Pregnancy and Anxious Thoughts: The Role of the Immune and Endocrine Systems
NCT ID: NCT03664128
Last Updated: 2023-01-10
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
157 participants
Study Classification
OBSERVATIONAL
Study Start Date
2016-06-24
Study Completion Date
2022-11-28
Brief Summary
Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.
The aim of the proposed research is to identify the clinical and biological phenotypes that define perinatal anxiety. The importance of this research to public health is that it will help to identify women at high risk, and will also serve as the basis for further studies that would identify genetic and epigenetic markers of risk and lead to research to identify novel treatment targets. The research is based upon preliminary data demonstrating a relationship between inflammatory cytokines and Trait anxiety in pregnancy; between progesterone and postpartum anxiety; and between allopregnanolone and obsessive symptoms in pregnancy. The proposed research will build upon these preliminary findings by prospectively examining the clinical features of anxiety in a cohort of pregnant women and healthy matched controls, and by analyzing blood samples from the same cohort for inflammatory cytokines, reproductive hormones, and immune cell types. The proposed study will therefore identify the clinical and biological phenotypes that characterize perinatal anxiety and will identify potential novel targets for treatment.
Related Clinical Trials
Explore similar clinical trials based on study characteristics and research focus.
Happy Mother - Healthy Baby: Supplement Study on Biological Processes Underlying Anxiety During Pregnancy
NCT04566861
Anxiety
COMPLETED
NA
Evaluating the Effects of Stress in Pregnancy
NCT00525226
Depression
Panic Disorder
Generalized Anxiety Disorder
+2 more
COMPLETED
Anxiety is One of the Most Frequent Disorders During the Perinatal Stage Which is Associated with Adverse Health Effects for Women and Their Babies. This Study Will Be to Evaluate the Effectiveness of a Telematic Cognitive-behavioral Preventive Intervention to Manage Anxiety During Pregnancy.
NCT06609291
Anxiety Disorder (Panic Disorder or GAD)
Anxiety Symptoms
NOT_YET_RECRUITING
NA
Mindfulness Based Cognitive Therapy for Psychological Distress in Pregnancy
NCT02214732
Depression
Anxiety
Stress
COMPLETED
NA
Feasibility of Calm to Reduce Stress and Improve Sleep During Pregnancy
NCT05285956
Pregnancy Related
TERMINATED
NA
Detailed Description
Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.
My preliminary data from the Viral Immunity in Pregnancy Study found a strong association in 49 pregnant women between levels of anxiety and of cytokines. When the investigators controlled for clinical confounders, some of those associations disappeared - but there was still a strong correlation between anxiety score and the cytokine interleukin (IL) 6.
Hypothesis: Anxious pregnant women (as determined by a score \> 21 on the Perinatal Anxiety Screening Scale (PASS)) will have elevated pro-inflammatory cytokines in pregnancy (at second and third trimesters) and will demonstrate greater continued elevation at 6 weeks and 6 months postpartum when compared to healthy controls. Leukocyte subpopulation analysis in anxious women will show a higher ratio of T-helper 1-type (Th1) to T-helper 2- type (Th2) cells and a greater monocyte activation across the perinatal period than that in healthy controls.
Hypothesis: There will be a negative correlation between allopregnanolone (ALLO) and pro-inflammatory markers (as listed above in primary outcome measure) in pregnancy, and between allopregnanolone (ALLO) in pregnancy and pro-inflammatory markers in the postpartum.
Hypothesis: Women with a pro-inflammatory immune fingerprint and low levels of allopregnanolone (ALLO) as determined by outcomes 1 and 2 will show increased attentional bias to threat, as demonstrated by measurement of autonomic reactivity in response to a validated pregnancy-specific modified Stroop task.
Hypothesis: Anxious pregnant women will find it feasible and acceptable to engage in a mindfulness-based cognitive behavioral therapy intervention for perinatal anxiety.
For each of these, the investigators will compare the outcome between anxious and non-anxious women.
The current study has 2 parts. The initial part, funded by Brain and Behavior Foundation, was designed to collect general information about the immune and endocrine mechanisms of perinatal anxiety and to test following aims:
Aim 1: To determine if obsessional anxiety in pregnancy corresponds to changes in immune functioning.
Aim 2: To determine if symptoms of obsessional anxiety in pregnancy are associated with changes in the levels of progesterone and its metabolites.
Aim 3: To determine feasibility and acceptability of mindfulness-based cognitive behavioral intervention designed to ameliorate prenatal anxiety and the accompanying inflammatory dysregulation.
I next expanded the study to obtain more detailed biological data; There is no intervention in the expansion for this phase.
I plan to recruit a group of 200 pregnant women (100 who screen positive for anxiety and 100 healthy controls). Subjects will answer questionnaires about mood and anxiety symptoms and have participants' blood drawn at four visits across pregnancy and the postpartum; in the second visit, participants will also perform a computer task designed to test how well participants can inhibit responses. A small subset of subjects will enroll in a group mindfulness intervention as well. This study is designed to achieve the following aims:
1. To compare the "immune fingerprint" of women with significant perinatal anxiety with that of a cohort of healthy matched controls.
2. To determine how perinatal changes in the "immune fingerprint" relate to changes in levels of progesterone metabolites (specifically, allopregnanolone) across pregnancy.
