Children of Depressed Mothers

这个项目的主要焦点是在受控的实验室环境中测量患有重度抑郁症的母亲的婴儿的应激反应，这是ELS的一种形式。文献中充斥着关于母亲抑郁、焦虑和压力对婴儿健康影响的研究，其中包括32,000对母婴。据报道，与对照组婴儿相比，对患有情感障碍遗传易感性的婴儿进行的研究发现，在实验室任务后，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，很少有研究衡量抑郁母亲的婴儿对受控实验室应激刺激的行为和心理生理功能，也没有这类研究控制母亲的共病焦虑、孕期和/或哺乳期的母体药物、产科事件、早期生活创伤和最近的母体应激生活事件。这项研究旨在通过评估在6个月大时有严重抑郁症病史的母亲的婴儿的行为和皮质醇应激反应来进一步这一重要的研究领域。对孕期和产后精神疾病发病率、共患焦虑、产科并发症、早期生活创伤和母亲应激性生活事件的前瞻性评估将解决这一稀少的日期。 关于调节婴儿反应性的母体因素。研究人群将包括25名没有抑郁症病史的婴儿作为对照，这些婴儿将与三个年龄匹配的队列中的婴儿进行比较：1)在怀孕期间和产后期间接受抗抑郁药物治疗(单一疗法)治疗严重抑郁症的妇女；2)有产前抑郁史的妇女，她们选择不服用抗抑郁药；以及3)有严重抑郁症史的妇女，她们在怀孕期间保持愉悦状态，但没有接触抗抑郁药。这些较后的队列将来自NIH资助的正在进行的研究(性和性别影响专门研究中心，专注于孕期PK/PD建模，并专注于产后抑郁复发的预测因素)。在六个月大时，婴儿将暴露在实验室应激源(噪音爆发、手臂束缚)下，并将评估他们的行为和生理反应(心率变异性、唾液皮质醇)。这些数据的新颖性通过出生前和出生后对可能影响对这些应激源的反应的变量的前瞻性评估而增强。

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.