Plasma Oxytocin Concentration during Pregnancy is
associated with Development of Postpartum Depression
Marta Skrundz1, Margarete Bolten1,2, Irina Nast1, Dirk H Hellhammer3and Gunther Meinlschmidt*,1,4
1SesamFSwiss Etiological Study of Adjustment and Mental HealthFNational Centre of Competence in Research, Faculty of Psychology,
University of Basel, Basel, Switzerland;2Child and Adolescents Psychiatric Clinic, Department of Developmental Psychopathology, University
of Basel, Basel, Switzerland;3Division of Theoretical and Clinical Psychobiology, University of Trier, Trier, Germany;4Department of Clinical
Psychology and Epidemiology, Faculty of Psychology, University of Basel, Basel, Switzerland
Postpartum depression (PPD) affects up to 19% of all women after parturition. The non-apeptide oxytocin (OXT) is involved in
adjustment to pregnancy, maternal behavior, and bonding. Our aim was to examine the possible association between plasma OXT
during pregnancy and the development of PPD symptoms. A total of 74 healthy, pregnant women were included in this prospective
study. During the third trimester of pregnancy and within 2 weeks after parturition, PPD symptoms were assessed using the Edinburgh
Postnatal Depression Scale (EPDS). Blood samples for plasma OXT assessment were collected in the third trimester. Following the
literature, participants with postpartum EPDS scores of 10 or more were regarded as being at risk for PPD development (rPPD group).
In a logistic regression analysis, plasma OXT was included as a potential predictor for being at risk for PPD. Results were controlled for
prepartal EPDS score, sociodemographic and birth-outcome variables. Plasma OXT concentration in mid-pregnancy significantly
predicted PPD symptoms at 2 weeks postpartum. Compared with the no-risk-for-PPD group, the rPPD group was characterized by
lower plasma OXT concentrations. To our knowledge, this is the first study to show an association between prepartal plasma OXT
concentration and postpartal symptoms of PPD in humans. Assuming a causal relationship, enhancing OXT release during pregnancy
could serve as a potential target in prepartum PPD prevention, and help to minimize adverse effects of PPD on the mother–child
Neuropsychopharmacology (2011) 36, 1886–1893; doi:10.1038/npp.2011.74; published online 11 May 2011
Keywords: postpartum depression; oxytocin; pregnancy; EPDS; adaptation to motherhood
Postpartum depression (PPD) affects up to 19% of all
mothers and adversely influences maternal adaptation to
motherhood (Gavin et al, 2005) with negative effects on
child development, as children of depressive mothers are
more vulnerable to develop mental disorders in later life
(Grace et al, 2003).
The etiology of PPD is closely related to psychological
determinants and experiences during pregnancy (O’Hara
and Swain, 1996). Identification of psychological risk factors
for PPD has been an important issue in the recent years.
Major identified risk factors are a history of previous PPD
or affective disorders in general, stressful life events, lack of
social support, and low self-esteem (Beck, 2006; Robertson
et al, 2004). Additionally, the early postpartum period is
seen as a time of increased emotional vulnerability, partly
caused by dysregulations of the endocrinological homeo-
stasis (Wisner and Stowe, 1997). Because of the challenging
reorganization of physiological processes that comes along
with pregnancy and parturition, research started to address
endocrine factors as potential determinants in the etiology
of PPD. From animal models of PPD, we know that
withdrawal from high doses of estradiol and progesterone,
comparable to the respective amounts available during
pregnancy, is followed by depression-like symptoms (Green
et al, 2009). Addtionally, the regulation of the hypothalamic–
pituitary–adrenal (HPA) axis seems to be disturbed in
women with PPD (Brummelte and Galea, 2010) or short
periods of Postpartum Blues (Ehlert et al, 1990). However,
existing findings are not consistent (Bloch et al, 2003). One
biological parameter that has not yet been considered in
PPD etiology, is the non-apeptide oxytocin (OXT). OXT is
synthesized in the paraventricular nucleus (PVN) and the
supraoptic nucleus (SON) of the hypothalamus and released
peripherally into the blood and centrally into different brain
regions (Gimpl and Fahrenholz, 2001). In context of
pregnancy, OXT is known for its involvement in the
process of delivery (Russell et al, 2003) and its physiological
Received 5 December 2010; revised 24 February 2011; accepted 21
*Correspondence: Dr G Meinlschmidt, SesamFSwiss Etiological Study
of Adjustment and Mental Health, Institute of Psychology, University of
Tel: +41 61 267 0275, Fax: +41 61 267 0659,
Neuropsychopharmacology (2011) 36, 1886–1893
& 2011 American College of Neuropsychopharmacology.All rights reserved 0893-133X/11
role in the onset and maintenance of lactation (Sala and
Beyond its physiological functions in the periphery,
animal studies provide evidence for a major role of OXT
in behavioral adaptation to pregnancy and motherhood.
