ABSTRACT
Introduction .................................................................................................................................... 422 Proposed Risk Factors and Etiologies for Development of Perinatal and Postpartum Depression ....................................................................................... 423
Sociocultural ............................................................................................................................. 423 Psychosocial Stress in Pregnancy ............................................................................................. 423
Neuroendocrine and Psychoimmunological Changes ................................................................... 423 Inammation, Toxins, and Neuroamines ..................................................................................424
Hormonal Dysregulation ................................................................................................................424 Dysregulation of HPA Axis .......................................................................................................424 Reproductive Steroid Hormones ............................................................................................... 425 Thyroid Hormones .................................................................................................................... 425 Oxytocin .................................................................................................................................... 426
Nutrition and Neurotransmitters .................................................................................................... 426 Polyunsaturated Fatty Acids ...................................................................................................... 426 Homocysteine Metabolism and S-Adenosyl L-Methionine (SAMe) ........................................ 427 Vitamins B (Folate and B12) ..................................................................................................... 427 Vitamin D .................................................................................................................................. 427
Neuronal Plasticity and Brain Structure Changes .......................................................................... 428 Perinatal Depression: Diagnosis .................................................................................................... 428
