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World J Psychiatry. Sep 19, 2026; 16(9): 118509
Published online Sep 19, 2026. doi: 10.5498/wjp.118509
Published online Sep 19, 2026. doi: 10.5498/wjp.118509
Letter to the Editor: Re-evaluating fixed thyroid thresholds in postpartum depression risk stratification
Huan Zhang, Department of Obstetrics and Gynecology, Jianhu County People’s Hospital, Yancheng 224700, Jiangsu Province, China
Sheng-Mei Lu, Miao-Miao Deng, Na Dong, Department of Neurology, Jianhu County People’s Hospital, Yancheng 224700, Jiangsu Province, China
Kang-Kang Ji, College of Biomedicine and Health, Huazhong Agricultural University, Wuhan 430070, Hubei Province, China
Co-corresponding authors: Na Dong and Kang-Kang Ji.
Author contributions: Ji KK and Dong N conceived the theme of this letter; Zhang H completed the drafting with the assistance of Lu S and Deng M; Ji KK and Zhang H made significant contributions in gathering expert opinions. All authors have read and approved the final manuscript. Both Ji KK and Dong N are designated as co-corresponding authors due to their distinct and essential contributions. Ji KK conceived the study's theme, coordinated expert consultations, and provided senior oversight from an academic institution. Dong N, as the clinical lead, conceived the theme, supervised the neurological perspective, and ensured the manuscript’s clinical relevance and accuracy. Their combined expertise- Ji KK’s in biomedical research and Dong N’s in clinical neurology-was indispensable for developing this interdisciplinary critique on thyroid function in postpartum depression.
Conflict-of-interest statement: No conflict-of-interest to declare.
Corresponding author: Kang-Kang Ji, PhD, College of Biomedicine and Health, Huazhong Agricultural University, No. 1 Shizishan Street, Wuhan 430070, Hubei Province, China.
Received: January 4, 2026
Revised: February 12, 2026
Accepted: March 31, 2026
Published online: September 19, 2026
Processing time: 229 Days and 13.8 Hours
Revised: February 12, 2026
Accepted: March 31, 2026
Published online: September 19, 2026
Processing time: 229 Days and 13.8 Hours
Core Tip
Core Tip: Chen et al identified thyroid-stimulating hormone ≥ 3 mIU/L and thyroid peroxidase antibody ≥ 7 U/mL as independent predictors for adverse pregnancy outcomes (APOs) in postpartum depression (PPD). While this underscores the thyroid-PPD link, reliance on universal, fixed thresholds is problematic. Pregnancy induces profound, individualized thyroid physiological changes, making static cut-offs potentially misleading for risk stratification. Future research must prioritize trimester-specific reference ranges and longitudinal biomarker profiling to capture dynamic thyroid-autoimmune interactions and refine personalized prediction models for PPD and APOs.