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Evaluating the Effects of Stress in Pregnancy

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00525226
Recruitment Status : Completed
First Posted : September 5, 2007
Last Update Posted : November 20, 2013
National Institute of Mental Health (NIMH)
Information provided by (Responsible Party):
Michael J. Owens, Emory University

Brief Summary:
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.

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

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.

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Study Type : Observational
Actual Enrollment : 1431 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Perinatal Stress and Gene Influences: Pathways to Infant Vulnerability
Study Start Date : September 2007
Actual Primary Completion Date : July 2012
Actual Study Completion Date : July 2012

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Anxiety

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

Primary Outcome Measures :
  1. 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 ]

Biospecimen Retention:   Samples With DNA
Plasm, serum, and urine samples are processed and stored at each research visit.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   18 Years to 45 Years   (Adult)
Sexes Eligible for Study:   Female
Accepts Healthy Volunteers:   Yes
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.

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

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00525226

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United States, Georgia
Emory University Women's Mental Health Program
Atlanta, Georgia, United States, 30322
Sponsors and Collaborators
Emory University
National Institute of Mental Health (NIMH)
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Principal Investigator: Zachary N. Stowe, MD Emory University
Principal Investigator: Michael J Owens, PhD Emory University
Additional Information:

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Responsible Party: Michael J. Owens, Professor, Psychiatry, Emory University Identifier: NCT00525226    
Other Study ID Numbers: IRB00004249
P50MH077928 ( U.S. NIH Grant/Contract )
First Posted: September 5, 2007    Key Record Dates
Last Update Posted: November 20, 2013
Last Verified: November 2013
Keywords provided by Michael J. Owens, Emory University:
Additional relevant MeSH terms:
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Stress Disorders, Traumatic
Anxiety Disorders
Stress Disorders, Post-Traumatic
Compulsive Personality Disorder
Obsessive-Compulsive Disorder
Panic Disorder
Pathologic Processes
Trauma and Stressor Related Disorders
Mental Disorders
Personality Disorders