Undergraduate Honors Thesis

 

Multigenerational depression and anxiety influence maternal measures of stress during pregnancy Público Deposited

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https://scholar.colorado.edu/concern/undergraduate_honors_theses/ng451j120
Abstract
  • Objective: The strongest risk factor for depression during pregnancy is a history of depression, and depression and anxiety during pregnancy can lead to adverse maternal, birth, and early childhood outcomes. There is a research gap in multigenerational studies that examine the influence of heredity on the development of maternal mood disorders during pregnancy and the postpartum period. The purpose of our research was to determine if a history of major depressive disorder (MDD) and/or anxiety in the pregnant woman’s mother (maternal grandmother, or MGM) predicts the same psychiatric illness in the pregnant woman and if a family history of depression and/or anxiety correlates with maternal and fetal hypothalamic-pituitary-adrenocortical (HPA) axis function, as represented by hair cortisol. We also sought to determine if a family history of psychiatric illness correlates with maternal and fetal hair cortisol concentration and maternal scores on the Center for Epidemiological Studies of Depression Scale (CES-D) and the State-Trait Anxiety Inventory (STAI). Methods: Pregnant participants ≥18 years old without major psychiatric or physical comorbidities were enrolled in a prospective longitudinal study at ≤15 weeks gestation. Family history of psychiatric illness was abstracted from a Structured Clinical Interview for DSM-IV Disorders (SCID), conducted during a scheduled study visit. Maternal diagnoses of MDD and anxiety were compared with the MGM’s psychiatric history. CES-D and STAI scores for participants who had a MGM with depression and/or anxiety were compared with participants who had no family history of psychiatric illness. Maternal hair was collected at 16 and 28 weeks and maternal and fetal (neonatal) hair was collected following delivery for cortisol analysis. Results: 153 participants in the study had data for analysis. Of these, 40% met criteria for MDD and 24% for an anxiety disorder (including PTSD) as determined by SCID. CES-D and STAI scores for participants with a history of MDD and/or anxiety in the MGM were higher compared to participants with no family history of psychiatric illness (p=0.02 and p=0.005), and these scores corresponded with the respective scales (CES-D for MDD and STAI for anxiety). A history of depression and/or anxiety in the MGM was not significantly correlated with maternal HPA axis function as represented by hair cortisol. Conclusion: History of MDD and/or anxiety in the MGM is associated with maternal scores on the CES-D and STAI that are consistent with depression and anxiety. A history of depression and/or anxiety in the MGM also predicts the same psychiatric illness in the pregnant participant. Healthcare providers must consider family history of psychiatric illness to improve recognition, diagnosis, and treatment of depression and anxiety during prenatal and postpartum care.
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  • 2016-01-01
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  • 2019-12-02
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