Breastfeeding is negatively affected by prenatal depression and reduces postpartum depression

Background. This prospective cohort study explored the effects of prenatal and postpartum depression on breastfeeding and the effect of breastfeeding on postpartum depression. Method. The Edinburgh Postpartum Depression Scale (EPDS) was administered to 145 women at the first, second and third trimester, and at the neonatal period and 3 months postpartum. Self-report exclusive breastfeeding since birth was collected at birth and at 3, 6 and 12 months postpartum. Data analyses were performed using repeated-measures ANOVAs and logistic and multiple linear regressions. Results. Depression scores at the third trimester, but not at 3 months postpartum, were the best predictors of exclusive breastfeeding duration (β =−0.30, t=−2.08, p<0.05). A significant decrease in depression scores was seen from childbirth to 3 months postpartum in women who maintained exclusive breastfeeding for53 months (F1,65 =3.73, p<0.10, ηp 2 =0.05). Conclusions. These findings suggest that screening for depression symptoms during pregnancy can help to identify women at risk for early cessation of exclusive breastfeeding, and that exclusive breastfeeding may help to reduce symptoms of depression from childbirth to 3 months postpartum.

Prenatal dysthymia versus major depression effects on maternal cortisol and fetal growth

To determine differences between pregnant women diagnosed with Dysthymia versus Major Depression, depressed pregnant women (N=102) were divided by their diagnosis into Dysthymic (N=48) and Major Depression (N=54) groups and compared on self-report measures (depression, anxiety, anger, daily hassles and behavioral inhibition), on stress hormone levels (cortisol and norepinephrine), and on fetal measurements. The Major Depression group had more self-reported symptoms. However, the Dysthymic group had higher prenatal cortisol levels and lower fetal growth measurements (estimated weight, femur length, abdominal circumference) as measured at their first ultrasound (M=18 weeks gestation). Thus, depressed pregnant women with Dysthymia and Major Depression appeared to have different prenatal symptoms.

Prenatal dopamine and neonatal behavior and biochemistry

Depressed pregnant women (N=126) were divided into high and low prenatal maternal dopamine (HVA) groups based on a tertile split on their dopamine levels at 20 weeks gestation. The high versus the low dopamine group had lower Center for Epidemiological Studies-Depression Scale (CES-D) scores, higher norepinephrine levels at the 20-week gestational age visit and higher dopamine and serotonin levels at both the 20- and the 32-week gestational age visits. The neonates of the mothers with high versus low prenatal dopamine levels also had higher dopamine and serotonin levels as well as lower cortisol levels. Finally, the neonates in the high dopamine group had better autonomic stability and excitability scores on the Brazelton Neonatal Behavior Assessment Scale. Thus, prenatal maternal dopamine levels appear to be negatively related to prenatal depression scores and positively related to neonatal dopamine and behavioral regulation, although these effects are confounded by elevated serotonin levels.

Prenatal serotonin and neonatal outcome: brief report

The purpose of the present study was to determine the relationships between prenatal serotonin levels and other biochemical values during pregnancy as well as their relationships to neonatal biochemical and behavioral variables. To address that question, the pregnant women were divided into the top and bottom tertiles based on their serotonin levels at 20 weeks gestational age.

Chronic prenatal depression and neonatal outcome

Four hundred and thirty pregnant women were recruited at approximately 22 weeks gestation at prenatal clinics. Of these, 86 (20%) were diagnosed as depressed. The women were seen again at approximately 32 weeks gestation and after delivery. Chronicity of depression was evidenced by continuing high depression scores in those women diagnosed as depressed. Comorbid problems were chronically high anxiety, anger, sleep disturbance, and pain scores. Less optimal outcomes for the depressed women included lower gestational age and lower birthweight of their newborns.

Massage therapy reduces pain in pregnant women, alleviates prenatal depression in both parents and improves their relationships

Prenatally depressed women (N=47) were randomly assigned to a group that received massage twice weekly from their partners from 20 weeks gestation until the end of pregnancy or a control group. Self-reported leg pain, back pain, depression, anxiety and anger decreased more for the massaged pregnant women than for the control group women. In addition, the partners who massaged the pregnant women versus the control group partners reported less depressed mood, anxiety and anger across the course of the massage therapy period. Finally, scores on a relationship questionnaire improved more for both the women and the partners in the massage group. These data suggest that not only mood states but also relationships improve mutually when depressed pregnant women are massaged by their partners.

