Postpartum Depressive Symptoms: A Search for a Biologic Marker

描述（由申请人提供）：这项研究计划是一个机会，我实现我的短期和长期目标。目前，我在伊利诺伊大学博士课程的第二年，我的长期目标包括提高我的研究技能，为我作为护士研究员和教育工作者的职业生涯奠定基础。我的论文研究计划的主要目的是研究神经内分泌机制（催产素和皮质醇）和生理过程（产后抑郁症状）之间的关系，在新生儿重症监护室照顾的极低出生体重婴儿的妇女。产后抑郁症状影响10-50%的母亲，并导致母亲和婴儿的不良后果。促成因素（如生物和心理因素，健康行为和压力）通过神经内分泌机制（皮质醇和催产素）的介导影响产后抑郁症状。皮质醇是一种在压力事件中释放的激素，它与抑郁症的关系有相互矛盾的结果。另一个引发母性行为的神经内分泌机制是催产素，它在分娩、母乳喂养和触摸时释放。催产素会受到情绪、焦虑和疼痛的抑制。催产素从未被用于产后抑郁症的研究，这是我们目前对这种情况的认识的一个空白。皮质醇和催产素是平衡激素，将从相同的标本中测量。许多研究人员（包括我自己）推测催产素和皮质醇与产后抑郁症状有关。我的研究将是由Diane Holditch-Davis（R 01 NR 009418）进行并由美国国立卫生研究院资助的主要研究的一部分。我的研究将采用探索性横断面设计，采用多元和可能的逻辑回归来检验上述目的。这项研究的工具和程序包括唾液分析（催产素和皮质醇），流行病学研究中心抑郁量表（产后抑郁症状），父母压力量表（压力），以及评估生物和心理因素和健康行为的问卷调查。将在入组主要研究时收集数据。从这项拟议的研究中获得的知识将进一步描述与产后抑郁症状的社会和生物关系。一旦建立了这些关系，一个潜在的生物标志物（例如，催产素和皮质醇）可以用作产后抑郁症的诊断程序。这将使高达50%的患有这种疾病的母亲受益，而这些母亲目前尚未被诊断出来。

DESCRIPTION (provided by applicant): This research proposal is an opportunity for me to achieve my short and long-term objectives. Currently, I am in my second year of the doctoral program at the University of Illinois and my long-term objectives include furthering my research skills to lay the foundation for my career as a nurse researcher and educator. The primary aim of my dissertation research proposal is to examine the relationships among neuroendocrine mechanisms (oxytocin and cortisol) and a physiological process (post part urn depressive symptoms) in women with very low birth weight infants who are cared for in the Neonatal Intensive Care Unit. Postpartum depressive symptoms affect 10-50% of mothers and causing mothers and infants adverse outcomes. Contributing factors (such as biologic and psychologic factors, health behaviors, and stress) affect postpartum depressive symptoms through the mediation of neuroendocrine mechanisms (cortisol and oxytocin). Cortisol is the hormone that is released during stressful events and has conflicting results on its relationship with depression. Another neuroendocrine mechanism that initiates mothering behavior is oxytocin, which is released during labor, breastfeeding, and touch. Oxytocin is inhibited by emotion, anxiety, and pain. Oxytocin has never been examined with postpartum depression and this is a gap in our current knowledge of this condition. Cortisol and oxytocin are balancing hormones and will be measured from the same specimens. Many researchers (including myself) speculate that oxytocin and cortisol will have a relationship with postpartum depressive symptoms. My study will be part of a primary study conducted by Diane Holditch-Davis, R01 NR009418, and funded by the National Institutes of Health. My study will use an exploratory cross sectional design with multiple and possible logistic regression to examine the aim stated above. Instruments and procedures for this research include salivary assays (for oxytocin and cortisol), the Center for Epidemiologic Studies Depression Scale (for postpartum depressive symptoms), Parental Stressor Scales (for stress), and questionnaires to assess biologic and psychologic factors and health behaviors. Data will be collected at enrollment into the primary study. The knowledge gained from this proposed research will further describe social and biological relationships with postpartum depressive symptoms. Once these relationships are established, a potential biologic marker (for example, oxytocin and cortisol) can be used as a diagnostic procedure for postnatal depression. This will benefit up to 50% of mothers with this condition that are not currently diagnosed.