Maternal antidepressant use and fetal neurobehavior

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DESCRIPTION (provided by applicant): The overall goal of the proposed research career development program is to prepare the investigator, Dr. Amy Salisbury, for a career as an independent investigator in the areas of fetal behavioral development and maternal mental health. The investigator's focus in these areas represents a strong aspiration to understand the mechanisms and mediators in the development of childhood mental illness. As a first step in achieving the long-term goals, Dr. Salisbury will study fetal and newborn neurobehavior in women with Major Depressive Disorder (MDD), diagnosed by structured interview, with and without antidepressant (S SRI) exposure. This study will be executed with intensive training in methodologies with at-risk fetuses and newborns (Dr. Barry Lester), fetal monitoring techniques (Dr. Janet DiPietro), structured interview techniques (SCID, SADS) and ongoing didactic training and clinical supervision with top experts in the field of mood disorders and medication management in women (Dr. Katherine Wisner and Dr. Teri Pearistein), and maternal-fetal medicine (Dr. Stephen Carr). Dr. Lester will serve as the primary mentor of this program and resource provider throughout the award period. Additional skills will be attained through coursework on research design and regression analyses at Brown University as well as advanced obstetric ultrasound training. The proposed program of career development will build on Dr. Salisbury's established research and clinical skills in fetal and newborn behavior. The investigator has the full support of the Brown Medical School, Women & Infants' Hospital, and her sponsors to achieve the goals outlined in this career development program. The broad, long-term objective of the research plan is to determine if there are differential effects of SSRI exposure and MDD on fetal and newborn neurobehavioral development. The data will provide information about how the fetal CNS responds to the two maternal biological environments as well as contribute to the urgently needed information for treatment guidelines of mood disorders during pregnancy. The specific aims of the proposed research plan are 1. To determine the effect of maternal S SRI-treated MDD (euthymic) versus nonSSRI exposed active MDD on fetal neurobehavior and controls, 2. To determine the effect of maternal S SRI-treated MDD versus non-SSRI exposed active MDD on newborn neurobehavior and controls. A secondary aim of this study is to examine the stability of the individual differences of neurobehavioral measures from the fetal to newborn period.