{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:44:12Z","timestamp":1792637052799,"version":"4.5.0"},"reference-count":80,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T00:00:00Z","timestamp":1657065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Psychiatr Scand"],"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Women have an increased risk for mental distress and depressive symptoms in relation to pregnancy and birth. The serotonin transporter (SERT) may be involved in the emergence of depressive symptoms postpartum and during other sex\u2010hormone transitions. It may be associated with cerebrospinal fluid (CSF) levels of the main serotonin metabolite 5\u2010hydroxyindolacetic acid (5\u2010HIAA). In 100 healthy pregnant women, who were scheduled to deliver by cesarean section (C\u2010section), we evaluated 5\u2010HIAA and estradiol contributions to mental distress 5\u2009weeks postpartum.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighty\u2010two women completed the study. CSF collected at C\u2010section was analyzed for 5\u2010HIAA, with high performance liquid chromatography. Serum estradiol concentrations were quantified by liquid chromatography tandem mass spectrometry before C\u2010section and postpartum. Postpartum mental distress was evaluated with the Edinburgh Postnatal Depression Scale (EPDS). Associations between EPDS, 5\u2010HIAA, and \u0394estradiol were evaluated in linear regression models adjusted for age, parity and SERT genotype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Higher levels of postpartum mental distress symptoms were negatively associated with a large decrease in estradiol concentrations (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      <jats:sub>\u0394E2<\/jats:sub>\n                      \u00a0=\u00a00.73,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.007) and, on a trend level, positively associated with high antepartum 5\u2010HIAA levels (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      <jats:sub>5\u2010HIAA<\/jats:sub>\n                      \u00a0=\u00a00.002,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.06).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a cohort of healthy pregnant women, postpartum mental distress was higher in women with high antepartum 5\u2010HIAA (trend) and lower in women with a large perinatal estradiol decrease. We speculate that high antepartum 5\u2010HIAA is a proxy of SERT levels, that carry over to the postpartum period and convey susceptibility to mental distress. In healthy women, the postpartum return to lower estradiol concentrations may promote mental well\u2010being.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acps.13461","type":"journal-article","created":{"date-parts":[[2022,6,22]],"date-time":"2022-06-22T01:38:50Z","timestamp":1655861930000},"page":"357-369","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The role of central serotonergic markers and estradiol changes in perinatal mental health"],"prefix":"10.1111","volume":"146","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1622-3949","authenticated-orcid":false,"given":"Camilla","family":"Borgsted","sequence":"first","affiliation":[{"name":"Neurobiology Research Unit Copenhagen University Hospital \u2010 Rigshospitalet  Copenhagen Denmark"},{"name":"Mental Health Services in the Capital Region of Denmark  Copenhagen Denmark"},{"name":"Department of Clinical Medicine, Faculty of Health and 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