3. To identify how changes in the "immune fingerprint" and progesterone metabolites are related to changes in maternal response to threat.
This study is an effort to further characterize the role of the immune system in common psychiatric symptomatology and the likely bidirectional relationship between the immune system and reproductive hormones that may be related to disease flares among a subset of patients. This work could eventually extend to the gene signatures responsible for immune pathways, to epigenetic studies, and/or to brain imaging studies examining differences in brain region function as affected by inflammation. Ultimately, this would allow the investigators to augment the traditional psychopharmacological focus on serotonin modification with new treatment targets, including cytokines, intracellular inflammatory mediators, neurogenesis, or glial cell activation.
Hypothesis: Anxious pregnant women (as determined by a score \> 21 on the Perinatal Anxiety Screening Scale (PASS)) will have elevated pro-inflammatory cytokines in pregnancy (at second and third trimesters) and will demonstrate greater continued elevation at 6 weeks and 6 months postpartum when compared to healthy controls. Leukocyte subpopulation analysis in anxious women will show a higher ratio of T-helper 1-type (Th1) to T-helper 2- type (Th2) cells and a greater monocyte activation across the perinatal period than that in healthy controls.
Hypothesis: There will be a negative correlation between allopregnanolone (ALLO) and pro-inflammatory markers (as listed above in primary outcome measure) in pregnancy, and between allopregnanolone (ALLO) in pregnancy and pro-inflammatory markers in the postpartum.
Hypothesis: Women with a pro-inflammatory immune fingerprint and low levels of allopregnanolone (ALLO) as determined by outcomes 1 and 2 will show increased attentional bias to threat, as demonstrated by measurement of autonomic reactivity in response to a validated pregnancy-specific modified Stroop task.
Hypothesis: Anxious pregnant women will find it feasible and acceptable to engage in a mindfulness-based cognitive behavioral therapy intervention for perinatal anxiety.
For each of these, the investigators will compare the outcome between anxious and non-anxious women.
The current study has 2 parts. The initial part, funded by Brain and Behavior Foundation, was designed to collect general information about the immune and endocrine mechanisms of perinatal anxiety and to test following aims:
Aim 1: To determine if obsessional anxiety in pregnancy corresponds to changes in immune functioning.
Aim 2: To determine if symptoms of obsessional anxiety in pregnancy are associated with changes in the levels of progesterone and its metabolites.
Aim 3: To determine feasibility and acceptability of mindfulness-based cognitive behavioral intervention designed to ameliorate prenatal anxiety and the accompanying inflammatory dysregulation.
I next expanded the study to obtain more detailed biological data; There is no intervention in the expansion for this phase.
I plan to recruit a group of 200 pregnant women (100 who screen positive for anxiety and 100 healthy controls). Subjects will answer questionnaires about mood and anxiety symptoms and have participants' blood drawn at four visits across pregnancy and the postpartum; in the second visit, participants will also perform a computer task designed to test how well participants can inhibit responses. A small subset of subjects will enroll in a group mindfulness intervention as well. This study is designed to achieve the following aims:
1. To compare the "immune fingerprint" of women with significant perinatal anxiety with that of a cohort of healthy matched controls.
2. To determine how perinatal changes in the "immune fingerprint" relate to changes in levels of progesterone metabolites (specifically, allopregnanolone) across pregnancy.
3. To identify how changes in the "immune fingerprint" and progesterone metabolites are related to changes in maternal response to threat.
This study is an effort to further characterize the role of the immune system in common psychiatric symptomatology and the likely bidirectional relationship between the immune system and reproductive hormones that may be related to disease flares among a subset of patients. This work could eventually extend to the gene signatures responsible for immune pathways, to epigenetic studies, and/or to brain imaging studies examining differences in brain region function as affected by inflammation. Ultimately, this would allow the investigators to augment the traditional psychopharmacological focus on serotonin modification with new treatment targets, including cytokines, intracellular inflammatory mediators, neurogenesis, or glial cell activation.
Conditions
See the medical conditions and disease areas that this research is targeting or investigating.
Perinatal 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.
pregnant women positive for anxiety
100 pregnant women who screen positive for anxiety symptoms (\>21 on the Perinatal Anxiety Screening Scale). Participants are matched for age, parity, and gestational age at enrollment.
Coping with Anxiety through Living Mindfully (CALM) Pregnancy: Mindfulness-based Cognitive Behavioral Therapy (CBT) for perinatal anxiety on a subset (8 participants)
Coping with Anxiety through Living Mindfully (CALM) Pregnancy
Intervention Type
OTHER
Mindfulness-based Cognitive Behavioral Therapy (CBT) for perinatal anxiety on a subset (8 participants); no intervention for other participants
healthy pregnant controls
100 matched healthy pregnant women. Participants are matched for age, parity, and gestational age at enrollment.
No interventions assigned to this group
Interventions
Learn about the drugs, procedures, or behavioral strategies being tested and how they are applied within this trial.
Coping with Anxiety through Living Mindfully (CALM) Pregnancy
Mindfulness-based Cognitive Behavioral Therapy (CBT) for perinatal anxiety on a subset (8 participants); no intervention for other participants
Intervention Type
OTHER
Eligibility Criteria
Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.
