Study Finds Symptoms of Depression During Pregnancy Linked to Specific Brain Activity

About 80% of women experience the “baby blues” after the birth of their child. This is usually a short period of sadness that disappears within a few days. However, about 1 in 7 women develop postpartum depression, a more serious depression that can affect the bond mothers form with their babies and can have long-term consequences. These women seem unable to regulate the negative emotions that can follow childbirth.

Now, a group of European researchers has discovered that in healthy pregnant women, activity in a specific area deep in the brain is linked to the regulation of negative emotions and the tendency to develop symptoms of depression. The researchers hope that testing for this activity, along with how emotions are regulated, will indicate which women are at risk for postpartum depression.

Presenting the work at the ECNP Congress in MilanPresenter Franziska Weinmar (University of Tübingen, Germany) said: “This is one of the first studies to compare brain activity in pregnant and non-pregnant women. The ability to regulate emotions is essential for mental health, and this interplay was our starting point.”

The findings are published in the diary Psychiatry and clinical psychology.

The researchers took 15 healthy pregnant women with very high estrogen levels (due to pregnancy). The pregnant women were between 5 and 6 months into their first pregnancy. These women were compared to 32 non-pregnant women, who had naturally fluctuating estrogen levels, such as during the menstrual cycle.

Each woman was placed in an MRI scanner and shown disturbing/upsetting pictures. They were then asked to regulate their emotional state using cognitive reappraisal, a technique in which the person attempts to change their emotional state by changing their thoughts and trying to reinterpret the situation.

Franziska Weinmar added: “We asked all the women in the study about how they dealt with negative emotions and found that the pregnant women in our study indicated that they rarely tried to change their emotional perspective through cognitive reappraisal, unlike the non-pregnant women. However, when they were asked to regulate their emotions during an MRI scan, they were just as successful in controlling their emotional state as the non-pregnant women.

“Both pregnant and non-pregnant women are equally able to manage their emotions by deliberately trying to reinterpret a situation. However, it seems more difficult for pregnant women to take this step towards consciously managing these negative emotions, although they may be able to cope in other ways.

“We found that pregnant women who showed greater amygdala activity during emotion regulation were less successful at controlling emotions. Furthermore, pregnant women with greater amygdala activity reported more symptoms of depression.”

Franziska Weinmar continued: “We have to be careful in interpreting this – this is a small sample and we are the first to undertake this work. However, if larger studies confirm higher activity in the amygdala in women at risk of postnatal depression, we can assess and specifically target these women during this vulnerable phase – for example by training them in emotion regulation skills. This could be an approach to dealing with the baby blues.”

Dr Susana Carmona (Gregorio Marañón Hospital, Madrid) commented: “Studies like this are essential to understand one of the most extreme physiological processes a human can experience: pregnancy. It is astonishing how little we still know. Recently, the FDA approved the first treatment for postnatal depression.”

“However, we still have a long way to go when it comes to characterizing what happens in the brain during pregnancy, identifying biomarkers that may indicate the risk of developing perinatal mental disorders and designing strategies to prevent maternal and fetal suffering during the delicate and critical peripartum period,” said Dr. Carmona, who was not involved in this work.