Oxytocin Levels and Their Impact on Postpartum Mental Health

Nivedha, N; Kavitha

doi:10.65188/nurexus.1014

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Journal of MedVerse Research & Practice

nurexus.com

Oxytocin Levels and Their Impact on Postpartum Mental Health

Dr Nivedha

1

, Dr Kavitha

2

Student, Professor

Faculty of Nursing, Meenakshi Nursing College, Kanchipuram.

Email ID: nivedharagu@gmail.com

Submission Date: 23.01.2025

Accepted Date: 18.02.2025

Published Date: 28.02.2025

DOI: 10.65188/nurexus.1014

article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0), which permits

unrestricted use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

Abstract

Background: Postpartum depression is a significant mental health challenge, particularly among vulnerable women.

Mothers experiencing mood or anxiety disorders may display less favourable interactions with their infants.

Oxytocin, a hormone crucial in childbirth, breastfeeding, and maternal-infant bonding, is also thought to influence

postpartum depression. This neuropeptide is associated with enhanced maternal interactions and could provide

antidepressant and anxiolytic effects, particularly in mothers with mood disorders.

Objective: This study aims to assess oxytocin levels in postpartum women on the first and third days after delivery

and evaluate their mental health.

Methods: The study employed a correlation design to investigate the relationship between oxytocin levels and

postpartum mental health on days 1 and 3 following childbirth. Oxytocin levels were measured using the ELISA

method, while postpartum mental health was assessed using the Edinburgh Postnatal Depression Scale (EPDS). The

study included postpartum mothers who underwent cesarean delivery and had no health complications.

Results: Findings indicated a significant difference in oxytocin levels between days 1 and 3 (p = 0.005). However,

no significant variation was found in maternal mental health across these days (p = 0.775). The analysis revealed a

strong correlation between oxytocin levels and EPDS scores on day 1, while no significant correlation was observed

on day 3.

Conclusion: Differences in oxytocin levels between postpartum days 1 and 3 were noted, though EPDS scores did

not significantly change. A correlation was observed between oxytocin levels and EPDS scores on day 1, but not on

day 3.

Keywords: Postpartum, Maternal Mental Health, Oxytocin, Depression, EPDS

Introduction

Maternal mental health significantly impacts both mothers and newborns. Early screening during

pregnancy and postpartum can facilitate the timely identification and management of perinatal mental

health disorders

[1]. Despite recommendations from multiple health organizations advocating for universal

screening, actual screening rates remain low, often lacking the use of validated assessment tools. Mental

health issues during pregnancy and postpartum can affect physical activity, nutrition, and sleep, thereby

influencing both maternal mood and child development. Proper interventions can help mitigate these effects

[2,3]. The postpartum period offers a unique opportunity for healthcare providers, including nursing

practitioners, to assess both parents' well-being and facilitate early intervention [4,5]. Studies suggest that

postpartum depression affects approximately 10% of mothers, significantly impacting both maternal and

infant health. Hormonal factors, particularly oxytocin levels, may play a crucial role in postpartum

depression [6,7].

ORIGINAL ARTICLE

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Materials and Methods

Study Design

A cross-sectional study was conducted to assess the association between oxytocin levels and postpartum

mental health among mothers during the early postpartum period. Oxytocin levels were considered the

independent variable and were assessed on postpartum days 1 and 3. Postpartum mental health was

considered the dependent variable and was assessed using the Edinburgh Postnatal Depression Scale

(EPDS) on the same days.

Study Setting and Duration

The study was conducted in hospital and clinic settings. The study period and specific study institution

were not specified in the provided study details.

Study Population

The study population consisted of postpartum mothers who had undergone cesarean delivery and were

clinically stable without reported health complications.

Sample Size

A total of 30 postpartum mothers were included in the study.

Inclusion Criteria

• Postpartum mothers who had undergone cesarean delivery.

• Mothers without reported health complications.

• Mothers who met the study eligibility requirements and participated in the assessment on

postpartum days 1 and 3.

Exclusion Criteria

The specific exclusion criteria were not provided in the available study details.

Data Collection Procedure

Data were collected by trained healthcare professionals in hospital and clinic settings. Eligible postpartum

mothers underwent venous blood sampling on postpartum days 1 and 3 for estimation of oxytocin levels.

Blood samples were analyzed using the enzyme-linked immunosorbent assay (ELISA) method.

Postpartum mental health was assessed using the Edinburgh Postnatal Depression Scale (EPDS). The

questionnaire was completed by the mothers before blood collection on the respective assessment days. The

EPDS consists of 10 items assessing symptoms experienced during the preceding week. Each item is scored

from 0 to 3, with the total score used to assess the severity of postpartum depressive symptoms.

Oxytocin levels and EPDS scores obtained on days 1 and 3 were recorded and compared to evaluate

changes during the early postpartum period and to determine the association between oxytocin levels and

postpartum mental health.

Study Variables

The primary independent variable was maternal oxytocin level measured on postpartum days 1 and 3. The

primary dependent variable was postpartum mental health, assessed using the EPDS score on postpartum

days 1 and 3.

Laboratory Assessment

Venous blood samples were collected from eligible postpartum mothers on days 1 and 3 following delivery.

Serum oxytocin levels were estimated using ELISA according to the standard procedure of the assay kit.