Inclusion Criteria
* Pregnant and \<27 weeks gestation
* Age 18 or above
* Able to provide written consent
* Healthy pregnancy.
* Significant anxiety symptoms as measured by a score of \> 21 on the Perinatal Anxiety Screening Scale (PASS)
* a diagnosis of current anxiety disorder by Structured Clinical Interview for Diagnostic And Statistical Manual Of Mental Disorders (DSM) V Diagnoses (SCID), or a diagnosis of a current anxiety disorder by a clinician interview using DSM-V criteria.
* Age 18 or above
* Able to provide written consent
* Healthy pregnancy.
* Significant anxiety symptoms as measured by a score of \> 21 on the Perinatal Anxiety Screening Scale (PASS)
* a diagnosis of current anxiety disorder by Structured Clinical Interview for Diagnostic And Statistical Manual Of Mental Disorders (DSM) V Diagnoses (SCID), or a diagnosis of a current anxiety disorder by a clinician interview using DSM-V criteria.
Exclusion Criteria
* Multifetal pregnancy
* Autoimmune or endocrine disease
* Meeting criteria for a major depressive episode at study entry
* Active suicidal ideation at study entry
* Bipolar disorder or primary psychotic disorder
* Recent or current substance abuse.
* No history of an anxiety or depressive disorder as determined by Structured Clinical Interview for DSM-V Diagnoses (SCID)
* No current use of an antidepressant.
* Autoimmune or endocrine disease
* Meeting criteria for a major depressive episode at study entry
* Active suicidal ideation at study entry
* Bipolar disorder or primary psychotic disorder
* Recent or current substance abuse.
* No history of an anxiety or depressive disorder as determined by Structured Clinical Interview for DSM-V Diagnoses (SCID)
* No current use of an antidepressant.
Minimum Eligible Age
18 Years
Eligible Sex
FEMALE
Accepts Healthy Volunteers
Yes
Sponsors
Meet the organizations funding or collaborating on the study and learn about their roles.
Brain & Behavior Research Foundation
OTHER
Sponsor Role
collaborator
National Institute of Mental Health (NIMH)
NIH
Sponsor Role
collaborator
Johns Hopkins University
OTHER
Sponsor Role
lead
Responsible Party
Identify the individual or organization who holds primary responsibility for the study information submitted to regulators.
Responsibility Role
SPONSOR
Principal Investigators
Learn about the lead researchers overseeing the trial and their institutional affiliations.
Lauren Osborne, MD
Role: PRINCIPAL_INVESTIGATOR
Johns Hopkins University
Locations
Explore where the study is taking place and check the recruitment status at each participating site.
Women's Mood Disorders Center
Baltimore, Maryland, 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.
Alder J, Fink N, Bitzer J, Hosli I, Holzgreve W. Depression and anxiety during pregnancy: a risk factor for obstetric, fetal and neonatal outcome? A critical review of the literature. J Matern Fetal Neonatal Med. 2007 Mar;20(3):189-209. doi: 10.1080/14767050701209560.
Reference Type
BACKGROUND
Andersson L, Sundstrom-Poromaa I, Wulff M, Astrom M, Bixo M. Implications of antenatal depression and anxiety for obstetric outcome. Obstet Gynecol. 2004 Sep;104(3):467-76. doi: 10.1097/01.AOG.0000135277.04565.e9.
Reference Type
BACKGROUND
Ashley V, Honzel N, Larsen J, Justus T, Swick D. Attentional bias for trauma-related words: exaggerated emotional Stroop effect in Afghanistan and Iraq war veterans with PTSD. BMC Psychiatry. 2013 Mar 14;13:86. doi: 10.1186/1471-244X-13-86.
Reference Type
BACKGROUND
Bar-Shai M, Gott D, Kreinin I, Marmor S. Atypical presentations of pregnancy-specific generalized anxiety disorders in women without a previous psychiatric background. Psychosomatics. 2015 May-Jun;56(3):286-91. doi: 10.1016/j.psym.2013.12.017. Epub 2014 Jan 1. No abstract available.
Reference Type
BACKGROUND
Backstrom T, Bixo M, Johansson M, Nyberg S, Ossewaarde L, Ragagnin G, Savic I, Stromberg J, Timby E, van Broekhoven F, van Wingen G. Allopregnanolone and mood disorders. Prog Neurobiol. 2014 Feb;113:88-94. doi: 10.1016/j.pneurobio.2013.07.005. Epub 2013 Aug 23.
Reference Type
BACKGROUND
Baer AN, Witter FR, Petri M. Lupus and pregnancy. Obstet Gynecol Surv. 2011 Oct;66(10):639-53. doi: 10.1097/OGX.0b013e318239e1ee.
Reference Type
BACKGROUND
Bergink V, Burgerhout KM, Weigelt K, Pop VJ, de Wit H, Drexhage RC, Kushner SA, Drexhage HA. Immune system dysregulation in first-onset postpartum psychosis. Biol Psychiatry. 2013 May 15;73(10):1000-7. doi: 10.1016/j.biopsych.2012.11.006. Epub 2012 Dec 25.