Characteristic maternal behaviors (pup-grooming, hover
over offspring and respond latency) are impaired, if OXT
availability is diminished (Higuchi and Kaba, 1997; Olazabal
and Young, 2005; Pedersen et al, 2006). Furthermore,
maternal OXT functioning influences reciprocal affective
behaviors between mother and offspring in mammalian
species (Nelson and Panksepp, 1998). Recently, this asso-
ciation was also shown in humans. Parents showing more
affectionate and stimulatory behaviors in interactions with
their children were characterized by higher plasma OXT
concentrations (Gordon et al, 2010). Further, Feldman et al.
(2007) reported associations between prepartum-assessed
OXT concentrations and postpartum maternal adaptation.
The maternal plasma OXT level, measured during early and
late pregnancy, as well as in the first month postpartum,
predicted maternal behavior (mother’s gaze at infant,
motherese vocalizations and affectionate touch) in inter-
action with the child. A study assessing plasma OXT twice
during pregnancy showed higher postpartum maternal–fetal
attachment-scores in women with a OXT rise between the
first and third trimester compared with women with stable
or decreasing patterns of OXT (Levine et al, 2007). In non-
pregnant women, OXT is known to promote interpersonal
relationships and enhance feelings of love and trust
(Heinrichs and Domes, 2008).
On the basis of current evidence, lower OXT levels
in pregnancy could result in impaired emotional adaptation
to motherhood, which is a major risk factor for PPD
development and subsequently affects the quality of
maternal behavior (Murray et al, 1993; Stein et al, 2010).
Therefore, the aim of this study was to assess a
potential association between OXT during pregnancy
and postpartum PPD symptoms in a sample of healthy
pregnant women. We expected, that lower plasma OXT
levels during the third trimester of pregnancy would
result in an increased risk for PPD, as assessed post-
partum. Results could help to elucidate the etiopathology
of PPD and provide new targets for prepartal prevention
Data were collected within a larger longitudinal study
conducted with 100 pregnant women in the area of Basel,
Switzerland. All participants were recruited between their
21st and 32nd week of gestation. Recruitment methods
included local newspaper announcements, promotion of the
study at local hospitals and a call for participants on local
TV. A detailed study description was given to all interested
women and, if any arised, questions were answered.
All participants were screened for the following inclusion
criteria: (a) no current mental illness, (b) no severe medical
complications (acute or chronic physical diseases, such as
gestational diabetes, metabolic diseases, hypertension and
thyroid dysfunction), (c) no signs of fetal malformation,
(d) a pre-pregnancy BMI below 32, (e) no smoking beyond
the 10th week of gestation and (f) good knowledge of
German language. Data for analyses of the present
paper were available for 73 participants, of which 16
were characterized by at least one lifetime depressive
episode. All lifetime episodes of depression occured more
than 2 years before participation in the study. A flowchart of
study participants is displayed in Figure 1. Comparisons
between the 73 women providing complete data and the 27
excluded women indicated no significant differences on age,
parity, socioeconomic status and PPD symptoms.
Informed written consent was obtained from all partici-
pants. The study protocol was approved by the local ethics
committee and is consistent with the revised Helsinki
Declaration of 1975.
Blood Sampling and OXT Measurement
All blood samples were obtained between the 30th and 34th
week of gestation. Participants visited the study centre for
an experimental session, which included blood sampling
and other physiological assessments. The samples for the
OXT assessment were collected at the beginning of the
session, starting between 1300 hours and 1500 hours.
Participants were seated on a examination couch and a
study nurse sampled 2.7ml of blood into vacutainer tubes
containing lithium heparin and 108ml of Aprotinin
(BioChemica, Germany). Tubes were kept on ice and centri-
fuged within 10min at 61C at 3000g for 10min. Super-
natants were pipetted into safe-lock devices and stored at
?801C until analysis.
