title: Prenatal depression effects and interventions: a review.
abstract: 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.
authors.affiliation: Touch Research Institutes, University of Miami Medical School, Department of Pediatrics, Miami, FL 33101, USA. tfield@med.miami.edu
authors.forename: Tiffany
authors.initials: T
authors.lastname: Field
authors.forename: Miguel
authors.initials: M
authors.lastname: Diego
authors.forename: Maria
authors.initials: M
authors.lastname: Hernandez-Reif
mesh_terms: 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
chemical_list: D012701:Serotonin; D004298:Dopamine; D006854:Hydrocortisone
references.citation: Pediatrics. 1996 Jun;97(6 Pt 1):851-5
references.pmid: 8657526
references.citation: Int J Neurosci. 2010 Mar;120(3):163-7
references.pmid: 20374082
references.citation: J Bodyw Mov Ther. 2009 Oct;13(4):297-303
references.pmid: 19761951
references.citation: J Affect Disord. 2008 Dec;111(2-3):214-20
references.pmid: 18394713
references.citation: Am J Obstet Gynecol. 1999 Dec;181(6):1530-6
references.pmid: 10601939
references.citation: Metabolism. 2005 May;54(5 Suppl 1):24-7
references.pmid: 15877309
references.citation: Int J Neurosci. 2005 Oct;115(10):1397-413
references.pmid: 16162447
references.citation: Int J Neurosci. 2005 Mar;115(3):423-9
references.pmid: 15825247
references.citation: Hum Reprod. 2009 Jan;24(1):146-53
references.pmid: 18948314
references.citation: Neurosci Biobehav Rev. 2005 Apr;29(2):237-58
references.pmid: 15811496
references.citation: Infant Behav Dev. 2006 Dec;29(4):579-83
references.pmid: 17138311
references.citation: Infant Behav Dev. 2008 Apr;31(2):316-20
references.pmid: 18279966
references.citation: J Clin Psychiatry. 2006;67 Suppl 6:27-32
references.pmid: 16848674
references.citation: BJOG. 2008 Jul;115(8):1043-51
references.pmid: 18651886
references.citation: Infant Behav Dev. 2008 Apr;31(2):190-3
references.pmid: 18037494
references.citation: Infant Behav Dev. 2009 Dec;32(4):454-60
references.pmid: 19646762
references.citation: J Altern Complement Med. 2005 Apr;11(2):237-44
references.pmid: 15865489
references.citation: Psychoneuroendocrinology. 2005 Aug;30(7):647-56
references.pmid: 15854781
references.citation: Psychopharmacol Bull. 2003;37(4):99-115
references.pmid: 15131521
references.citation: Expert Rev Neurother. 2007 Jul;7(7):761-4
references.pmid: 17610382
references.citation: Ultrasound Obstet Gynecol. 2002 Dec;20(6):580-5
references.pmid: 12493047
references.citation: Proc Natl Acad Sci U S A. 2009 Feb 17;106(7):2464-7
references.pmid: 19188591
references.citation: Prog Brain Res. 1975;42:333-41
references.pmid: 1239045
references.citation: J Intern Med. 2007 May;261(5):453-60
references.pmid: 17444884
references.citation: Infant Behav Dev. 2006 Apr;29(2):268-75
references.pmid: 17138282
references.citation: J Psychosom Obstet Gynaecol. 2004 Jun;25(2):115-22
references.pmid: 15715034
references.citation: J Health Psychol. 2007 Mar;12(2):285-300
references.pmid: 17284493
references.citation: Psychosom Med. 2006 Nov-Dec;68(6):938-46
references.pmid: 17079701
references.citation: Clin Psychol Rev. 2003 Nov;23(6):831-48
references.pmid: 14529700
references.citation: Dev Psychobiol. 1996 Dec;29(8):697-712
references.pmid: 8958482
references.citation: J Am Acad Child Adolesc Psychiatry. 2007 Jun;46(6):737-746
references.pmid: 17513986
references.citation: Eur J Obstet Gynecol Reprod Biol. 1997 Aug;74(2):149-55
references.pmid: 9306108
references.citation: Soc Work. 2002 Apr;47(2):114-23
references.pmid: 12019798
references.citation: J Obstet Gynaecol. 2001 Sep;21(5):468-73
references.pmid: 12521799
references.citation: Early Hum Dev. 2007 Jul;83(7):451-8
references.pmid: 17008033
references.citation: Health Psychol. 2000 Nov;19(6):535-43
references.pmid: 11129356
references.citation: J Womens Health (Larchmt). 2007 May;16(4):535-42
references.pmid: 17521257
references.citation: Womens Health Issues. 2002 Jan-Feb;12(1):16-22
references.pmid: 11786288
references.citation: J Clin Endocrinol Metab. 2004 Dec;89(12):6244-50
references.pmid: 15579784
