Like many first-time mothers, Lisette Lopez-Rose thought childbirth would usher in a time of joy. Instead, she experienced panic attacks as she imagined something bad happening to her baby, coupled with a heavy sadness that wouldn’t lift. The San Francisco Bay Area mother recognized that her extreme emotions weren’t normal, but she was afraid to tell her obstetrician. What if they took her baby away?
At about six months postpartum, Lopez-Rose discovered an online network of women with similar experiences and ultimately opened up to her primary care doctor. “About two months after I started medication, I started to feel like I was coming out of a deep hole and seeing light again,” she says.
Today, Lopez-Rose works at Postpartum Support International, coordinating volunteers to help new mothers form online connections.
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### Understanding Postpartum Depression
About one in eight U.S. women go through a period of postpartum depression (PPD), making it one of the most common complications of childbirth. It typically occurs in the first few weeks after delivery, coinciding with a sudden drop in the reproductive hormones estrogen and progesterone.
As scientists unravel the chemical and genetic changes caused by these shifting hormones, they are discovering new ways to diagnose and treat postpartum depression — and even ways to identify who is at risk.
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### A New Era in Postpartum Depression Diagnosis and Treatment
The first-ever drug specifically for postpartum depression, containing a derivative of progesterone, received U.S. Food and Drug Administration (FDA) approval in 2019. This marked a new approach to treating the disorder.
This winter, in another major advance, a San Diego–based startup will launch a blood test called myLuma that predicts a pregnant woman’s risk of postpartum depression with more than 80 percent accuracy. This product will be the first commercially available test to use biomarkers in the blood to predict the onset of a psychiatric disorder, much like blood tests that detect signs of diseases such as cancer and diabetes.
Pregnant women who learn they are at risk for postpartum depression could take preventive steps, such as starting antidepressants after childbirth or arranging for extra support.
Jennifer Payne, a reproductive psychiatrist at the University of Virginia and a lead investigator on the studies behind myLuma, says, “If we have a blood test, it brings psychiatry down to the level of biology, which I think your average person can understand as something that needs treatment and isn’t just in somebody’s head.”
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### The Unpredictable Effects of Hormones
In 2001, Payne became intrigued by postpartum depression as a window into the onset of mood disorders. This raised a key question: Why does the sudden drop in hormones after childbirth significantly affect some women but not others?
While transient feelings of anxiety and sadness are common within days of giving birth, only some women develop a deeper, more persistent depression.
Payne teamed up with Zachary Kaminsky, an epigeneticist then at Johns Hopkins University, who studied how estrogen affects mouse brains. Epigenetics involves small chemical groups called methyl groups attaching to genes, affecting how active these genes are. Environmental factors like pollution and nutrition can influence this reversible methylation.
By comparing female mice given high estrogen levels to those without, Kaminsky found estrogen caused specific gene methylation patterns in the hippocampus—a brain region involved in mood control.
These findings guided analyses of blood samples Payne collected from 51 women with histories of mood disorders, tracked throughout pregnancy and afterward. Two estrogen-sensitive genes — HP1BP3 and TTC9B — emerged as significant. Over 80 percent of women who developed postpartum depression showed greater methylation on one gene and less on the other.
Moreover, these gene changes were detectable throughout pregnancy, meaning “you can predict which women will develop postpartum depression,” Kaminsky says.
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### Validating the Biomarkers
Kaminsky, Payne, and collaborators replicated the findings in further studies. A 2016 Neuropharmacology paper reported that methylation patterns of these genes correctly predicted over 80 percent of postpartum depression cases in 240 pregnant women without psychiatric histories.
Another 2020 study published in Psychiatry Research, involving scientists from Johns Hopkins, Emory University, and the University of California, Irvine, confirmed these results in 285 pregnant women.
This epigenetic research forms the basis of the myLuma test, which also incorporates additional biomarkers to improve accuracy, according to Kaminsky.
Beginning January 2026, myLuma is expected to be available in some doctors’ offices in Florida, Texas, and California. Although not yet FDA-approved, doctors may use such lab tests to assist clinical decisions.
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### Exploring Other Hormonal Factors: Neuroactive Steroids
Not all postpartum depression cases involve these epigenetic changes. Researchers continue to explore other biomarkers, focusing on neuroactive steroids — molecules produced from progesterone in the brain and other tissues.
One key neuroactive steroid, allopregnanolone, has calming effects by affecting a brain receptor called GABA-A, known for stress reduction. Allopregnanolone levels rise during pregnancy and drop sharply after delivery.
Other related steroids include pregnanolone, which has similar effects, and isoallopregnanolone, which reduces the antidepressant effect of allopregnanolone, increasing stress.
A 2025 study in Neuropsychopharmacology on 136 pregnant women found that an imbalance of pregnanolone and isoallopregnanolone during pregnancy increased the likelihood of developing postpartum depression.
Measuring these chemicals’ ratios in blood could provide another way to predict postpartum depression, says reproductive psychiatrist Lauren M. Osborne of Weill Cornell Medicine.
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### Advances in Treatment: Synthetic Neuroactive Steroids
Allopregnanolone has also proven valuable in treating postpartum depression. A synthetic form, brexanolone, developed by Sage Therapeutics, was FDA-approved in 2019, becoming the first drug specifically for postpartum depression.
These “transformative therapies” work rapidly, according to a 2025 Annual Review of Medicine article.
Women at high risk might benefit from preventive use of zuranolone, another drug under study, though this has not yet been tested, notes Samantha Meltzer-Brody, a reproductive psychiatrist at the University of North Carolina.
The availability of blood tests like myLuma “opens up that entire line of questioning on how do you get ahead of it, so you don’t have to wait until someone starts suffering,” she adds.
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### Additional Biomarker Research
In a 2022 Molecular Psychiatry article, neuroscientist Sarven Sabunciyan and colleagues described a study showing that RNA types carried in blood differ in women who develop postpartum depression. Specifically, RNA related to autophagy — the cellular cleanup process — decreased. Autophagy has links to other psychiatric disorders.
Clinical psychologist Eynav Accortt from Cedars-Sinai Medical Center found altered protein patterns in plasma samples from women with perinatal mood and anxiety disorders, including postpartum depression. These proteins are involved in neuron function and inflammation, which is known to contribute to depression.
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### Moving Towards FDA Approval
Payne is leading a large clinical trial to provide more detailed data on myLuma, particularly regarding false positives (women identified as at risk who don’t develop postpartum depression) and false negatives (women who develop postpartum depression but weren’t identified).
This step is essential for FDA approval, which would eventually allow the test to be offered directly to pregnant women.
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### Looking Back: A Mother’s Perspective
Lopez-Rose recalls the fear she felt in the months after her daughter’s birth. In those dark times, she quit her job, barely slept, and was overwhelmed by negative thoughts and self-doubt.
Now, she understands that reaching out for help was a sign of strength and a good mother.
Today, her daughter is four and thriving, as is Lopez-Rose. She says a blood test would have warned her what to watch for, “instead of it being so shocking when I was going through my depression.”
https://www.livescience.com/health/fertility-pregnancy-birth/new-blood-test-can-predict-risk-of-postpartum-depression-with-more-than-80-percent-accuracy
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