Relationship between Discontinuation of Anti-depressant Medication During Pregnancy and Development of Postpartum Depression

Postpartum depression (PPD) is a serious and potentially debilitating disorder that frequently goes undetected due to stigma and a lack of understanding about its course and etiology. The factor of particular interest to this study concerns the relationship between discontinuation of anti-depressant medication in pregnancy and the development of PPD. The study examined how the variables of pregnancy mood, child care stress, emotional support, instrumental support, marital satisfaction, history of depression, baby temperament, birth experience, and medication status affect symptoms of postpartum depression (PPD) in a sample of 202 patients at the six-week postpartum check-up. In addition to a demographic and mood questionnaire, the Postpartum Depression Screening Scale (PDSS) was used to measure symptoms of postpartum depression. Prenatal depression, child care stress, history of depression, baby temperament, and birth experience correlated significantly with PPD. Significant inverse correlations were found between PPD and emotional support, instrumental support, marital satisfaction, and medication status. Hierarchical multiple regression indicated that pregnancy mood, child care stress, emotional support, and marital satisfaction predicted a significant amount of the variance in postpartum depression scores

Gamma-glutamyltransferase, arterial remodeling and prehypertension in a healthy population at low cardiometabolic risk

International audiencePlasma gamma-glutamyltransferase (GGT) was suggested to reflect the level of systemic oxidative stress. Oxidative stress induces changes in arterial structure and function and contributes to the development of hypertension. Therefore, GGT may be associated with arterial remodeling and blood pressure (BP) increment, even in absence of disease. To test this hypothesis, we evaluated, in 825 healthy subjects at low cardiometabolic risk, the associations of plasma GGT with carotid artery intima-media thickness (IMT), luminal diameter and prehypertension; in 154 subjects was evaluated also the association with aortic stiffness (cfPWV). Associations were controlled for insulin sensitivity, C-reactive protein, and life-style habits. In the main population, BP was remeasured after 3 years. Carotid diameter and cfPWV, but not IMT, were directly and independently related to plasma GGT. Subjects with prehypertension (N = 330) had higher GGT as compared with subjects with normal BP (22 [14] vs 17 [11] IU/L; adjusted P = 0.001), and within prehypertensive subjects, those who developed hypertension during 3 years had higher GGT than those without incident hypertension (27 [16] vs 21 [14] IU/L; adjusted P < 0.05). Within subjects with arterial stiffness measurement, those with prehypertension (N = 79) had higher both GGT and arterial stiffness (25 [14] vs 16 [20] IU/L and 9.11 ± 1.24 vs 7.90 ± 0.94 m/s; adjusted P < 0.01 and <0.05). In the view of previous evidence linking plasma GGT concentration to the level of systemic oxidative stress, our findings suggest a role of oxidative stress in subclinical arterial damage and in prehypertension, even in healthy subjects free of cardiometabolic risk. Arterial organ damage may represent the link between GGT and hypertension