Children of Depressed Mothers

这个项目的主要重点是在受控的实验室环境中测量患有严重抑郁症（ELS的一种形式）的母亲的婴儿的应激反应。关于母亲抑郁、焦虑和压力对婴儿健康的影响的研究文献很多，其中包括超过32，000对母婴。研究表明，与对照组婴儿相比，具有情感障碍遗传易感性的婴儿在完成实验室任务后，迷走神经张力较低，唾液皮质醇浓度较高。他们的被动或无反应行为与他们对压力的超敏感生理反应之间似乎存在不匹配。值得注意的是，有几个调查，已测量的行为和心理生理功能的婴儿抑郁症的母亲在控制实验室压力刺激，没有这种类型的研究控制了母亲共病焦虑，母亲在怀孕和/或哺乳期，产科事件，早期生活创伤和最近的母亲压力生活事件的药物。本研究旨在通过评估有重度抑郁症病史的女性婴儿在6个月大时的行为和皮质醇应激反应来进一步推进这一重要的研究领域。对妊娠期和产后期精神病发病率、共病焦虑、产科并发症、早期生活创伤和母亲压力性生活事件的前瞻性评估将解决稀疏的数据 关于母体因素介导婴儿反应性。研究人群将包括25名无抑郁症病史的妇女的婴儿作为对照，将其与来自三个年龄匹配的队列的婴儿进行比较; 1）接受抗抑郁治疗的妇女（单一疗法）用于妊娠期和产后期的重度抑郁症; 2）有产前抑郁症史的妇女，她们选择不服用抗抑郁药; 3）有重度抑郁症病史的妇女，在妊娠期间没有抗抑郁药暴露，但仍保持正常的情绪。这些后续队列将来自正在进行的NIH资助的研究（性别和性别效应专门研究中心，重点关注妊娠期PK/PD建模，并关注产后抑郁复发的预测因素）。在6个月大时，婴儿将暴露于实验室应激源（噪声爆发、手臂约束），并评估其行为和生理反应（心率变异性、唾液皮质醇）。这些数据的新奇得到增强的产前和产后的前瞻性评估的变量，可能会影响对这些压力的反应。

The primary focus of this project is to measure stress reactivity in infants of mothers' with major depression, a form of ELS, in a controlled laboratory setting. The literature is replete with studies of the effects of maternal depression, anxiety, and stress on infant well-being that includes >32,000 mother-infant pairs. Studies in infants with genetic vulnerability for affective disorders have been reported to have lower vagal tone, as well as higher salivary cortisol concentrations following lab tasks, when compared with control infants. There appears to be a mismatch between their passive or nonreactive behaviors, and their supersensitive physiological responses to stress. Remarkably, there are few investigations that have measured behavioral and psychophysiological functioning of infants of depressed mothers in response to controlled laboratory stress stimuli, and no study of this type has controlled for maternal co-morbid anxiety, maternal medications in pregnancy and/or lactation, obstetrical events, early life trauma and recent maternal stressful life events. This study is designed to further this important area of research by assessing behavioral and cortisol stress reactivity of infants of women with a history of major depression at six months of age. The prospective assessment of psychiatric morbidity during pregnancy and the postpartum period, comorbid anxiety, obstetric complications,early life trauma and maternal stressful life events will address the sparse date regarding maternal factors mediating infant reactivity. The study population will include 25 infants of women with no history of depression to serve as controls, that will be compared to infants from three age matched cohorts; 1) Women undergoing antidepressant treatment (monotherapy) for major depression during pregnancy and the postpartum period; 2) Women with a history of prenatal depression who choose not to take antidepressants; and 3) Women with a history of major depression who remain euthymic during pregnancy without antidepressant exposure. These later cohorts will be derived from ongoing NIH-funded investigations (Specialized Center of Research on Sex and Gender Effects focusing on PK/PD Modeling in Pregnancy and focusing on predictors of relapse of Depression during the Postpartum). At six months of age the infants will be exposed to laboratory stressors (noise burst, arm restraint), and their behavioral and physiological reactivity (heart rate variability, salivary cortisol) will be assessed. The novelty of these data is enhanced by the pre-natal and postnatal prospective assessment of variables that could influence response to these stressors.