Prenatal depression effects and interventions: a review.
This review covers research on the negative effects of prenatal depression and cortisol on fetal growth, prematurity and low birthweight. Although prenatal depression and cortisol were typically measured at around 20 weeks gestation, other research suggests the stability of depression and cortisol levels across pregnancy. Women with Dysthymia as compared to Major Depression Disorder had higher cortisol levels, and their newborns had lower gestational age and birthweight. The cortisol effects in these studies were unfortunately confounded by low serotonin and low dopamine levels which in themselves could contribute to non-optimal pregnancy outcomes. The negative effects of depression and cortisol were also potentially confounded by comorbid anxiety, by demographic factors including younger age, less education and lower SES of the mothers and by the absence of a partner or a partner who was unhappy about the pregnancy or a partner who was depressed. Substance use (especially caffeine use) was still another risk factor. All of these problems including prenatal depression, elevated cortisol, prematurity and low birthweight and even postpartum depression have been reduced by prenatal massage therapy provided by the women's partners. Massage therapy combined with group interpersonal psychotherapy was also effective for reducing depression and cortisol levels. Several limitations of these studies were noted and suggestions for future research included exploring other predictor variables like progesterone/estriol ratios, immune factors and genetic determinants. Further research is needed both on the potential use of cortisol as a screening measure and the use of other therapies that might reduce prenatal depression and cortisol in the women and prematurity and low birthweight in their infants.
Field
Tiffany
T
Touch Research Institutes, University of Miami Medical School, Department of Pediatrics, Miami, FL 33101, USA. tfield@med.miami.edu
Diego
Miguel
M
Hernandez-Reif
Maria
M
D003710:Demography; D019052:Depression, Postpartum / Q000150:complications* / Q000378:metabolism / Q000534:rehabilitation*; D004298:Dopamine / Q000378:metabolism; D005260:Female; D047109:Fetal Development / Q000187:drug effects; D005865:Gestational Age; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects / Q000378:metabolism; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology* / Q000534:rehabilitation*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology; D011295:Prenatal Care; D011297:Prenatal Exposure Delayed Effects / Q000503:physiopathology*; D012307:Risk Factors; D012701:Serotonin / Q000378:metabolism
D012701:Serotonin; D004298:Dopamine; D006854:Hydrocortisone
Pediatrics. 1996 Jun;97(6 Pt 1):851-5
8657526
Int J Neurosci. 2010 Mar;120(3):163-7
20374082
J Bodyw Mov Ther. 2009 Oct;13(4):297-303
19761951
J Affect Disord. 2008 Dec;111(2-3):214-20
18394713
Am J Obstet Gynecol. 1999 Dec;181(6):1530-6
10601939
Metabolism. 2005 May;54(5 Suppl 1):24-7
15877309
Int J Neurosci. 2005 Oct;115(10):1397-413
16162447
Int J Neurosci. 2005 Mar;115(3):423-9
15825247
Hum Reprod. 2009 Jan;24(1):146-53
18948314
Neurosci Biobehav Rev. 2005 Apr;29(2):237-58
15811496
Infant Behav Dev. 2006 Dec;29(4):579-83
17138311
Infant Behav Dev. 2008 Apr;31(2):316-20
18279966
J Clin Psychiatry. 2006;67 Suppl 6:27-32
16848674
BJOG. 2008 Jul;115(8):1043-51
18651886
Infant Behav Dev. 2008 Apr;31(2):190-3
18037494
Infant Behav Dev. 2009 Dec;32(4):454-60
19646762
J Altern Complement Med. 2005 Apr;11(2):237-44