Samples were analyzed at the Department of Behavioural
Neuroendocrinology, Max Plank Institute of Psychiatry,
Munich, Germany, using a radioimmunoassay, as described
elsewhere (Landgraf et al, 1995). This assay was reported
to have an antiserum cross-reactivity of less than 0.7%, with
a detection limit of 0.1pg per sample. All samples were
analyzed in duplicates. The intra-assay and inter-assay
coefficients of variability were 6–8 and 8–10%, respectively.
Figure 1 Flowchart of study participants.
Oxytocin and postpartum depression
M Skrundz et al
Assessment of Demographic and Psychological
After inclusion, participants were interviewed for assessing
possible present, recent or life-time depression and anxiety
disorders using the German translation of corresponding
sections of the Computer Assisted Personal Interview
(CAPI) version of the Composite International Diagnostic
Interview (Wittchen et al, 1998; Wittchen and Pfister, 1997;
World Health Organization, 1990) and general socioeco-
Depressive symptoms were assessed within 2 weeks after
delivery using the Edinburgh Postnatal Depression Scale
(EPDS), a scale originally developed as a screening measure
for depression, showing good reliability (split-half: 0.82;
standardized a¼0.81) (Bergant et al, 1998). A total of
10 items, dealing with typical PPD symptoms are answered
on a 4-point scale. As a control variable, the prepartal EPDS
score was assessed between the 32nd and 34th week of
Information on length of gestation and birth outcome
were collected from medical records.
All variables were checked for normal distribution, missing
data and outliers (defined as more than two standard
deviations below or above the mean) by the Kolmogorov–
Smirnof test and visual inspection. Outliers were checked
for validity and excluded if reasonable. If necessary,
variables were subjected to transformation by natural
logarithm before further analyses. Differences on demo-
graphic, biological and psychological characteristics bet-
ween included and excluded study participants were tested
by t and w2tests. Participants were divided into a risk-for
PPD group (rPPD) and a no-risk-for PPD group (nPPD),
according to the respective postpartum EPDS score. On the
basis of the proposals of Bergant et al. (1998) and Jardri
et al. (2006), the chosen cut-off score for being at risk for
PPD was 10 or more within the first 2 weeks postpartum.
T and w2tests were computed between the groups, to
identify possible confounders among the demographical
and medical variables. Descriptive statistics of EPDS scores
and OXT values are reported. The postpartal EPDS scores of
nursing and not nursing mothers were compared using the
t-test. The bivariate correlation was computed between the
pre- and postpartal EPDS score. The association between
OXT and PPD symptoms was tested by conducting a binary
logistic regression analysis with the group variable as
outcome variable and OXT concentration as the potential
predictor in the first run. In a second run the prepartal
EPDS score was added, to control for potential confounding
by previous depressive symptoms. Further analyses were
computed including OXT concentration as the first
predictor and other potential predictors, identified through
previous group comparisons. Because of the expected,
unequal group sizes, every logistic regression analysis was
conducted with not more than two predictors, of which the
first one was always OXT concentration. Because accurate
classification of participants is difficult when groups are not
evenly split, primary emphasis was placed on prediction
rather than classification of being at risk for PPD. Data were
analyzed using SPSS 16.0.2 for Mac OS X. The level of
significance for all analyses was set at a¼0.05.
Sample and Group Characteristics
Demographic and pregnancy-related sample and group
characteristics are displayed in Table 1. A group variable
was introduced according to the postpartum EPDS score. In
all, 14 participants were identified as having a postpartum
EPDS score of 10 or more and were assigned to the rPPD
group, representing a higher risk for the development of
PPD. The remaining 59 participants were assigned to the
nPPD group. Groups were tested for significant differences
regarding sociodemographic and birth characteristics.
Groups differed only in length of gestation. Participants in
the rPPD group had a significantly shorter length of gesta-
tion (M¼39.02 weeks) compared with participants in the
nPPD group (M¼39.73 weeks) (T (71)¼2.049; Po0.05).
Therefore length of gestation was included as a potential
mediator in further analysis of the relationship between
OXT and PPD symptoms.
Pre and Postpartal EPDS Scores
Postpartal EPDS scores did not differ between nursing and
not nursing mothers (T (69)¼0.025; P¼0.98). Prepartal
EPDS scores (Range 0–17) were significantly correlated with
postpartal EDPS scores (Range 0–22) (r¼0.232; p¼0.048).
Mean prepartal and postpartal total EPDS scores were
4.77 and 5.85 respectively.
Plasma OXT Concentrations
Plasma OXT concentrations had a range of 14.39–245.71pg/ml
and mean OXT concentration for the overall sample was
80.81pg/ml (SD¼48.81pg/ml). Three outliers with OXT
values above 200pg/ml were identified. Information on these
three subjects did not provide a clear reason for exclusion of
these cases or any indication for invalidity of assessments.
