Longitudinal trends in postpartum mental health, cognition and steroid hormones

The temporal association between psychiatric and cognitive disturbances during pregnancy and postpartum is clear in the literature. However, associations between these disturbances and puerperal hormones are equivocal. The present study followed nine primigravid women from late pregnancy through one year postpartum to investigate trends in psychiatric and cognitive disturbances relative to postpartum hormone changes. Participants completed a battery of neuropsychological instruments at 37 weeks of pregnancy, at 10 days and four-, eight- and twelve-months postpartum and provided salivary specimen from which dehydroepiandrosterone sulfate (DHEAS), testosterone, estradiol and estriol concentrations were quantified. Results showed psychiatric disturbances and cognitive decrements in late pregnancy that often worsened following parturition. Psychiatric symptoms generally resolved by four months postpartum and were associated predominantly with elevated DHEAS. Cognitive performance improved across the year but spatial and verbal working memory remained impaired. Cognitive performance was not associated with hormone changes and inconsistently associated with mood symptoms