Reference Type
BACKGROUND
Biggio G, Pisu MG, Biggio F, Serra M. Allopregnanolone modulation of HPA axis function in the adult rat. Psychopharmacology (Berl). 2014 Sep;231(17):3437-44. doi: 10.1007/s00213-014-3521-6.
Reference Type
BACKGROUND
Brunton PJ. Neuroactive steroids and stress axis regulation: Pregnancy and beyond. J Steroid Biochem Mol Biol. 2016 Jun;160:160-8. doi: 10.1016/j.jsbmb.2015.08.003. Epub 2015 Aug 7.
Reference Type
BACKGROUND
Buyon JP. The effects of pregnancy on autoimmune diseases. J Leukoc Biol. 1998 Mar;63(3):281-7. doi: 10.1002/jlb.63.3.281.
Reference Type
BACKGROUND
Chen SJ, Liu YL, Sytwu HK. Immunologic regulation in pregnancy: from mechanism to therapeutic strategy for immunomodulation. Clin Dev Immunol. 2012;2012:258391. doi: 10.1155/2012/258391. Epub 2011 Nov 3.
Reference Type
BACKGROUND
Coe CL. Maternal anxiety during pregnancy influences infant responses to immunization. Brain Behav Immun. 2013 Aug;32:19-20. doi: 10.1016/j.bbi.2013.05.004. Epub 2013 May 21. No abstract available.
Reference Type
BACKGROUND
Coussons-Read ME, Okun ML, Nettles CD. Psychosocial stress increases inflammatory markers and alters cytokine production across pregnancy. Brain Behav Immun. 2007 Mar;21(3):343-50. doi: 10.1016/j.bbi.2006.08.006. Epub 2006 Oct 6.
Reference Type
BACKGROUND
Dayan J, Creveuil C, Herlicoviez M, Herbel C, Baranger E, Savoye C, Thouin A. Role of anxiety and depression in the onset of spontaneous preterm labor. Am J Epidemiol. 2002 Feb 15;155(4):293-301. doi: 10.1093/aje/155.4.293.
Reference Type
BACKGROUND
74 Diggle P, Heagerty P, Liang K-Y, and Zeger S. Analysis of Longitudinal Data. 2nd edition. Oxford Statistical Science Series: 25. Oxford: Oxford University Press, 2002.
Reference Type
BACKGROUND
DiPietro JA, Costigan KA, Gurewitsch ED. Fetal response to induced maternal stress. Early Hum Dev. 2003 Nov;74(2):125-38. doi: 10.1016/j.earlhumdev.2003.07.001.
Reference Type
BACKGROUND
Duivis HE, Vogelzangs N, Kupper N, de Jonge P, Penninx BW. Differential association of somatic and cognitive symptoms of depression and anxiety with inflammation: findings from the Netherlands Study of Depression and Anxiety (NESDA). Psychoneuroendocrinology. 2013 Sep;38(9):1573-85. doi: 10.1016/j.psyneuen.2013.01.002. Epub 2013 Feb 8.
Reference Type
BACKGROUND
Dunkel Schetter C, Tanner L. Anxiety, depression and stress in pregnancy: implications for mothers, children, research, and practice. Curr Opin Psychiatry. 2012 Mar;25(2):141-8. doi: 10.1097/YCO.0b013e3283503680.
Reference Type
BACKGROUND
Field T, Diego M, Hernandez-Reif M, Schanberg S, Kuhn C, Yando R, Bendell D. Pregnancy anxiety and comorbid depression and anger: effects on the fetus and neonate. Depress Anxiety. 2003;17(3):140-51. doi: 10.1002/da.10071.
Reference Type
BACKGROUND
Field T. Prenatal depression effects on early development: a review. Infant Behav Dev. 2011 Feb;34(1):1-14. doi: 10.1016/j.infbeh.2010.09.008.
Reference Type
BACKGROUND
Furtado M, Katzman MA. Neuroinflammatory pathways in anxiety, posttraumatic stress, and obsessive compulsive disorders. Psychiatry Res. 2015 Sep 30;229(1-2):37-48. doi: 10.1016/j.psychres.2015.05.036. Epub 2015 Jun 6.
Reference Type
BACKGROUND
Gao J. Correlation between anxiety-depression status and cytokines in diarrhea-predominant irritable bowel syndrome. Exp Ther Med. 2013 Jul;6(1):93-96. doi: 10.3892/etm.2013.1101. Epub 2013 May 8.
Reference Type
BACKGROUND
Gilbert Evans SE, Ross LE, Sellers EM, Purdy RH, Romach MK. 3alpha-reduced neuroactive steroids and their precursors during pregnancy and the postpartum period. Gynecol Endocrinol. 2005 Nov;21(5):268-79. doi: 10.1080/09513590500361747.
Reference Type
BACKGROUND
Glover V. Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. Best Pract Res Clin Obstet Gynaecol. 2014 Jan;28(1):25-35. doi: 10.1016/j.bpobgyn.2013.08.017. Epub 2013 Sep 18.
Reference Type
BACKGROUND
Goodman JH, Guarino A, Chenausky K, Klein L, Prager J, Petersen R, Forget A, Freeman M. CALM Pregnancy: results of a pilot study of mindfulness-based cognitive therapy for perinatal anxiety. Arch Womens Ment Health. 2014 Oct;17(5):373-87. doi: 10.1007/s00737-013-0402-7. Epub 2014 Jan 22.