Looking for mechanisms regulating lung growth in CDH: rat and human studies

Tese de Doutoramento em Ciências da Saúde

Mother’s depression at childbirth does not contribute to the effects of antenatal depression on neonate’s behavioral development

Background: Maternal depression is a worldwide phenomenon that has been linked to adverse developmental outcomes in neonates. Aims: To study the effect of antenatal depression (during the third trimester of pregnancy) on neonate behavior, preference, and habituation to both the mother and a stranger’s face/voice. To analyze mother’s depression at childbirth as a potential mediator or moderator of the relationship between antenatal depression and neonate behavioral development. Method: A sample of 110 pregnant women was divided in 2 groups according to their scores on the Edinburgh Postnatal Depression Scale during pregnancy (EPDS; ≥10, depressed; <10, non-depressed). In the first 5 days after birth, neonatal performance on the Neonatal Behavioral Assessment Scale (NBAS) and in the ‘Preference and habituation to the mother’s face/voice versus stranger’ paradigm was assessed; each mother filled out an EPDS. Results: Neonates of depressed pregnant women, achieved lower scores on the NBASs (regulation of state, range of state, and habituation); did not show a visual/auditory preference for the mother’s face/voice; required more trials to become habituated to the mother’s face/voice; and showed a higher visual/auditory preference for the stranger’s face/voice after habituation compared to neonates of non-depressed pregnant women. Depression at childbirth does not contribute to the effect of antenatal depression on neonatal behavioral development. Conclusion: Depression even before childbirth compromises the neonatal behavioral development. Depression is a relevant issue and should be addressed as a routine part of prenatal health care.

Comorbid depression and anxiety effects on pregnancy and neonatal outcome

The effects of comorbid depression and anxiety were compared to the effects of depression alone and anxiety alone on pregnancy mood states and biochemistry and on neonatal outcomes in a large multi-ethnic sample. At the prenatal period the comorbid and depressed groups had higher scores than the other groups on the depression measure. But, the comorbid group had higher anxiety, anger and daily hassles scores than the other groups, and they had lower dopamine levels. As compared to the non-depressed group, they also reported more sleep disturbances and relationship problems. The comorbid group also experienced a greater incidence of prematurity than the depressed, the high anxiety and the non-depressed groups. Although the comorbid and anxiety groups were lower birthweight than the non-depressed and depressed groups, the comorbid group did not differ from the depressed and anxiety groups on birth length. The neonates of the comorbid and depressed groups had higher cortisol and norepinephrine and lower dopamine and serotonin levels than the neonates of the anxiety and non-depressed groups as well as greater relative right frontal EEG. These data suggest that for some measures comorbidity of depression and anxiety is the worst condition (e.g., incidence of prematurity), while for others, comorbidity is no more impactful than depression alone.

Mother's stress, mood and emotional involvement with the infant: 3 months before and 3 months after childbirth

Adverse effects of maternal anxiety and depression are well documented, namely on the foetus/child behaviour and development, but not as much attention has been given to the mother's emotional involvement with the offspring. To study mother's prenatal and postpartum stress, mood and emotional involvement with the infant, the State-Trait Anxiety Inventory, the Edinburgh Postnatal Depression Scale and the Mother-to-Infant Bonding Scale were filled in and cortisol levels were measured, 3 months before and 3 months after childbirth, in a sample of 91 Portuguese women. From pregnancy to the postpartum period, mother's cortisol levels, anxiety and emotional involvement toward the child decrease. No significant change was observed regarding mother's depression. Mother's depression predicted a worse emotional involvement before childbirth, while mother's anxiety predicted a worse emotional involvement with the infant after childbirth. Additionally, pregnant women with a worse emotional involvement with the offspring are at risk of poorer emotional involvement with the infant and higher anxiety and depression at 3 months postpartum. It should be given more attention to mother's poor emotional involvement with the offspring during pregnancy, as it interferes with her emotional involvement with the infant and her psychological adjustment 3 months after childbirth.

Partner relationships during pregnancy in anxious and depressed women and men

To assess anxiety, depression and relationship satisfaction in both women and men during pregnancy, the State Anxiety Inventory (STAI), The Center for Epidemiological Studies-Depression Scale (CES-D) and The Relationship Questionnaire (RQ) were administered during the second trimester to a sample of 59 pregnant women and their partners. Anxious pregnant women rated their relationships as less positive. Depressed pregnant women also rated their relationships as less positive. The women’s anxiety scores were predictive of their positive and negative relationship scores. The women and their partners’ negative relationship scores were also predictive of each others’ negative relationship scores. These results highlight the importance of targeting anxiety as well as depression, and pregnant women as well as their partners in prenatal intervention programs.

Vinculação pré-natal e ansiedade em mães e pais: impacto da ecografia do 1º trimestre de gestação

Com o objectivo de avaliar o impacto da ecografia do 1º trimestre de gravidez na ansiedade e vinculação pré-natal, 22 mães e 22 pais foram recrutados numa Unidade de Medicina Fetal e Diagnóstico Pré-Natal. Foram administrados a Bonding Scale (Taylor, Atkins, Kumar, Adams, & Glover, 2005; versão portuguesa de Figueiredo, Marques, Costa, Pacheco, & Pais, 2005b) e o State-Trait Anxiety Inventory (Spielberger, Gorsuch, Lushene, Vagg, & Jacobs, 1983; versão portuguesa de Silva, 2003), antes e depois da ecografia, a ambos os membros do casal. Os resultados revelaram que a vinculação pré-natal aumenta significativamente enquanto a sintomatologia ansiosa diminui, depois da realização da ecografia. Conclui-se que a ecografia pode ter um papel tranquilizador e potenciador da ligação dos pais ao seu bebé por nascer.