological variables were also assessed. Sixty three percent of women had suffered childhood trauma, which was childhood sexual abuse in 27.2%. Childhood sexual abuse in postpartum major depression women increased the risk for thyroid dysfunction (OR=5.018, 95%CI=1.128-22.327), presence of thyroid autoantibodies (OR=2.528; 95%CI=1.00-6.39) and HPTD (OR=2.955; 95%CI=1.191-7.32). Moreover, age over 34 (OR=12.394; 95%CI=1.424-107.910) and previous postpartum depression (OR=8.470; 95%CI=1.20-59.43) increased the risk for thyroid dysfunction in postpartum depression. The study design does not allow us to know the direction of the association and there is a lack of previous assessment of current posttraumatic stress disorder. According to the present findings, childhood sexual abuse may represent an important risk factor for the presence of thyroid autoantibodies and HPTD in women with postpartum depression.

Plaza A ，Garcia-Esteve L ，Ascaso C ，Navarro P ，Gelabert E ，Halperin I ，Valdés M ，Martín-Santos R ... -  《-》

Different Thyroidal Responses to Human Chorionic Gonadotropin Under Different Thyroid Peroxidase Antibody and/or Thyroglobulin Antibody Positivity Conditions During the First Half of Pregnancy.

Hou Y ，Liu A ，Li J ，Wang H ，Yang Y ，Li Y ，Fan C ，Zhang H ，Wang H ，Ding S ，Teng W ，Shan Z ... -  《-》