Homocysteine and serotonin: association with postpartum depression

Postpartum depression (PPD) is a disorder of multifactorial origin with significant consequences on both maternal and child health. One of the biological factors implicated is perturbed methionine-homocysteine metabolism. Since this metabolic pathway plays a significant role in myelination of nerve fibers, the growth and development of the child would also be adversely affected. We carried out this study in 103 women (58 with PPD and 45 without PPD) who delivered their child in our institute from December 2010 to November 2011. The study group was evaluated for PPD using Edinburgh postnatal depression scale with a cut-off score of 10. Assessment of fetal well being was done by APGAR score assessed immediately after birth. Serum folic acid, vitamin B12, homocysteine and serotonin was done by ELISA. We found significantly elevated levels of homocysteine in women with PPD as compared to those without PPD, both at 24-48h as well as six weeks after delivery, although no associations were found with folate and vitamin B12 levels. Also, there was a significant negative correlation between serum homocysteine and serotonin levels in the postpartum depression group with a significant negative correlation between homocysteine and serotonin. Our study showed a significantly lower APGAR score in the infants born to mothers with PPD. Our study also shows that homocysteinemia is associated with PPD whether at the first week or sixth week, while low serum serotonin may play a role in depression during the first week, but may not have a role in depression status at the sixth week. Also, PPD in the mother is related to a low APGAR score in infants born to these mothers emphasizing the significance of both mental as well as nutritional status of the mother.