Postpartum depression (PPD) affects 10-15% of mothers. Even when treated, PPD is associated with impaired development of the mother-infant dyad, leading to intergenerational transmission of psychiatric disease. The neuroendocrine mechanisms underlying PPD and impaired dyadic development remain to be determined. The long-term goal of this research is to identify mother-infant dyads at risk of PPD in order to implement targeted interventions to address their personal behavioral and neuroendocrine vulnerabilities, thereby improving the health of mother and child. The objective here is to define the neuroendocrine mechanisms underlying PPD and impaired dyadic development, indexed by failed lactation, reduced maternal sensitivity, and impaired infant emotional regulation. The central hypothesis is that both PPD and impaired dyadic development arise from shared neuroendocrine pathways. This hypothesis has been formulated based on preliminary data showing diminished oxytocin release, elevated cortisol, and more negative affect during feeding among women with anxiety and depression symptoms. The rationale for this work is that once the underlying neuroendocrine mechanisms of PPD and impaired dyadic development are identified, targeted therapies can be implemented to prevent or diminish maternal PPD and its sequellae, thereby mitigating the transmission of psychiatric illness to offspring. Guided by strong preliminary data, the central hypothesis will be tested by pursuing three specific aims: 1. Measure the effect of maternal depression/anxiety on maternal physiology and behavior during infant feeding, infant interaction, and standardized laboratory stressors; 2. Quantify the effect of maternal depression/anxiety on infant physiology and behavior during feeding, mother-infant interaction, and attachment quality. 3. Determine the extent to which maternal and infant neuroendocrine physiology mediates associations between depressed mood and infant emotional regulation, maternal sensitivity, and breastfeeding, as well as insecure attachment at 12 months postpartum. These aims will be achieved through a longitudinal cohort study of 200 mother-infant dyads spanning late pregnancy through 12 months postpartum, half with a history of depression and/or anxiety and half with no psychiatric history, confirmed by diagnostic interview. Mother-infant dyads will be assessed during visits to the Mother-Infant Biobehavioral Lab. The approach is innovative, because this project will quantify dynamic intersections among maternal and infant neuroendocrine physiology, emotional regulation, feeding, and caregiving, thereby shedding light on both maternal mental health and infant emotional development. The proposed research is significant, because it is expected to identify targets for prevention and treatment of perinatal depression and impaired dyadic development. Ultimately, such knowledge has the potential to mitigate perinatal transmission of psychiatric disease to offspring.
|Effective start/end date||4/1/13 → 3/31/18|
- NIH National Institute of Child Health and Human Development (NICHD)