Background: Antenatal depression is a frequent mental disorder with much less attention, and most women remain undiagnosed. Altered hypothalamic-pituitary-adrenal (HPA)-axis function mediates maternal depressive symptoms and has been widely reported. The present research aimed to determine the plasma marker HPA-axis including Adrenocorticotropic hormone (ACTH), cortisol, and beta-endorphin, as a suitable representation of mental health in pregnancy by evaluating the psychometric properties.
Methods: Therefore, we examined a case-control study of 216 Bontang pregnant women. Psychological measures were conducted during the 27th week of pregnancy, including the Patient Health Questionnaire-9 (PHQ-9) assessment and Depression Anxiety Stress Scale (DASS). Blood samples were collected for plasma ACTH, Cortisol, and beta-endorphins assay as a marker of the HPA axis profile. Data were analyzed Stata for Mac version 14 (StataCorp, USA).
Results: our finding showed that DASS scores correlated with PHQ-9 (r=0.79), ACTH (r=0.22), and beta-endorphin (r=54). PHQ-9 score significantly related to ACTH (r=0.27), cortisol (r=0.36) and beta-endorphin (r=0.71). Women with the highest DASS score and PHQ-9 depression scores at 27 weeks of pregnancy had significantly lower baby birth weight (P=0.000) than those women whose stress improved to or normal state. Plasma ACTH, cortisol, and beta-endorphin concentrations were significantly higher in pregnant women with antenatal depression compared to normal pregnancy (p<0.01). All effects remain without controlling unwanted pregnancy.
Conclusion: Our study demonstrates a role for circulating ACTH in regulating maternal cortisol secretion and a significant correlation between the HPA-axis profile and antenatal depression at 27 weeks of pregnancy.