15865489
Psychoneuroendocrinology. 2005 Aug;30(7):647-56
15854781
Psychopharmacol Bull. 2003;37(4):99-115
15131521
Expert Rev Neurother. 2007 Jul;7(7):761-4
17610382
Ultrasound Obstet Gynecol. 2002 Dec;20(6):580-5
12493047
Proc Natl Acad Sci U S A. 2009 Feb 17;106(7):2464-7
19188591
Prog Brain Res. 1975;42:333-41
1239045
J Intern Med. 2007 May;261(5):453-60
17444884
Infant Behav Dev. 2006 Apr;29(2):268-75
17138282
J Psychosom Obstet Gynaecol. 2004 Jun;25(2):115-22
15715034
J Health Psychol. 2007 Mar;12(2):285-300
17284493
Psychosom Med. 2006 Nov-Dec;68(6):938-46
17079701
Clin Psychol Rev. 2003 Nov;23(6):831-48
14529700
Dev Psychobiol. 1996 Dec;29(8):697-712
8958482
J Am Acad Child Adolesc Psychiatry. 2007 Jun;46(6):737-746
17513986
Eur J Obstet Gynecol Reprod Biol. 1997 Aug;74(2):149-55
9306108
Soc Work. 2002 Apr;47(2):114-23
12019798
J Obstet Gynaecol. 2001 Sep;21(5):468-73
12521799
Early Hum Dev. 2007 Jul;83(7):451-8
17008033
Health Psychol. 2000 Nov;19(6):535-43
11129356
J Womens Health (Larchmt). 2007 May;16(4):535-42
17521257
Womens Health Issues. 2002 Jan-Feb;12(1):16-22
11786288
J Clin Endocrinol Metab. 2004 Dec;89(12):6244-50
15579784
Infant Behav Dev. 2006 Jan;29(1):54-8
17138261
Can J Appl Physiol. 1997 Jun;22(3):280-91
9189307
Psychol Med. 2007 Mar;37(3):453-62
17121688
J Am Acad Child Adolesc Psychiatry. 2004 Mar;43(3):283-90
15076261
Am J Obstet Gynecol. 1996 Nov;175(5):1286-92
8942502
Psychopharmacology (Berl). 2004 Aug;174(4):512-24
15249991
Brain Behav Immun. 2005 Jul;19(4):296-308
15944068
Infant Behav Dev. 2006 Apr;29(2):262-7
17138281
Can J Clin Pharmacol. 2009 Winter;16(1):e15-22
19164843
J Child Psychol Psychiatry. 2008 Oct;49(10):1099-107
18492036
Lancet. 1998 Aug 29;352(9129):707-8
9728994
J Womens Health (Larchmt). 2003 May;12(4):373-80
12804344
Int J Neurosci. 2008 Jan;118(1):95-103
18041608
Psychol Med. 1998 May;28(3):573-84
9626714
Psychosom Med. 2006 Sep-Oct;68(5):747-53
17012528
Nihon Yakurigaku Zasshi. 2002 Jun;119(6):319-25
12089903
Obstet Gynecol. 2008 Feb;111(2 Pt 1):309-16
18238967
Psychoneuroendocrinology. 2000 Oct;25(7):707-20
10938450
Int J Neurosci. 2008 Aug;118(8):1181
18589921
Dev Psychol. 2003 Nov;39(6):1083-94
14584986
Pediatrics. 1991 Sep;88(3):477-80
1881726
Child Adolesc Psychiatr Clin N Am. 2005 Oct;14(4):707-26, viii
16171699
Am J Public Health. 2004 Aug;94(8):1358-65
15284044
BMJ. 1999 Jan 16;318(7177):153-7
9888905
Depress Anxiety. 2008;25(6):E11-6
17587221
Infant Behav Dev. 2009 Jan;32(1):10-6
19004502
Psychiatry. 2004 Spring;67(1):63-80
15139586
Psychoneuroendocrinology. 2005 Feb;30(2):199-211
15471617
J Bodyw Mov Ther. 2008 Apr;12(2):146-50
19083666
Early Hum Dev. 2003 Nov;74(2):139-51
14580753
Am J Psychiatry. 2007 Aug;164(8):1206-13
17671283
Infant Behav Dev. 2010 Feb;33(1):23-9
19945170
Gen Hosp Psychiatry. 2006 Jul-Aug;28(4):289-95
16814627
Psychoneuroendocrinology. 2007 Sep-Nov;32(8-10):1013-20
17855000
Infant Behav Dev. 2007 Feb;30(1):127-33
17292785
Ann N Y Acad Sci. 2006 Dec;1094:287-91
17347363
Int J Neurosci. 2009;119(5):630-8
19283590
Psychoneuroendocrinology. 2003 Feb;28(2):121-37
12510008
Infant Behav Dev. 2006 Apr;29(2):169-74
17138272
Curr Drug Targets. 2006 Feb;7(2):177-85
16475959
Peptides. 2006 Jun;27(6):1457-63
16309788
Acta Obstet Gynecol Scand. 2009;88(5):599-605
19308810
Brain Behav Immun. 2001 Sep;15(3):199-226
11566046
Infant Behav Dev. 2008 Dec;31(4):590-3
18774177
Soc Sci Med. 2005 May;60(10):2217-28
15748670
Psychiatr Pol. 2006 May-Jun;40(3):415-30
17037809
Psychoneuroendocrinology. 2004 Oct;29(9):1119-28
15219635