Therefore, they were retained in the analyses. All further
analyses were conducted with the log-transformed OXT
concentrations to assure normal distribution. The bivariate
correlation between prepartal EPDS scores and OXT concen-
trations was not significant (r¼?0.086; p¼0.467).
The Association between OXT Concentration in
Pregnancy and Postpartum PPD Symptoms
The test statistics of the logistic regression analyses, with
OXT predicting PPD symptoms are displayed in Table 2.
Plasma OXT level significantly predicted PPD symptoms
(Exp (b)¼0.290; po0.05). The coefficient of association
between OXT concentration and PPD was below one,
indicating lower OXT levels in the rPPD group and higher
OXT levels in the nPPD group. The addition of the prepartal
EPDS score as a further covariate in a second analysis
did not improve the model fit (Dw2(1)¼0.302; P40.05).
According to the results of descriptive statistics, length of
gestation was tested as a potential mediator in a third
analysis. Length of gestation did not predict PPD symptoms
Oxytocin and postpartum depression
M Skrundz et al
(Exp (b)¼0.931; p40.05) and the model fit did not
improve either (Dw2(1)¼3.507; P40.05).
With OXT as predictor of PPD symptoms, 83.6% of the
sample was classified correctly into the nPPD and rPPD
group. To visualize the difference in OXT values between
the groups, mean OXT concentrations are displayed in
Repeating the analyses, excluding the three cases with
outlying OXT concentrations, did not change the results.
In line with our hypothesis, we could show that OXT during
pregnancy was negatively associated with a positive screen
Table 1 Sample and Group Characteristics and Tests for Group Differences
Test between nPPD
Maternal age (years)31.05 (4.70)31.22 (4.69) 30.36 (4.88)0.541a
Very high17.4017.90 15.40
Pre-pregnancy BMI22.31 (3.47)22.10 (3.26) 23.32 (4.40)0.292a
Primiparae 74.071.20 85.70
Multiparae 26.0 28.8014.30
Length of gestation (weeks)39.6 (1.2)39.7 (1.1)39.1 (1.4)0.044a
Cesarean section 23.323.70 21.40
Mother is nursing 90.089.7 92.3
Infant birth weight (g)3338.56 (378.44)3345.93 (359.21) 3307.50 (465.02)0.735a
Male 53.449.2 71.4
Monthly income categories low¼0–3750 swiss franks, average/high¼3750–11250 swiss franks, very high¼above 11250 swiss franks; nPPD¼no risk for postpartum
depression; rPPD¼at risk for postpartum depression; BMI¼body mass-index.
Table 2 Binary Logistic Regression Analysis Fort he Prediction of Being at Risk for Postpartal Depression
Model statistics Predictor statistics
?2 LLWald’s v2(df)p Exp(b) 95% CI for Exp(b)
First analysis6.195 (1) 0.0130.130 65.169
Plasma oxytocin5.555 (1)0.018 0.290 0.103–0.812
Second analysis6.497 (2)0.0390.13764.867
Plasma oxytocin 5.366 (1)0.0210.294 0.105–0.828
Prepartal EPDS score0.299 (1)0.5841.2540.557–2.828
Change of model fit compared with first analysis: Dw2(1)¼0.302; p¼0.583
Third analysis 9.702 (2)0.008 0.20061.662
Plasma oxytocin5.250 (1)0.022 0.294 0.103–0.838
Length of gestation3.447 (1)0.063 0.931 0.864–1.004
Change of model fit compared with first analysis: Dw2(1)¼3.507; p¼0.061
NK¼Nagelkerke R2; ?2 LL¼?2 log likelihood (deviance); EPDS¼Edinburgh Postnatal Depression Scale.
Oxytocin and postpartum depression
M Skrundz et al
on the EPDS at greater than or equal to 10, indicating a
higher risk for the development of PPD. This suggests
an increased occurrence of depressive symptoms in the
first 2 weeks after delivery in individuals with low plasma
OXT concentrations during pregnancy. The relationship
persisted after controlling for prepartal EPDS scores.