Reference Type
BACKGROUND
Grace SL, Evindar A, Stewart DE. The effect of postpartum depression on child cognitive development and behavior: a review and critical analysis of the literature. Arch Womens Ment Health. 2003 Nov;6(4):263-74. doi: 10.1007/s00737-003-0024-6.
Reference Type
BACKGROUND
Guintivano J, Arad M, Gould TD, Payne JL, Kaminsky ZA. Antenatal prediction of postpartum depression with blood DNA methylation biomarkers. Mol Psychiatry. 2014 May;19(5):560-7. doi: 10.1038/mp.2013.62. Epub 2013 May 21.
Reference Type
BACKGROUND
Haupl T, Ostensen M, Grutzkau A, Radbruch A, Burmester GR, Villiger PM. Reactivation of rheumatoid arthritis after pregnancy: increased phagocyte and recurring lymphocyte gene activity. Arthritis Rheum. 2008 Oct;58(10):2981-92. doi: 10.1002/art.23907.
Reference Type
BACKGROUND
Jedel S, Hoffman A, Merriman P, Swanson B, Voigt R, Rajan KB, Shaikh M, Li H, Keshavarzian A. A randomized controlled trial of mindfulness-based stress reduction to prevent flare-up in patients with inactive ulcerative colitis. Digestion. 2014;89(2):142-55. doi: 10.1159/000356316. Epub 2014 Feb 14.
Reference Type
BACKGROUND
Kalanthroff E, Henik A, Derakshan N, Usher M. Anxiety, emotional distraction, and attentional control in the Stroop task. Emotion. 2016 Apr;16(3):293-300. doi: 10.1037/emo0000129. Epub 2015 Nov 16.
Reference Type
BACKGROUND
Kane HS, Dunkel Schetter C, Glynn LM, Hobel CJ, Sandman CA. Pregnancy anxiety and prenatal cortisol trajectories. Biol Psychol. 2014 Jul;100:13-9. doi: 10.1016/j.biopsycho.2014.04.003. Epub 2014 Apr 21.
Reference Type
BACKGROUND
49. Kasper, S., den Boer, J.A., Ad Sitsen, J.M., 2003. Handbook of Depression and Anxiety: A Biological Approach, 2nd Ed. Marcel Dekker Inc., New York.
Reference Type
BACKGROUND
Kim C, Brawarsky P, Jackson RA, Fuentes-Afflick E, Haas JS. Changes in health status experienced by women with gestational diabetes and pregnancy-induced hypertensive disorders. J Womens Health (Larchmt). 2005 Oct;14(8):729-36. doi: 10.1089/jwh.2005.14.729.
Reference Type
BACKGROUND
Kivlighan KT, DiPietro JA, Costigan KA, Laudenslager ML. Diurnal rhythm of cortisol during late pregnancy: associations with maternal psychological well-being and fetal growth. Psychoneuroendocrinology. 2008 Oct;33(9):1225-35. doi: 10.1016/j.psyneuen.2008.06.008. Epub 2008 Aug 8.
Reference Type
BACKGROUND
Kurki T, Hiilesmaa V, Raitasalo R, Mattila H, Ylikorkala O. Depression and anxiety in early pregnancy and risk for preeclampsia. Obstet Gynecol. 2000 Apr;95(4):487-90. doi: 10.1016/s0029-7844(99)00602-x.
Reference Type
BACKGROUND
Lambert JJ, Belelli D, Hill-Venning C, Peters JA. Neurosteroids and GABAA receptor function. Trends Pharmacol Sci. 1995 Sep;16(9):295-303. doi: 10.1016/s0165-6147(00)89058-6.
Reference Type
BACKGROUND
Maes M, Bosmans E, Ombelet W. In the puerperium, primiparae exhibit higher levels of anxiety and serum peptidase activity and greater immune responses than multiparae. J Clin Psychiatry. 2004 Jan;65(1):71-6. doi: 10.4088/jcp.v65n0112.
Reference Type
BACKGROUND
Maes M, Lin AH, Ombelet W, Stevens K, Kenis G, De Jongh R, Cox J, Bosmans E. Immune activation in the early puerperium is related to postpartum anxiety and depressive symptoms. Psychoneuroendocrinology. 2000 Feb;25(2):121-37. doi: 10.1016/s0306-4530(99)00043-8.
Reference Type
BACKGROUND
Maes M, Song C, Lin A, De Jongh R, Van Gastel A, Kenis G, Bosmans E, De Meester I, Benoy I, Neels H, Demedts P, Janca A, Scharpe S, Smith RS. The effects of psychological stress on humans: increased production of pro-inflammatory cytokines and a Th1-like response in stress-induced anxiety. Cytokine. 1998 Apr;10(4):313-8. doi: 10.1006/cyto.1997.0290.
Reference Type
BACKGROUND
Maes M, Verkerk R, Bonaccorso S, Ombelet W, Bosmans E, Scharpe S. Depressive and anxiety symptoms in the early puerperium are related to increased degradation of tryptophan into kynurenine, a phenomenon which is related to immune activation. Life Sci. 2002 Sep 6;71(16):1837-48. doi: 10.1016/s0024-3205(02)01853-2.
