Objective:To determine associations between postpartum depression (PPD) and plasma neurotransmitters.Methods:We conducted a case-control study nested to a prospective cohort established in 3 comprehensive tertiary hospitals in Changsha,Hunan,China from February to September 2007.The Chinese version of the Edinburgh Postnatal Depression Scale (EPDS) was used at 2 weeks postpartum to screen PPD,with a score of 13 or higher as the cut-off for PPD.The women with matched age but without PPD and delivery within 5 years were selected as controls.The levels of plasma monoamine neurotransmitters including serotonin (5-hydroxytryptamine,5-HT),dopamine (DA),and norepinephrine (NE),and peptide neurotransmitters including neuropeptide Y (NPY) and substance P (SP) in maternal blood samples taken at 2 weeks postpartum were measured and compared between PPD women (n=42) and controls (n=42).Results:Plasma levels of 5-HT and NPY were significantly lower while plasma levels of NE and SP were significantly higher in PPD women than those in the controls.For women with PPD,a negative correlation between NPY and NE (r=-0.36,P＜0.05) was observed.Conclusion:There are changes in plasma levels of neurotransmitters in women with PPD,and there are potential interactions between different neurotransmitters.

BACKGROUNDChanging health care providers frequently breaks the continuity of care, which is associated with many health care problems. The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C, D and X drugs.

METHODSA 50% random sample of women who gave a birth in Saskatchewan between January 1, 1997 and December 31, 2000 were chosen for this study. The association between the number of changes in health care providers and with pregnancy exposure to category C, D, and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression, with adjusted odds ratios (ORs) and its 95% confidence intervals (CIs) as the association measures.

RESULTSA total of 18 568 women were included in this study. Rates of FDA C, D, and X drug uses were 14.35%, 17.07%, 21.72%, and 31.14%, in women with no change of provider, 1-2 changes, 3-5 changes, and more than 5 changes of health care providers. An association between the number of changes of health care providers and pregnancy exposure to FDA C, D, and X drugs existed in women without chronic diseases but not in women with chronic disease.

CONCLUSIONChange of health care providers is associated with pregnancy exposure to FDA category C, D and X drugs in women without chronic diseases.

Adult ; Continuity of Patient Care ; Databases, Factual ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization ; statistics & numerical data ; Female ; Health Personnel ; Humans ; Logistic Models ; Pharmaceutical Preparations ; Pregnancy ; drug effects ; Saskatchewan ; United States ; United States Food and Drug Administration