Progesterone May Not Significantly Reduce Depressive Symptoms in Women in the Postpartum Period

By Louise Gagnon

CHICAGO -- March 7, 2016 -- The use of progesterone did not affect depressive symptoms in the postpartum period compared with placebo, according to results of a controlled study examining the effects of exogenous progesterone on women in the postpartum period, presented at the 2016 Annual Meeting of the Society for Research on Nicotine and Tobacco (SRNT).

The study did not have sufficient power to demonstrate statistical significance between groups, however.

A study from 2009 concluded that women who had quit smoking during pregnancy were at a greater risk of relapse if they had depressive symptoms in the postpartum period. Given hormonal fluctuations in the postpartum period, administration of progesterone, it was hypothesised, may ward off postpartum depression and potentially reinforce smoking abstinence.

“We enrolled women who were previous smokers who had quit smoking during pregnancy and who were motivated to remain abstinent after childbirth,” explained principal investigator Sharon Allen MD, PhD, University of Minnesota Medical School Minneapolis, Minnesota, speaking a poster session here on March 3.

Dr. Allen and colleagues enrolled a total of 46 women, aged 18 through 35 years (mean age: 26.5 years). The investigators screened the participants for depressive symptoms during the prepartum period, and only included those with stable mental health who also were having a low-risk pregnancy.

At day 4 postpartum, the investigators randomised participants in a double-blinded fashion to either daily placebo or progesterone for 4 weeks. The researchers then followed all subjects for 8 weeks after oral therapy was completed. The participants received relapse-prevention counselling at all contact points.

Investigators assessed the presence of depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS), following the subjects on a weekly basis either in person or by phone during the treatment and follow-up periods. Mean EPDS scores were calculated for both groups and Analysis of Covariance models were used to assess differences. A paired t-test was also run to assess overall change in EPDS scores from 4 days postpartum to 12 weeks, regardless of randomisation assignment.

Both at the end of treatment and at the end of the follow-up period, Dr. Allen and colleagues found no statistically significant difference in depressive symptoms between the women treated with progesterone and the women who received placebo. They stressed, however, that the study did not have sufficient power to demonstrate statistical significance between groups.

The investigators plan to conduct a larger-sized study in the future that would be powered to show a statistically significant difference between the impact of active treatment and placebo on depressive symptoms and smoking abstinence in the postpartum period.

Funding for this study was provided by the National Institute on Drug Abuse, Rockville, Maryland.

[Presentation title: Progesterone & Postpartum Depression on Smoking Relapse. Abstract POS1-60]
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