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Impact of treating perinatal depression on infant HPA axis function

治疗围产期抑郁症对婴儿HPA轴功能的影响

基本信息

批准号：
10006021
负责人：
Joanna Maselko
金额：
$ 7.78万
依托单位：
UNIV OF NORTH CAROLINA CHAPEL HILL
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-09-01 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10006021
关键词：
Address Adrenal Glands Adrenal hormone preparation Age-Months Behavioral Biological Biological Markers Brain Child Child Development Child Health Child Rearing Chronic stress Cognitive Cognitive Therapy Data Data Set Depressed mood Development Distress Early Intervention Enrollment Environment Evaluation Exposure to Future Goals Hair Health Home environment Hormones Hydrocortisone Hypothalamic structure Infant Intervention Intervention Trial Interview Knowledge Life Life Cycle Stages Light Link Literature Measurable Measures Mental Health Mental disorders Mission Mothers National Institute of Child Health and Human Development Outcome Output Pakistan Pituitary Gland Postpartum Period Pregnancy Pregnant Women Psyche structure Public Health Randomized Research Research Priority Risk Role Sampling Studies Shapes Stress Surveys System Thinking Third Pregnancy Trimester Variant Woman arm base caregiving comparison group control trial dehydroepiandrosterone design health disparity health of the mother high risk population hypothalamic-pituitary-adrenal axis improved indexing insight interest intergenerational maternal depression maternal stress novel novel marker offspring peer peripartum depression prenatal programs public health priorities randomized trial recruit response sociodemographic factors stem transmission process treatment arm

项目摘要

ABSTRACT Globally, about 20% of children are exposed to maternal depression in the first years of life, increasing risk for poor physical and developmental outcomes over the life course. Identifying interventions that can mitigate the negative consequences of maternal depression on children is key to reducing health disparities and is therefore a major public health priority. However, measurable impacts on child development may not emerge immediately after an intervention and so there is a great need to identify interim indicators of effect. Such indicators would provide early information about the intervention’s causal impact, as well as point to the biological mechanism through which these interventions shape future child development. The HPA axis is a robust marker of biological responses to stress, and there is growing evidence linking HPA axis biomarkers to both maternal depression and infant brain development. Using a cluster Randomized Control Trial in Pakistan, this study leverages novel hair-derived biomarker data (cortisol and DHEA), from 104 mother-infant dyads, to determine if treating maternal depression can alter infant HPA axis function, and to examine to what extent infant HPA axis function predicts future development outcomes. The trial’s intervention is a peer-delivered version of the Thinking Healthy Programme provided to women identified as depressed in their 3rd trimester. The study sample also includes a subset of women who were not depressed during pregnancy, as a low-risk comparison group. The mother-child dyads are being followed through 36 months post-partum, and the resulting dataset is rich with data related to mothers’ health, sociodemographic factors, parenting, and child development from 3 to 36 months post-partum. The randomized design allows us to assess the intervention’s causal effects on infant cortisol and DHEA. The main outcomes of interest are child cognitive and socioemotional development indicators at 36 months of age. The specific aims of this project are to (1) evaluate the impact of a perinatal depression intervention on infant cortisol in hair; (2) examine whether infant cortisol at 12 months predicts child development at 24 and 36 months; and (3) examine the impact of the intervention on DHEA levels in infants and the link between infant DHEA at 12 months and child developmental outcomes at 24 and 36 months. The results from this study will improve our understanding of the role of maternal mental health in child development as well as help identify important indicators to improve early intervention evaluation.

摘要