Evaluating the Effects of Stress in Pregnancy

NCT ID: NCT00525226

Last Updated: 2013-11-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Total Enrollment

1431 participants

Study Classification

OBSERVATIONAL

Study Start Date

2007-09-30

Study Completion Date

2012-07-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

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.

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

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.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Depression Panic Disorder Generalized Anxiety Disorder Post-Traumatic Stress Disorder Obsessive Compulsive Disorder (OCD)

Keywords

Explore important study keywords that can help with search, categorization, and topic discovery.

Psychiatry Psychology Pregnancy Stress Anxiety

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

1

Women who have experienced symptoms of depression or anxiety during pregnancy.

No interventions assigned to this group

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

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
Minimum Eligible Age

18 Years

Maximum Eligible Age

45 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

Meet the organizations funding or collaborating on the study and learn about their roles.

National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Emory University

OTHER

Sponsor Role lead

Responsible Party

Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.

Michael J. Owens

Professor, Psychiatry

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

Learn about the lead researchers overseeing the trial and their institutional affiliations.

Zachary N. Stowe, MD

Role: PRINCIPAL_INVESTIGATOR

Emory University

Michael J Owens, PhD

Role: PRINCIPAL_INVESTIGATOR

Emory University

Locations

Explore where the study is taking place and check the recruitment status at each participating site.

Emory University Women's Mental Health Program

Atlanta, Georgia, United States

Site Status

Countries

Review the countries where the study has at least one active or historical site.

United States

References

Explore related publications, articles, or registry entries linked to this study.

Ji S, Long Q, Newport DJ, Na H, Knight B, Zach EB, Morris NJ, Kutner M, Stowe ZN. Validity of depression rating scales during pregnancy and the postpartum period: impact of trimester and parity. J Psychiatr Res. 2011 Feb;45(2):213-9. doi: 10.1016/j.jpsychires.2010.05.017. Epub 2010 Jun 9.

Reference Type BACKGROUND
PMID: 20542520 (View on PubMed)

Miller AM, Hogue CJ, Knight BT, Stowe ZN, Newport DJ. Maternal expectations of postpartum social support: validation of the Postpartum Social Support Questionnaire during pregnancy. Arch Womens Ment Health. 2012 Aug;15(4):307-11. doi: 10.1007/s00737-012-0287-x. Epub 2012 May 16.

Reference Type BACKGROUND
PMID: 22588510 (View on PubMed)

Newport DJ, Ji S, Long Q, Knight BT, Zach EB, Smith EN, Morris NJ, Stowe ZN. Maternal depression and anxiety differentially impact fetal exposures during pregnancy. J Clin Psychiatry. 2012 Feb;73(2):247-51. doi: 10.4088/JCP.10m06783. Epub 2011 Nov 29.

Reference Type BACKGROUND
PMID: 22152400 (View on PubMed)

Schroeder JW, Conneely KN, Cubells JC, Kilaru V, Newport DJ, Knight BT, Stowe ZN, Brennan PA, Krushkal J, Tylavsky FA, Taylor RN, Adkins RM, Smith AK. Neonatal DNA methylation patterns associate with gestational age. Epigenetics. 2011 Dec;6(12):1498-504. doi: 10.4161/epi.6.12.18296.

Reference Type BACKGROUND
PMID: 22139580 (View on PubMed)

Monk C, Newport DJ, Korotkin JH, Long Q, Knight B, Stowe ZN. Uterine blood flow in a psychiatric population: impact of maternal depression, anxiety, and psychotropic medication. Biol Psychiatry. 2012 Sep 15;72(6):483-90. doi: 10.1016/j.biopsych.2012.05.006. Epub 2012 Jun 12.

Reference Type BACKGROUND
PMID: 22695184 (View on PubMed)

Schroeder JW, Smith AK, Brennan PA, Conneely KN, Kilaru V, Knight BT, Newport DJ, Cubells JF, Stowe ZN. DNA methylation in neonates born to women receiving psychiatric care. Epigenetics. 2012 Apr;7(4):409-14. doi: 10.4161/epi.19551. Epub 2012 Apr 1.

Reference Type BACKGROUND
PMID: 22419064 (View on PubMed)

Lusby CM, Goodman SH, Bell MA, Newport DJ. Electroencephalogram patterns in infants of depressed mothers. Dev Psychobiol. 2014 Apr;56(3):459-73. doi: 10.1002/dev.21112. Epub 2013 Jul 12.

Reference Type BACKGROUND
PMID: 23852456 (View on PubMed)

McConathy J, Capello C, Jarkas N, Stowe ZN, Owens MJ. Preparation of antidepressants for use in preclinical research. Int J Neuropsychopharmacol. 2007 Dec;10(6):759-63. doi: 10.1017/S1461145706007474. Epub 2007 Jan 4.

Reference Type BACKGROUND
PMID: 17201995 (View on PubMed)

Capello CF, Bourke CH, Ritchie JC, Stowe ZN, Newport DJ, Nemeroff A, Owens MJ. Serotonin transporter occupancy in rats exposed to serotonin reuptake inhibitors in utero or via breast milk. J Pharmacol Exp Ther. 2011 Oct;339(1):275-85. doi: 10.1124/jpet.111.183855. Epub 2011 Jul 20.

Reference Type BACKGROUND
PMID: 21775476 (View on PubMed)

Bourke CH, Capello CF, Rogers SM, Yu ML, Boss-Williams KA, Weiss JM, Stowe ZN, Owens MJ. Prenatal exposure to escitalopram and/or stress in rats: a prenatal stress model of maternal depression and its treatment. Psychopharmacology (Berl). 2013 Jul;228(2):231-41. doi: 10.1007/s00213-013-3030-z. Epub 2013 Feb 24.

Reference Type BACKGROUND
PMID: 23436130 (View on PubMed)

Smith AK, Newport DJ, Ashe MP, Brennan PA, Laprairie JL, Calamaras M, Nemeroff CB, Ritchie JC, Cubells JF, Stowe ZN. Predictors of neonatal hypothalamic-pituitary-adrenal axis activity at delivery. Clin Endocrinol (Oxf). 2011 Jul;75(1):90-5. doi: 10.1111/j.1365-2265.2011.03998.x.

Reference Type BACKGROUND
PMID: 21521269 (View on PubMed)

Related Links

Access external resources that provide additional context or updates about the study.

http://www.emorywomensprogram.org

Click here for the Women's Mental Health Program Web site

Other Identifiers

Review additional registry numbers or institutional identifiers associated with this trial.

P50MH077928

Identifier Type: NIH

Identifier Source: secondary_id

View Link

DDTR B3-PDB

Identifier Type: -

Identifier Source: secondary_id

IRB00004249

Identifier Type: -

Identifier Source: org_study_id