Serum cholesterol levels and mood symptoms in the postpartum period

Abstract 

During pregnancy, the total serum cholesterol concentration rises up to 43%, followed by a rapid fall after delivery. Mild depressive symptoms (‘postpartum blues’) are a common complication of the puerperium and affect 30–85% of women in the early postpartum period. Based on these observations, it has been suggested that the sudden fall in cholesterol levels after delivery could serve as a ‘natural model’ to test the suggested association between cholesterol and mood. The present study was designed to expand the database concerning the association between cholesterol levels and mood in the postpartum period and to address some methodological problems raised by previous studies. Forty-seven healthy primiparous women were interviewed with a structured clinical interview on two occasions: during late pregnancy (median: day −20 before the expected delivery) and during the early postpartum period (median: day 32 after delivery). On both occasions, serum concentrations of total and HDL cholesterol were measured and mood symptoms were assessed with the state form of Spielberger's State-Trait Anxiety Index (STAI), the state form of the State-Trait Anger Scale (STAS), and the Beck Depression Inventory (BDI). We found significant, albeit moderate, relationships between serum cholesterol levels and mood symptoms in the postpartum period that were not present during late pregnancy. Lower postpartum levels of total cholesterol were associated with symptoms of anxiety (r=−0.30, P=0.04), anger/hostility (r=−0.31, P=0.04), and depression (r=−0.35, P=0.02), and lower postpartum levels of HDL cholesterol were associated with symptoms of anxiety (r=−0.34, P=0.02). This study confirms that the physiological fall in blood lipids in the postpartum period can be a useful model to test the relationship between serum cholesterol levels and mood.

Keywords:  Depression, Anxiety, Anger, Hostility, Pregnancy, Puerperium, Cholesterol