Our findings are in agreement with the only human study
addressing the link between plasma OXT during pregnancy
and postpartal maternal behavior. Plasma OXT concentra-
tions during pregnancy were found to be positively
associated with a set of maternal bonding behaviors, such
as positive affect and gaze in interactions, as well as cogni-
tive attachment representations towards the newborn in the
early postpartum period (Feldman et al, 2007). In women
suffering from PPD the same behaviors are impaired,
accompanied by feelings of overload and difficulties in
emotional attachment development towards their child
(Beck, 2006; Martins and Gaffan, 2000). Correspondingly
studies with rodents report deficits in maternal behavior,
such as less protective behavior and less pup-licking, and
longer latencies in postpartal onset of maternal behavior in
animals with decreased central OXT availability (Pedersen
et al, 2006; van Leengoed et al, 1987). Non-human primate
mothers show increased maternal affiliation towards off-
spring when central OXT is enhanced (Holman and Goy,
1995). The present findings are also in agreement with
human studies reporting relationships between plasma
OXT, assessed in the 2nd and 6th month postpartum and
affectionate maternal behavior during mother–child inter-
actions (Gordon et al, 2010). Again, mothers’ OXT concen-
trations were positively correlated with the behavioral
indicators of attachment, such as motherese vocalization,
affectionate touch and positive affect. As anxiety and exces-
sive preoccupation are other important symptoms of PPD,
our results also match reports of OXT acting as anxiolytic
and enhancing positive emotional affiliation in non-preg-
nant humans (Uvnas-Moberg, 1998). There is also evidence
for decreased plasma OXT concentrations in individuals
suffering from major depression or reporting increased
depressive symptoms (Frasch et al, 1995; Ozsoy et al, 2009;
Scantamburlo et al, 2007).
The herein observed prevalence of subjects above cutoff
resembles to those of other studies using the same screening
instrument. Here, we identified 19.18% of the sample having
an EPDS score of 10 or more. Other comparable studies
found a rate of 20% at 5 days postpartum (Bergant et al,
1998) and 16% at 2 months postpartum (Yim et al, 2009).
Group comparisons revealed a significantly shorter
gestation among women within the rPPD group. In women
with lower OXT availability in pregnancy, the oxytocinergic
inhibition of the HPA axis could be decreased. Decreased
HPA axis inhibition would enhance the exponential increase
of placental corticotropin-releasing factor that promotes the
onset of labor (Smith, 1998). However, the length of
gestation variable did not reach significance in the following
prediction of PPD symptoms. It remains to be elucidated
whether length of gestation has a mediating role in the
relationship between OXT and PPD in samples including
The range of OXT concentrations found in the present
sample, is in line with those of previous studies (Dawood
et al, 1979; De Geest et al, 1985). One often-mentioned issue
concerning OXT assessment in human samples is that
central OXT release is not necessarily related to peripheral
OXT release, and therefore associations between centrally
regulated psychological variables and peripheral measured
OXT should be handled with caution (Jones et al, 1983;
Landgraf and Neumann, 2004). However, in animals, there
are also studies accounting for joint control mechanisms of
central and peripheral OXT release in context of fear-related
stress responses (Wotjak et al, 1998), and for autostimula-
tory effects at the level of the hypothalamus, in terms of
peripheral OXT release activation by centrally released OXT
(McKenzie et al, 1995; Neumann et al, 1994). Given the
current evidence from animal studies and the difficulties in
the determination of central OXT release in humans, it
seems justifiable to revert to peripheral OXT assessment.
This is supported by several findings reporting relations
between peripheral OXT in humans and various psycho-
logical constructs, all representing aspects of human
affiliation and attachment (Feldman et al, 2007; Light
et al, 2004; Tops et al, 2007; Wismer Fries et al, 2005).
The mechanisms behind the observed association be-
tween OXT and PPD symptoms remain to be elucidated.
Although we cannot rule out residual confounding by
unknown factors, the prospective design and the inclusion
of pre-pregnancy EPDS scores as a covariate make a causal
relationship imaginable. There already exists evidence that
OXT concentrations are lower in mothers characterized by
depressive symptoms and negative affect during pregnancy,
when assessed postpartum (Light et al, 2004). Further, OXT
is known to reduce psychological and physiological stress
responses (Heinrichs et al, 2003) and to inhibit hyperactive
fear-responses of the amygdala (Labuschagne et al, 2010).
There is also evidence that the properties of endocrine
systems during pregnancy have programming functions for
groups and group means. Oxytocin values are shown on a logarithmic scale.
