Abstract：
BACKGROUND: Allopregnanolone (ALLO) is a metabolite of progesterone and a neuroactive steroid hormone. As a positive allosteric modulator of gamma-aminobutyric acid (GABA) receptors, ALLO seems to have antidepressant and anxiolytic effects, and was therefore approved as a specific medication for the treatment of postpartum depression in 2019. Despite the growing number of publications investigating ALLO levels, results on the biological and psychological correlates in the peripartum period remain inconsistent, possibly due to methodological challenges regarding measurement. To date, however, there is no systematic review examining the correlates, concentrations, and challenges in measuring ALLO in peripartum women.
METHODS: A systematic literature search of PubMed and PsycINFO was conducted in August 2023. Original research articles that measured ALLO concentrations in peripartum women were included. Reports were excluded if they were not original research, included non-human subjects, did not include peripartum women, did not include ALLO measurement as an outcome, included (pharmacological) interventions, constituted method validations, or used the same cohort as another study.
RESULTS: The literature search yielded 234 articles, and two articles were identified from other sources. After full-text screening, 19 articles (N = 1401) met the inclusion criteria, of which seven focused on biological correlates of ALLO and 12 on mood correlates. Of the latter, six found no association between ALLO and mood, four found a negative association, and two found a positive association. Overall, the results show an increase in ALLO levels during pregnancy and a decrease after birth, with levels then remaining low until six months postpartum. ALLO was most commonly measured in blood plasma and by gas chromatography-mass spectrometry (GC-MS). A significant matrix effect was found for blood serum and a significant method effect for radioimmunoassays (RIAs). A significant effect of time of measurement was found.
CONCLUSIONS: ALLO measurement shows method and matrix effects. ALLO levels are higher when measured in serum compared to in plasma, and when measured using RIA compared to other methods. Time of measurement, study design, and standardization of measurement also influence the reliability of measurement and the interpretation of results.
METHODS: A systematic literature search of PubMed and PsycINFO was conducted in August 2023. Original research articles that measured ALLO concentrations in peripartum women were included. Reports were excluded if they were not original research, included non-human subjects, did not include peripartum women, did not include ALLO measurement as an outcome, included (pharmacological) interventions, constituted method validations, or used the same cohort as another study.
RESULTS: The literature search yielded 234 articles, and two articles were identified from other sources. After full-text screening, 19 articles (N = 1401) met the inclusion criteria, of which seven focused on biological correlates of ALLO and 12 on mood correlates. Of the latter, six found no association between ALLO and mood, four found a negative association, and two found a positive association. Overall, the results show an increase in ALLO levels during pregnancy and a decrease after birth, with levels then remaining low until six months postpartum. ALLO was most commonly measured in blood plasma and by gas chromatography-mass spectrometry (GC-MS). A significant matrix effect was found for blood serum and a significant method effect for radioimmunoassays (RIAs). A significant effect of time of measurement was found.
CONCLUSIONS: ALLO measurement shows method and matrix effects. ALLO levels are higher when measured in serum compared to in plasma, and when measured using RIA compared to other methods. Time of measurement, study design, and standardization of measurement also influence the reliability of measurement and the interpretation of results.
摘要：
背景：别孕烯醇酮（ALLO）是孕酮的代谢产物和一种神经活性类固醇激素。作为γ-氨基丁酸（GABA）受体的正变构调节剂，ALLO似乎有抗抑郁和抗焦虑作用，因此在2019年被批准为治疗产后抑郁症的特定药物。尽管调查ALLO水平的出版物越来越多，围产期生物和心理相关的结果仍然不一致，可能是由于有关测量的方法论挑战。迄今为止,然而,没有系统的审查来检查相关因素，浓度,以及测量围产期妇女ALLO的挑战。
方法：于2023年8月对PubMed和PsycINFO进行了系统的文献检索。包括测量围产期妇女ALLO浓度的原始研究文章。如果不是原始研究，报告将被排除在外，包括非人类受试者，不包括围产期妇女，不包括ALLO测量作为结果，包括（药理）干预措施，构成的方法验证，或使用与另一项研究相同的队列。
结果：文献检索产生了234篇文章，两篇文章是从其他来源识别出来的。经过全文筛选,19篇文章(N=1401)符合入选标准，其中7个侧重于ALLO的生物学相关性，12个侧重于情绪相关性。在后者中，六个人发现ALLO和情绪之间没有关联，四个人发现了负关联，两个人发现了正相关。总的来说,结果显示，怀孕期间ALLO水平升高，出生后下降，然后保持低水平，直到产后六个月。ALLO最常用于血浆和气相色谱-质谱(GC-MS)测定。对于血清发现了显着的基质效应，对于放射免疫测定（RIA）发现了显着的方法效应。发现测量时间的显著影响。
结论：ALLO测量显示方法和基质效应。与血浆相比，血清中的ALLO水平更高，与其他方法相比，使用RIA进行测量。测量时间,研究设计，测量的标准化也影响测量的可靠性和结果的解释。
方法：于2023年8月对PubMed和PsycINFO进行了系统的文献检索。包括测量围产期妇女ALLO浓度的原始研究文章。如果不是原始研究，报告将被排除在外，包括非人类受试者，不包括围产期妇女，不包括ALLO测量作为结果，包括（药理）干预措施，构成的方法验证，或使用与另一项研究相同的队列。
结果：文献检索产生了234篇文章，两篇文章是从其他来源识别出来的。经过全文筛选,19篇文章(N=1401)符合入选标准，其中7个侧重于ALLO的生物学相关性，12个侧重于情绪相关性。在后者中，六个人发现ALLO和情绪之间没有关联，四个人发现了负关联，两个人发现了正相关。总的来说,结果显示，怀孕期间ALLO水平升高，出生后下降，然后保持低水平，直到产后六个月。ALLO最常用于血浆和气相色谱-质谱(GC-MS)测定。对于血清发现了显着的基质效应，对于放射免疫测定（RIA）发现了显着的方法效应。发现测量时间的显著影响。
结论：ALLO测量显示方法和基质效应。与血浆相比，血清中的ALLO水平更高，与其他方法相比，使用RIA进行测量。测量时间,研究设计，测量的标准化也影响测量的可靠性和结果的解释。