Reference Type
BACKGROUND
Makhseed M, Raghupathy R, Azizieh F, Farhat R, Hassan N, Bandar A. Circulating cytokines and CD30 in normal human pregnancy and recurrent spontaneous abortions. Hum Reprod. 2000 Sep;15(9):2011-7. doi: 10.1093/humrep/15.9.2011.
Reference Type
BACKGROUND
Matthey S, Barnett B, Howie P, Kavanagh DJ. Diagnosing postpartum depression in mothers and fathers: whatever happened to anxiety? J Affect Disord. 2003 Apr;74(2):139-47. doi: 10.1016/s0165-0327(02)00012-5.
Reference Type
BACKGROUND
Mautner E, Greimel E, Trutnovsky G, Daghofer F, Egger JW, Lang U. Quality of life outcomes in pregnancy and postpartum complicated by hypertensive disorders, gestational diabetes, and preterm birth. J Psychosom Obstet Gynaecol. 2009 Dec;30(4):231-7. doi: 10.3109/01674820903254757.
Reference Type
BACKGROUND
Mendelson T, DiPietro JA, Costigan KA, Chen P, Henderson JL. Associations of maternal psychological factors with umbilical and uterine blood flow. J Psychosom Obstet Gynaecol. 2011 Mar;32(1):3-9. doi: 10.3109/0167482X.2010.544427. Epub 2011 Jan 10.
Reference Type
BACKGROUND
Miaskowski C, Elboim C, Paul SM, Mastick J, Cooper BA, Levine JD, Aouizerat BE. Polymorphisms in Tumor Necrosis Factor-alpha Are Associated With Higher Anxiety Levels in Women After Breast Cancer Surgery. Clin Breast Cancer. 2016 Feb;16(1):63-71.e3. doi: 10.1016/j.clbc.2014.12.001. Epub 2014 Dec 24.
Reference Type
BACKGROUND
Milgrom J, Gemmill AW, Bilszta JL, Hayes B, Barnett B, Brooks J, Ericksen J, Ellwood D, Buist A. Antenatal risk factors for postnatal depression: a large prospective study. J Affect Disord. 2008 May;108(1-2):147-57. doi: 10.1016/j.jad.2007.10.014. Epub 2007 Dec 18.
Reference Type
BACKGROUND
O'Connor TG, Tang W, Gilchrist MA, Moynihan JA, Pressman EK, Blackmore ER. Diurnal cortisol patterns and psychiatric symptoms in pregnancy: short-term longitudinal study. Biol Psychol. 2014 Feb;96:35-41. doi: 10.1016/j.biopsycho.2013.11.002. Epub 2013 Nov 12.
Reference Type
BACKGROUND
O'Donnell KJ, Bugge Jensen A, Freeman L, Khalife N, O'Connor TG, Glover V. Maternal prenatal anxiety and downregulation of placental 11beta-HSD2. Psychoneuroendocrinology. 2012 Jun;37(6):818-26. doi: 10.1016/j.psyneuen.2011.09.014. Epub 2011 Oct 15.
Reference Type
BACKGROUND
Oglodek EA, Szota AM, Just MJ, Mos DM, Araszkiewicz A. The MCP-1, CCL-5 and SDF-1 chemokines as pro-inflammatory markers in generalized anxiety disorder and personality disorders. Pharmacol Rep. 2015 Feb;67(1):85-9. doi: 10.1016/j.pharep.2014.08.006. Epub 2014 Aug 21.
Reference Type
BACKGROUND
Oliveira Miranda D, Soares de Lima TA, Ribeiro Azevedo L, Feres O, Ribeiro da Rocha JJ, Pereira-da-Silva G. Proinflammatory cytokines correlate with depression and anxiety in colorectal cancer patients. Biomed Res Int. 2014;2014:739650. doi: 10.1155/2014/739650. Epub 2014 Sep 17.
Reference Type
BACKGROUND
Orr ST, James SA, Blackmore Prince C. Maternal prenatal depressive symptoms and spontaneous preterm births among African-American women in Baltimore, Maryland. Am J Epidemiol. 2002 Nov 1;156(9):797-802. doi: 10.1093/aje/kwf131.
Reference Type
BACKGROUND
Osborne L, Clive M, Kimmel M, Gispen F, Guintivano J, Brown T, Cox O, Judy J, Meilman S, Braier A, Beckmann MW, Kornhuber J, Fasching PA, Goes F, Payne JL, Binder EB, Kaminsky Z. Replication of Epigenetic Postpartum Depression Biomarkers and Variation with Hormone Levels. Neuropsychopharmacology. 2016 May;41(6):1648-58. doi: 10.1038/npp.2015.333. Epub 2015 Oct 27.
Reference Type
BACKGROUND
Osborne LM, Monk C. Perinatal depression--the fourth inflammatory morbidity of pregnancy?: Theory and literature review. Psychoneuroendocrinology. 2013 Oct;38(10):1929-52. doi: 10.1016/j.psyneuen.2013.03.019. Epub 2013 Apr 20.