Assessment of Postpartum Mental Health

Postpartum mental health was assessed using the Edinburgh Postnatal Depression Scale, a 10-item

structured questionnaire. Each item was scored from 0 to 3 based on the mother's responses. The total

EPDS score was used to quantify postpartum depressive symptoms.

Statistical Analysis

The collected data were entered into a suitable database and analyzed using appropriate statistical methods.

Oxytocin levels on postpartum days 1 and 3 were compared to assess changes over time. The association

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between oxytocin levels and EPDS scores was also evaluated. Appropriate statistical tests were selected

based on the distribution and type of variables. A p-value of less than 0.05 was considered statistically

significant.

Ethical Considerations

The study received ethical approval before commencement, with approval number 074/KEPK-

RSISJS/V/2023. Participation was voluntary, and data collected from the participants were handled

confidentially. The study procedures were performed by trained healthcare professionals, and participants

were assessed according to the approved study protocol.

Results

Table 1: Comparison of Oxytocin Levels on Days 1 and 3

Day

Average Oxytocin Level (pg/ml)

p-value

1

607.87

0.00

3

820.87

The study found significant variations in oxytocin levels between days 1 and 3. On day 1, the average

oxytocin level was 607.87 pg/ml, whereas on day 3, it increased to 820.87 pg/ml. The statistical analysis

indicated a significant difference (p = 0.005), suggesting a physiological shift during the postpartum period.

Figure 1: Oxytocin Level Variation Between Day 1 and Day 3

Oxytocin plays a vital role in maternal adaptation post-delivery, influencing emotional responses, stress

management, and breastfeeding. Its levels can also be affected by the mode of delivery, with oxytocin

infusion during cesarean section increasing hormone levels in maternal serum.

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Figure 2: & 3: Postpartum Mental Health Distribution Day 1 & 3

Figure 4: Oxytocin levels on day 1 and day 3

Postpartum Mental Health Based on EPDS Scores

The study assessed maternal mental health using the EPDS on days 1 and 3 postpartum. The frequency

distribution of responses revealed that most mothers were categorized as “not likely depressed” on day 1,

whereas a higher proportion moved into the “possible depression” category by day 3. However, statistical

analysis indicated no significant difference between EPDS scores on both days (p = 0.775).

Discussion

The findings of the present study align with existing literature suggesting a complex role of oxytocin in

postpartum mental health. Massey et al. [14] reported that higher oxytocin levels were associated with

greater severity of postpartum depressive symptoms among women with a prior history of depression,

indicating that oxytocin’s effects may be modulated by individual psychological vulnerability. Similarly,

Bell et al. [7] highlighted that although oxytocin plays a role in stress regulation and maternal bonding, its

influence on postpartum depression varies depending on personal, biological, and contextual factors.

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In contrast, a systematic review by Thul et al. [11] concluded that there is no consistent or uniform

relationship between oxytocin levels and postpartum depression. The variability in findings across studies

underscores the complexity of oxytocin’s involvement in mood regulation during the postpartum period.

Some evidence suggests that endogenous oxytocin may exert protective effects, whereas exposure to

synthetic oxytocin during labor has been associated with an increased risk of postpartum depressive

symptoms in certain populations, as discussed by Bell et al. [7], Farewell et al. [8], and Buckley et al. [6].

Environmental and psychosocial stressors also appear to play a critical role in postpartum mental health.

Chrzan-Dętkoś et al. [9] demonstrated that external factors, including stress related to the COVID-19

pandemic, had a greater impact on postpartum mental well-being than oxytocin levels alone. These findings

are consistent with observations by Yan et al. [2] and ACOG Committee Opinion et al. [10], which

emphasized the importance of contextual and environmental influences in the development of postpartum

depression.

While the present study identified a significant correlation between oxytocin levels and EPDS scores on

postpartum day 1, the absence of a similar association on day 3 suggests that additional biological,

psychological, and social factors may predominate beyond the immediate postpartum period. This temporal

variation supports conclusions drawn by Cardaillac et al. [13] and Zhu et al. [12], who emphasized that

postpartum depression is a multifactorial condition and cannot be explained by oxytocin dynamics alone.

Strengths of the Study

The study objectively measured oxytocin levels using ELISA and assessed postpartum mental health using

the standardized EPDS. Repeated assessment on postpartum days 1 and 3 allowed evaluation of early

postpartum changes in oxytocin and mental health. Data collection by trained healthcare professionals also

helped maintain consistency in the study procedures.

Limitations of the Study

The small sample size of 30 mothers limits the statistical power and generalizability of the findings. The

cross-sectional design allows identification of associations but does not establish a causal relationship

between oxytocin levels and postpartum mental health. Restriction of the study population to mothers who

underwent cesarean delivery and had no health complications limits the applicability of the findings to

mothers with vaginal deliveries or maternal complications. Assessment was limited to postpartum days 1

and 3, preventing evaluation of longer-term changes in oxytocin levels and postpartum mental health.

Conclusion

This study identified significant changes in oxytocin levels between postpartum days 1 and 3. However,

EPDS scores remained relatively stable across these days. A notable correlation between oxytocin levels

and EPDS scores was observed on day 1 but not on day 3. These findings underscore the complexity of

hormonal influences on postpartum mental health and highlight the need for further investigation into

oxytocin’s role in maternal well-being.

Declaration

Funding: Nil

Acknowledgment: The authors extend their gratitude and to our department.

Conflict of Interest: None declared.

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