Reducing maternal prenatal depression to improve child cardiovascular health

减少母亲产前抑郁症，改善儿童心血管健康

• 批准号: 10548740
• 负责人: Elysia Poggi Davis
• 金额: $ 67.58万
• 依托单位: UNIVERSITY OF DENVER (COLORADO SEMINARY)
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-15 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10548740
• 关键词: Address; Adult; Age; American Heart Association; Arterial Fatty Streak; Barker Hypothesis; Behavior; Birth; Blood Pressure; Body fat; Body mass index; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Child; Child Behavior; Child Mental Health; Childhood; Clinical Trials; Cognitive; Data; Deposition; Development; Diabetes Mellitus; Diet; Eating; Eating Behavior; Emotional; Epidemiology; Epigenetic Process; Exposure to; Fatty acid glycerol esters; Feeding behaviors; Feeds; Food; Gestational Age; Goals; Health; Health Promotion; Health behavior; Hypertension; Immune; Impairment; Informal Social Control; Intervention; Knowledge; Life; Longevity; Longitudinal Studies; Low Birth Weight Infant; Low income; Maternal Behavior; Mediating; Mediator; Metabolic; Modeling; Mothers; Neurosecretory Systems; Nursery Schools; Obesity; Organizational Policy; Outcome; Participant; Pathway interactions; Physical activity; Physiological; Physiology; Pregnant Women; Premature Birth; Prevalence; Prevention; Randomized, Controlled Trials; Recommendation; Research; Risk; Risk Factors; Sampling; Signal Transduction; Sleep; Stress; System; Testing; Time; Work; adverse birth outcomes; antepartum depression; arterial stiffness; associated symptom; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; depressive symptoms; dietary; early childhood; effective intervention; efficacious intervention; emotion regulation; emotional functioning; endothelial dysfunction; ethnic diversity; follow-up; food quality; improved; insulin sensitivity; intrauterine environment; longitudinal design; maternal depression; next generation; obesity in children; obesogenic; offspring; postnatal; preference; prenatal; prenatal intervention; protective factors; psychosocial; racial diversity; rapid infant weight gain; reduce symptoms; sedentary lifestyle; symptomatic improvement; trial design; waist circumference

PROJECT SUMMARY/ABSTRACT It is critical to understand risk and protective factors for health to optimize developmental outcomes and inform prevention of poor health behaviors across the lifespan. Research using longitudinal designs, multiple levels of analysis, and experimental clinical trials are needed. Cardiovascular disease (CVD) is the leading cause of death worldwide. The origins of adult CVD begin prenatally: High prenatal maternal depressive symptoms robustly predict offspring CVD risk. However, knowledge on risk and protective factors for CVD for offspring of mothers with high depressive symptoms has been correlational. There is a lack of experimental work using a randomized controlled trial (RCT) design to understand potential mechanisms that contribute to children's CVD risk following exposure to high maternal prenatal depressive symptoms across multiple levels (e.g., maternal and child behaviors, physiology) over time. Although efficacious interventions to diminish depressive symptoms among pregnant women exist, research has not investigated whether reducing prenatal maternal depressive symptoms can reduce offspring cardiovascular risk. The current study proposes to leverage a RCT of an effective psychosocial intervention for prenatal maternal depression to test whether reducing prenatal maternal depressive symptoms improves offspring cardiovascular health at ages 3-4 years. We hypothesize that the prenatal intervention operates by reducing both prenatal and postnatal depressive symptoms to improve child outcomes. This study will identify intervention targets for offspring of mothers with high prenatal depressive symptoms to reduce cardiovascular risk. These goals will be accomplished by building on a RCT (R01MH109662) of an established psychosocial intervention that effectively reduces maternal prenatal depressive symptoms. We propose to leverage this unique opportunity to follow up mothers and children who participated in this RCT to test whether this intervention improves offspring cardiovascular health. This project increases rigor of the existing correlational research by using an experimental RCT design. The following 3 aims will be addressed. Aim 1: To test whether reducing prenatal maternal depressive symptoms improves the quality of food the mother feeds her child, maternal feeding behaviors, and modeling of eating behaviors at 3 years. Aim 2: To test whether reducing prenatal maternal depressive symptoms improves child diet, eating behaviors, sleep, and physical activity at 3 years. Aim 3: To test whether reducing prenatal maternal depressive symptoms reduces child CVD risk at 3 and 4 years, including BMI, waist circumference, body fat, blood pressure, and arterial stiffness. This project will provide the strongest evidence to date for a mechanistic model of prenatal maternal depressive symptoms' influence on child cardiovascular health. Importantly, the project will also provide evidence for whether effective psychosocial interventions to reduce prenatal maternal depressive symptoms should be used to reduce the burden of CVD in the next generation.

项目概要/摘要 了解健康的风险和保护因素对于优化发育结果并提供信息至关重要 在整个生命周期中预防不良健康行为。使用纵向设计、多层次的研究 需要进行分析和实验性临床试验。心血管疾病（CVD）是导致这些疾病的主要原因 全世界的死亡。成人心血管疾病的起源始于产前：产前母亲抑郁症状高 稳健地预测后代 CVD 风险。然而，关于后代CVD风险和保护因素的知识 母亲患有高度抑郁症状是相关的。缺乏使用的实验工作 随机对照试验 (RCT) 设计旨在了解导致儿童 CVD 的潜在机制 暴露于多个层面的高产前抑郁症状（例如，产妇 以及儿童行为、生理）随着时间的推移。尽管有效的干预措施可以减少抑郁症状 孕妇中存在这种情况，但尚未有研究调查是否可以减少产前孕产妇抑郁 症状可以降低后代心血管风险。目前的研究建议利用随机对照试验 有效的心理社会干预对产前孕产妇抑郁的影响 检验是否可以减少产前孕产妇抑郁 抑郁症状可改善 3-4 岁时后代的心血管健康。我们假设 产前干预通过减少产前和产后抑郁症状来改善儿童 结果。这项研究将确定针对产前抑郁症母亲的后代的干预目标 症状以降低心血管风险。这些目标将通过 RCT 的基础上实现 （R01MH109662）已建立的心理社会干预措施，可有效减少产妇产前 抑郁症状。我们建议利用这个独特的机会来跟踪那些 参加了这项随机对照试验，以测试这种干预措施是否可以改善后代心血管健康。这个项目 通过使用实验性 RCT 设计，提高了现有相关研究的严谨性。以下3个 将解决目标。目标 1：测试减少产前母亲抑郁症状是否可以改善产前母亲抑郁症状 母亲喂养孩子的食物质量、母亲喂养行为以及 3 岁时的饮食行为模型 年。目标 2：测试减少产前母亲抑郁症状是否可以改善儿童饮食、饮食 3岁时的行为、睡眠和体力活动。目标 3：测试是否可以减少产前孕产妇 抑郁症状可降低儿童 3 岁和 4 岁时的 CVD 风险，包括 BMI、腰围、体脂、 血压和动脉硬化。该项目将为机械论提供迄今为止最有力的证据 产前母亲抑郁症状对儿童心血管健康的影响模型重要的是， 项目还将提供证据，证明有效的社会心理干预措施是否可以减少产前孕产妇的死亡率。 应该利用抑郁症状来减轻下一代CVD的负担。