Reference Type
BACKGROUND
Palmsten K, Setoguchi S, Margulis AV, Patrick AR, Hernandez-Diaz S. Elevated risk of preeclampsia in pregnant women with depression: depression or antidepressants? Am J Epidemiol. 2012 May 15;175(10):988-97. doi: 10.1093/aje/kwr394. Epub 2012 Mar 22.
Reference Type
BACKGROUND
Pan W. Akaike's information criterion in generalized estimating equations. Biometrics. 2001 Mar;57(1):120-5. doi: 10.1111/j.0006-341x.2001.00120.x.
Reference Type
BACKGROUND
Patchev VK, Hassan AH, Holsboer DF, Almeida OF. The neurosteroid tetrahydroprogesterone attenuates the endocrine response to stress and exerts glucocorticoid-like effects on vasopressin gene transcription in the rat hypothalamus. Neuropsychopharmacology. 1996 Dec;15(6):533-40. doi: 10.1016/S0893-133X(96)00096-6.
Reference Type
BACKGROUND
Phillips J, Sharpe L, Matthey S. Rates of depressive and anxiety disorders in a residential mother-infant unit for unsettled infants. Aust N Z J Psychiatry. 2007 Oct;41(10):836-42. doi: 10.1080/00048670701579108.
Reference Type
BACKGROUND
Phillips J, Sharpe L, Matthey S, Charles M. Maternally focused worry. Arch Womens Ment Health. 2009 Dec;12(6):409-18. doi: 10.1007/s00737-009-0091-4. Epub 2009 Jul 21.
Reference Type
BACKGROUND
Raghupathy R, Al-Azemi M. Modulation of Cytokine Production by the Dydrogesterone Metabolite Dihydrodydrogesterone. Am J Reprod Immunol. 2015 Nov;74(5):419-26. doi: 10.1111/aji.12418. Epub 2015 Aug 7.
Reference Type
BACKGROUND
Robinson DP, Klein SL. Pregnancy and pregnancy-associated hormones alter immune responses and disease pathogenesis. Horm Behav. 2012 Aug;62(3):263-71. doi: 10.1016/j.yhbeh.2012.02.023. Epub 2012 Mar 3.
Reference Type
BACKGROUND
Rosenkranz MA, Davidson RJ, Maccoon DG, Sheridan JF, Kalin NH, Lutz A. A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation. Brain Behav Immun. 2013 Jan;27(1):174-84. doi: 10.1016/j.bbi.2012.10.013. Epub 2012 Oct 22.
Reference Type
BACKGROUND
Ross LE, McLean LM. Anxiety disorders during pregnancy and the postpartum period: A systematic review. J Clin Psychiatry. 2006 Aug;67(8):1285-98. doi: 10.4088/jcp.v67n0818.
Reference Type
BACKGROUND
Russell EJ, Fawcett JM, Mazmanian D. Risk of obsessive-compulsive disorder in pregnant and postpartum women: a meta-analysis. J Clin Psychiatry. 2013 Apr;74(4):377-85. doi: 10.4088/JCP.12r07917.
Reference Type
BACKGROUND
Schofield CA, Battle CL, Howard M, Ortiz-Hernandez S. Symptoms of the anxiety disorders in a perinatal psychiatric sample: a chart review. J Nerv Ment Dis. 2014 Feb;202(2):154-60. doi: 10.1097/NMD.0000000000000086.
Reference Type
BACKGROUND
Schumacher M, Mattern C, Ghoumari A, Oudinet JP, Liere P, Labombarda F, Sitruk-Ware R, De Nicola AF, Guennoun R. Revisiting the roles of progesterone and allopregnanolone in the nervous system: resurgence of the progesterone receptors. Prog Neurobiol. 2014 Feb;113:6-39. doi: 10.1016/j.pneurobio.2013.09.004. Epub 2013 Oct 27.
Reference Type
BACKGROUND
72. Segal ZV, Williams JM, Teasdale JD (2002) Mindfulness-based cognitive therapy for depression. Guilford, New York
Reference Type
BACKGROUND
73. Segal ZV, Williams JM, Teasdale JD (2013) Mindfulness-based cognitive therapy for depression second edition. Guilford, New York
Reference Type
BACKGROUND
Shadigian E, Bauer ST. Pregnancy-associated death: a qualitative systematic review of homicide and suicide. Obstet Gynecol Surv. 2005 Mar;60(3):183-90. doi: 10.1097/01.ogx.0000155967.72418.6b.
Reference Type
BACKGROUND
Slattery MJ, Dubbert BK, Allen AJ, Leonard HL, Swedo SE, Gourley MF. Prevalence of obsessive-compulsive disorder in patients with systemic lupus erythematosus. J Clin Psychiatry. 2004 Mar;65(3):301-6. doi: 10.4088/jcp.v65n0303.
Reference Type
BACKGROUND
Sutter-Dallay AL, Giaconne-Marcesche V, Glatigny-Dallay E, Verdoux H. Women with anxiety disorders during pregnancy are at increased risk of intense postnatal depressive symptoms: a prospective survey of the MATQUID cohort. Eur Psychiatry. 2004 Dec;19(8):459-63. doi: 10.1016/j.eurpsy.2004.09.025.
