The Changes Of Serum Estradiol And Progesterone Levels Of The Patients With Postpartum Depression:A Meta-analysis

BACKGRROUNDPostpartum depression is a common mental disorder that endangers maternal physical and mental health,and its incidence is reported differently.Women with postpartum depression usually show sadness,depression,anxiety and a strong will to suicide and kill babies.Postpartum depression also have an impact on baby’s development,mood,cognition,etc,increasing their susceptibility to mental disorders.In order to identify and prevent postpartum depression as soon as possible,researchers have been trying to explore its pathogenesis.However,due to the complexity of the causes of postpartum depression,it is still not achieved.Because of the sharply change of estrogen and progestin in women during pregnancy and childbirth,many scholars think that may be one of the causes of postpartum depression.After consulting the literature,we can know that the results of the study on the difference about the levels of estrogen and progestin between depression patients and normal one were very different,and it is difficult for us to draw a definite conclusion.OBJECTIVETo systematically evaluate the changes of serum estrogen and progesterone levels in patients with postpartum depression and normal puerperant.METHODUsing the identified search terms,we comprehensively searched the literature of case-control trials about comparison of serum estrogen and progesterone levels between patients with postpartum depression and normal puerperant in Scopus、Pubmed、Embase、Wed of Science、the Cochrane library 、 Chinese Biomedical Literature Database(CBM),China Knowledge Network(CNKI)and Wanfang Database,with the publication time ended in February 2021.To screen Roughly and finely based on inclusion and exclusion criteria,we could get the literature.To evaluate the quality of literature by using NOS scales,and to collect research data in the literature accurately and overall.Finallly,we used Revman5.3 to analyze the data and used Stata16.0 tests for publication bias.RESULTA total of 14 papers were finally included in the study,including 3610 patients,of which 10 detected serum estrogen and progesterone levels within 2 weeks after delivery,including 945patients(407 in the depression group and 547 in the control group).There were 10 papers which detected serum estrogen and progesterone levels outside 2 weeks after delivery,including 1462patients(384 in the depression group and 1078 in the control group).Within 2 weeks of delivery,the level of serum estrogen in depression group was lower than that in control group,and the difference was statistically significant[SMD=-2.89,95%Cl:(-3.97,-1.81),P<0.00001];there was no significant difference in serum progesterone level between the depression group and the control group[SMD=0.08,95%Cl:(-0.94,1.10),P=0.88].Outside 2 weeks after delivery,the level of serum estrogen in the depression group was lower compared with the control groupand the difference was statistically significant[SMD=-4.73,95%Cl:(-6.64,-2.82),P<0.00001];the serum progesterone of depression group was lower than that of control group [SMD=-1.54,95%Cl:(-2.54,-0.54),P<0.00001],and the difference was statistically significant.CONCLUSIONLow levels of postpartum estrogen and progesterone are one of the causes of postpartum depression.Serum estrogen has potential value in the diagnosis of postpartum depression.