Perinatal/PPD and Mental Health Flashcards
(13 cards)
describe chronic stress
constant, debilitating, associated with other chronic diseases, muscle pain, HTN, immunocompromised, can contrib to heart disease, depression, obesity
describe the mechanisms of chronic stress
hypothalamic pit adrenal axis involving CRH, ACTH and cortisol
what complications are associated with hypercortisolaemia
depression, obesity, poor immunity, HTN, Cushing’s syndrome
what symptoms are associated with hypocortisolaemia
fatigue, anaemia, low BP, appetite loss, Addison’s disease
describe cortisol in pregnancy
increases in circulation and ACTH increases, placenta produces CRH influencing rise in cortisol which is important for maturing fetal systems, low levels of cortisol ideal in placenta until late in preg
what happens to fetus if cortisol too high?
IUGR, poor immunity, altered brain development, risk of adult diseases increases inc DM, CVD, mental illness, Ca, allergy
what happens if fetal cortisol too low?
poor development of genitalia and repro organs, altered brain development
compare effects of cortisol on male vs female fetuses
females get small if cortisol levels too high whereas males don’t and sometimes get bigger, females more sensitive to changes
describe mechanisms of anx
women more susceptible than men, estrogen and cortisol important, rise in cortisol causes activation of immune system through inflam cytokines -> changes in brain function and inhib of dopamine and serotonin function
what is the prevalence of depression in pregnancy?
23%
describe the mechanisms of depression in pregnancy
HPA axis dysfunction causes increase in glucocorticoids decreasing T3 and T4, and estrogen, inflam cytokines affect brain function
what are the effects of depression on fetal outcomes?
LBW, shorter gest age, lower APGAR scores, NICU, BF
describe pathophysiology of PPD
placenta inflam genes increased, Gr alpha D1 increased expression in placenta assoc with IL6 -> inflammation, drop in anti-inflam cells