Reference Type
BACKGROUND
Tamasi L, Horvath I, Bohacs A, Muller V, Losonczy G, Schatz M. Asthma in pregnancy--immunological changes and clinical management. Respir Med. 2011 Feb;105(2):159-64. doi: 10.1016/j.rmed.2010.11.006. Epub 2010 Dec 8.
Reference Type
BACKGROUND
Vogelzangs N, Beekman AT, de Jonge P, Penninx BW. Anxiety disorders and inflammation in a large adult cohort. Transl Psychiatry. 2013 Apr 23;3(4):e249. doi: 10.1038/tp.2013.27.
Reference Type
BACKGROUND
Wohleb ES, Patterson JM, Sharma V, Quan N, Godbout JP, Sheridan JF. Knockdown of interleukin-1 receptor type-1 on endothelial cells attenuated stress-induced neuroinflammation and prevented anxiety-like behavior. J Neurosci. 2014 Feb 12;34(7):2583-91. doi: 10.1523/JNEUROSCI.3723-13.2014.
Reference Type
BACKGROUND
Zernicke KA, Campbell TS, Blustein PK, Fung TS, Johnson JA, Bacon SL, Carlson LE. Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms: a randomized wait-list controlled trial. Int J Behav Med. 2013 Sep;20(3):385-96. doi: 10.1007/s12529-012-9241-6.
Reference Type
BACKGROUND
Riddle JN, Jager LR, Sherer M, Pangtey M, Osborne LM. Anxiety in pregnancy and stress responsiveness: An exploratory study of heart rate variability, cortisol, and alpha-amylase in the third trimester. J Neuroendocrinol. 2023 Jul;35(7):e13238. doi: 10.1111/jne.13238. Epub 2023 Mar 3.
Reference Type
DERIVED
Related Links
Access external resources that provide additional context or updates about the study.
http://www.ncss.com.
Hintze, J. PASS 12. 2013. NCSS, LLC. Kaysville, Utah, USA
Other Identifiers
Review additional registry numbers or institutional identifiers associated with this trial.
IRB00087653
Identifier Type: -
Identifier Source: org_study_id
More Related Trials
Additional clinical trials that may be relevant based on similarity analysis.
Happy Mother-Healthy Baby: An Anxiety-focused Early Prenatal Intervention
NCT03880032
COMPLETED
NA
CALM for Pregnant and Post-Partum Women
NCT03351465
WITHDRAWN
NA
Exploring the Effectiveness of a Brief CBT Intervention for Anxious Pregnant Women
NCT03103217
COMPLETED
NA
Treatment of Anxiety in Pregnancy Study
NCT05064254
UNKNOWN
NA
Preventing Depressive Relapse in Pregnant Women With Recurrent Depression
NCT03623620
COMPLETED
NA
Screening for Depression and Anxiety in Pregnant and Postpartum Women: Evaluating Prevalence, Risk Factors, and the Stepped Screening Protocol in a Care Pathway
NCT06664593
COMPLETED
Personalized Integrated Chronotherapy for Perinatal Depression
NCT04364646
COMPLETED
NA
Risk Factors for Anxiety and Depression Among Pregnant Women During the COVID-19 Pandemic
NCT04377412
UNKNOWN
Determining Relationships Among Maternity Stress & Sleep
NCT02133963
COMPLETED
Antenatal Relaxation Group for Anxiety and Depression Management
NCT00855192
UNKNOWN
NA
Mindfulness-Based Cognitive Therapy for the Prevention of Perinatal Depressive Relapse/Recurrence
NCT02387424
COMPLETED
NA
The Staying Well Study: An Open Trial of Mindfulness-Based Cognitive Therapy for the Prevention of Perinatal Depression
NCT02391870
COMPLETED
NA
Feasibility of Heart Rate Variability Biofeedback With In-patient Pregnant Women
NCT02119936
TERMINATED
NA
Integration of Stepped Care for Perinatal Mood and Anxiety Disorders Among Women Attending MCH Clinics
NCT06456307
RECRUITING
NA
How Does Mindful Mood Balance for Moms Work?
NCT05000879
COMPLETED
NA
Mindfulness-based Prenatal Education on Women
NCT04693130
COMPLETED
NA
Stress Reactivity and Mother-Infant Cardiovascular Disease Risk
NCT06805799
NOT_YET_RECRUITING
NA
Mindfulness in High Risk Pregnancies
NCT04496115
NOT_YET_RECRUITING
NA
Preventing Maternal Mood, Anxiety, and Trauma Symptoms After Cesarean Delivery
NCT06949813
RECRUITING
NA
Mindful Moms: Mechanisms of Mindfulness-based Cognitive Therapy During Pregnancy and Postpartum
NCT05137925
ACTIVE_NOT_RECRUITING
NA
Mindfulness-Based Cognitive Therapy for Perinatal Women With Mood Disorders
NCT02150681
COMPLETED
PHASE1
Accelerating Implementation of Mindful Mood Balance for Moms
NCT04846504
COMPLETED
NA
Telemedicine Mindfulness-based Therapy for Perinatal Insomnia: An Open-label Trial.
NCT04443959
COMPLETED
NA
Cognitive Behavioural Group Therapy for Perinatal Anxiety
NCT02850523
COMPLETED
NA
Mindfulness in Pregnancy
NCT03635697
TERMINATED
NA