Evaluating the Effects of Stress in Pregnancy

November 19, 2013 updated by: Michael J. Owens, Emory University

Perinatal Stress and Gene Influences: Pathways to Infant Vulnerability

This study will evaluate pregnant women with a past or current diagnosis of depression or anxiety to gain a better understanding of how these disorders can affect an infant's development, both during and after pregnancy.

Study Overview

Status

Completed

Conditions

Detailed Description

Depression and anxiety are serious conditions affecting millions of people each year. In fact, it is estimated that approximately one in every four women will be treated for a mood disorder, such as depression or anxiety, at some point in her life. As effective treatment options continue to develop, many women diagnosed with depression or anxiety are able to resume normal lives and may choose to become pregnant. However, studies suggest that the intrauterine environment can be altered by maternal stress, depression, and anxiety, which may affect the fetus during pregnancy. Also, antidepressant medications have been known to cause complications for both the mother and fetus, which can make pregnancy a very difficult time for women with a history of depression and anxiety. These women are more prone to relapse during pregnancy, even if they previously recovered from the disorder. The purpose of this study is to evaluate whether symptoms of depression and anxiety, during or soon after pregnancy, affect an infant's social and emotional development.

Participation in this study will occur from early in the woman's pregnancy until her infant's first birthday. Participants will attend at least eight study visits during pregnancy and five study visits during the first year of the infant's life. Most study visits will take place at the Emory University clinic on campus. During the first study visit, participants will complete questionnaires regarding their current mood, stressors, supports, experiences during pregnancy, symptoms of depression or anxiety, and any treatment or medications they are currently receiving. Urine and blood will also be collected at the initial visit. Follow-up visits, lasting 1 hour, will occur monthly until delivery. During these visits, similar questionnaires will be administered and blood, urine, and saliva samples will be collected. Uterine blood flow, fetal activity, and fetal heart rate will be recorded at some follow-up visits. Women who undergo an amniocentesis will have the option of providing a sample of amniotic fluid and an additional blood sample.

Immediately after delivery, blood from the baby's umbilical cord and blood from the mother will be collected. A week after delivery, a home visit will be scheduled to assess each mother's mood, stress, supports, delivery complications, and first impressions of the new baby. At this time, a behavioral assessment will also be conducted on each infant, and mothers will be observed while interacting with their child. At the infant's 6-month pediatrician visit, a saliva sample will be taken to measure levels of cortisol and other indicators of stress. Infants will be assessed at three other times before their first birthday. During these assessments, the infant's ability to regulate his or her emotions will be evaluated by videotaped behavioral observations, stress hormones from saliva, heart rate, or recordings of brain activity through the use of either an electroencephalogram (EEG) or event related potentials (ERP). Lastly, participants will be given the option to provide a DNA sample for further analysis and future research. Fathers of the babies will be included in selected study visits. Results from this study will be used to help prevent emotional and social developmental problems in infants whose mothers have been diagnosed with either depression or anxiety.

Study Type

Observational

Enrollment (Actual)

1431

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Georgia
      • Atlanta, Georgia, United States, 30322
        • Emory University Women's Mental Health Program

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 45 years (Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

Female

Sampling Method

Non-Probability Sample

Study Population

Women of child bearing potential between the ages of 18 to 45 years of age with or without a history of depression or anxiety disorders.

Description

Inclusion Criteria:

  • Meets DSM-IV criteria for major depressive disorder, panic disorder, obsessive-compulsive disorder, generalized anxiety disorder, or post-traumatic stress disorder
  • Planning pregnancy or less than 16 weeks pregnant by last menstrual period
  • Written and verbal fluency in English
  • Known identity of biological father

Exclusion Criteria:

  • Suicidal or homicidal
  • Psychosis
  • Meets DSM-IV criteria for bipolar disorder, schizophrenia, or an eating disorder
  • Alcohol or substance abuse within 6 months prior to study start date
  • Current illness requiring treatment that can influence outcomes (e.g., epilepsy, asthma, autoimmune disorders)
  • Abnormal thyroid stimulating hormone
  • Anemic

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
1
Women who have experienced symptoms of depression or anxiety during pregnancy.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Social and emotional development of infants who have mothers with depression and anxiety, during or soon after pregnancy
Time Frame: Measured at Year 1 post-pregnancy
Measured at Year 1 post-pregnancy

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Emory University

Collaborators

National Institute of Mental Health (NIMH)

Investigators

  • Principal Investigator: Zachary N. Stowe, MD, Emory University
  • Principal Investigator: Michael J Owens, PhD, Emory University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

September 1, 2007

Primary Completion (Actual)

July 1, 2012

Study Completion (Actual)

July 1, 2012

Study Registration Dates

First Submitted

September 4, 2007

First Submitted That Met QC Criteria

September 4, 2007

First Posted (Estimate)

September 5, 2007

Study Record Updates

Last Update Posted (Estimate)

November 20, 2013

Last Update Submitted That Met QC Criteria

November 19, 2013

Last Verified

November 1, 2013

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • IRB00004249
  • P50MH077928 (U.S. NIH Grant/Contract)
  • DDTR B3-PDB

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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