Graph shows individual oxytocin concentrations in the two
Oxytocin and postpartum depression
M Skrundz et al
the postpartal period (Meinlschmidt et al, 2010; Pop et al,
1993). In our study, an interplay between low OXT and
effects on amygdala reactivity and the HPA axis in
pregnancy could indicate an increased reactivity to stressful
stimuli at that time and promote the development of
depressive symptoms after birth, when mothers are
challenged by a bulk of potentially stressful new conditions.
Additionally, expectations of the social environment and the
growing demands of the child may promote feelings of fear
and insecurity. Notably, a study comparing the symptoma-
tology of postpartum and non-postpartum depression
found more anxious features among the investigated PPD
group (Hendrick et al, 2000). As we know from animal
studies, besides the general importance of OXT in the
formation of social bonds in females (Insel, 1997), the
positive feedback mechanism of the oxytocinergic system is
supposed to provide long-lasting stimulation of maternal
behaviors after parturition (DaCosta et al, 1996). It may be
less efficient, if OXT availability is diminished. Adopted to
human mothers, this would be reflected by the difficulties
depressed mothers have in implementing maternal beha-
viors and forming a relationship with their child (Beck,
1995; Cooper and Murray, 1998). Considering the profound
physiological challenge caused by endocrinological changes
over the course of gestation and the following abrupt shift
after parturition, it is not possible to form a biological
model for PPD development, that accounts for all con-
tributing factors yet. Future studies should try to experi-
mentally modify OXT concentrations in mid-pregnancy, to
verify, whether OXT during pregnancy contributes to the
generation of depressive symptoms during the postpartum
There are some limitations of the study. First, our finding
needs to be confirmed in future studies with more than one
OXT assessment over the course of pregnancy to clarify, if
the relationship is specific to OXT concentrations between
the 30th and 34th week of gestation. Studies assessing OXT
at different stages of gestation suggest individually different
patterns of OXT fluctuations over time, indicating that there
might be a functional difference between women with stable
OXT levels and those with rising ones (Dawood et al, 1979;
Levine et al, 2007). But high intra-individual stability of
values has also been reported (Feldman et al, 2007; Leake
et al, 1981; van der Post et al, 1997). From our point of view,
the present results refer to plasma OXT levels between the
30th and 34th week of gestation only, as we did not assess
potential alterations in peripheral OXT release over the
course of gestation. Second, the sample consisted of women
with mostly medium to high socioeconomic status. Conse-
quently, results need to be replicated with more hetero-
genous samples. Third, PPD symptoms were assessed by
questionnaire (EPDS), which should be complemented in
future studies by structured or standardized interviews to
verify the presence of a diagnosis of PPD. It should be noted
that as yet, estimations of the sensitivity and specificity of
the EPDS to detect PPD vary across studies, warranting
further attention of this issue (Eberhard-Gran et al, 2001;
Gaynes et al, 2005; Gibson et al, 2009). Nevertheless there
are validation studies reporting good sensitivity and
specificity values for the EPDS within comparable study
designs and according to DSM-III and ICD-10 criteria
(Harris et al, 1989; Jardri et al, 2006). Important to note, our
use of the EPDS within a period of 2 weeks postpartum does
not provide information on the diagnosis of PPD, which
requires the presence of symptoms for at least 2 weeks.
Moreover, heightened EPDS scores in this early postpartum
period may still be picking up the tail end of postpartum
blues, which itself is a risk factor for the development of
PPD. Finally, future studies should clarify, if the association
between prepartal OXT and depressive symptoms during
the postpartum period remains stable beyond the first 2
weeks up to several months postpartum, and if this
relationship holds true for individuals with diagnosed
episodes of PPD, as not all women with increased depressive
symptoms after delivery develop a full-blown affective
In summary, our findings suggest that OXT is involved in
the etiology of depressive symptoms during the postpartum
period, and need to be further elaborated in studies
assessing neuroendocrinological aspects of PPD. If repli-
cated, the presented results will have important clinical
relevance. Prepartal identification of subjects at risk for
PPD could allow for early preventive interventions and
minimize adverse effects for the physiological and psycho-
logical wellbeing of mother and child.
This work is part of the National Centre of Competence in
Research (NCCR) Swiss Etiological Study of Adjustment
and Mental Health (sesam). The Swiss National Science
Foundation (SNF) (project no. 51A240-104890), the Uni-
versity of Basel, the Hoffmann-La Roche Corp. and the Basel
Scientific Society provided core support for the NCCR
sesam. We are grateful to the Max Planck Institute of
Psychiatry, Munich, Germany for the biochemical analyses.
Further, we thank Andrea H Meyer, PhD, for his statistical
The authors declare no conflict of interest.
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