references.citation: Infant Behav Dev. 2006 Jan;29(1):54-8
references.pmid: 17138261
references.citation: Can J Appl Physiol. 1997 Jun;22(3):280-91
references.pmid: 9189307
references.citation: Psychol Med. 2007 Mar;37(3):453-62
references.pmid: 17121688
references.citation: J Am Acad Child Adolesc Psychiatry. 2004 Mar;43(3):283-90
references.pmid: 15076261
references.citation: Am J Obstet Gynecol. 1996 Nov;175(5):1286-92
references.pmid: 8942502
references.citation: Psychopharmacology (Berl). 2004 Aug;174(4):512-24
references.pmid: 15249991
references.citation: Brain Behav Immun. 2005 Jul;19(4):296-308
references.pmid: 15944068
references.citation: Infant Behav Dev. 2006 Apr;29(2):262-7
references.pmid: 17138281
references.citation: Can J Clin Pharmacol. 2009 Winter;16(1):e15-22
references.pmid: 19164843
references.citation: J Child Psychol Psychiatry. 2008 Oct;49(10):1099-107
references.pmid: 18492036
references.citation: Lancet. 1998 Aug 29;352(9129):707-8
references.pmid: 9728994
references.citation: J Womens Health (Larchmt). 2003 May;12(4):373-80
references.pmid: 12804344
references.citation: Int J Neurosci. 2008 Jan;118(1):95-103
references.pmid: 18041608
references.citation: Psychol Med. 1998 May;28(3):573-84
references.pmid: 9626714
references.citation: Psychosom Med. 2006 Sep-Oct;68(5):747-53
references.pmid: 17012528
references.citation: Nihon Yakurigaku Zasshi. 2002 Jun;119(6):319-25
references.pmid: 12089903
references.citation: Obstet Gynecol. 2008 Feb;111(2 Pt 1):309-16
references.pmid: 18238967
references.citation: Psychoneuroendocrinology. 2000 Oct;25(7):707-20
references.pmid: 10938450
references.citation: Int J Neurosci. 2008 Aug;118(8):1181
references.pmid: 18589921
references.citation: Dev Psychol. 2003 Nov;39(6):1083-94
references.pmid: 14584986
references.citation: Pediatrics. 1991 Sep;88(3):477-80
references.pmid: 1881726
references.citation: Child Adolesc Psychiatr Clin N Am. 2005 Oct;14(4):707-26, viii
references.pmid: 16171699
references.citation: Am J Public Health. 2004 Aug;94(8):1358-65
references.pmid: 15284044
references.citation: BMJ. 1999 Jan 16;318(7177):153-7
references.pmid: 9888905
references.citation: Depress Anxiety. 2008;25(6):E11-6
references.pmid: 17587221
references.citation: Infant Behav Dev. 2009 Jan;32(1):10-6
references.pmid: 19004502
references.citation: Psychiatry. 2004 Spring;67(1):63-80
references.pmid: 15139586
references.citation: Psychoneuroendocrinology. 2005 Feb;30(2):199-211
references.pmid: 15471617
references.citation: J Bodyw Mov Ther. 2008 Apr;12(2):146-50
references.pmid: 19083666
references.citation: Early Hum Dev. 2003 Nov;74(2):139-51
references.pmid: 14580753
references.citation: Am J Psychiatry. 2007 Aug;164(8):1206-13
references.pmid: 17671283
references.citation: Infant Behav Dev. 2010 Feb;33(1):23-9
references.pmid: 19945170
references.citation: Gen Hosp Psychiatry. 2006 Jul-Aug;28(4):289-95
references.pmid: 16814627
references.citation: Psychoneuroendocrinology. 2007 Sep-Nov;32(8-10):1013-20
references.pmid: 17855000
references.citation: Infant Behav Dev. 2007 Feb;30(1):127-33
references.pmid: 17292785
references.citation: Ann N Y Acad Sci. 2006 Dec;1094:287-91
references.pmid: 17347363
references.citation: Int J Neurosci. 2009;119(5):630-8
references.pmid: 19283590
references.citation: Psychoneuroendocrinology. 2003 Feb;28(2):121-37
references.pmid: 12510008
references.citation: Infant Behav Dev. 2006 Apr;29(2):169-74
references.pmid: 17138272
references.citation: Curr Drug Targets. 2006 Feb;7(2):177-85
references.pmid: 16475959
references.citation: Peptides. 2006 Jun;27(6):1457-63
references.pmid: 16309788
references.citation: Acta Obstet Gynecol Scand. 2009;88(5):599-605
references.pmid: 19308810
references.citation: Brain Behav Immun. 2001 Sep;15(3):199-226
references.pmid: 11566046
references.citation: Infant Behav Dev. 2008 Dec;31(4):590-3
references.pmid: 18774177
references.citation: Soc Sci Med. 2005 May;60(10):2217-28
references.pmid: 15748670
references.citation: Psychiatr Pol. 2006 May-Jun;40(3):415-30
references.pmid: 17037809
references.citation: Psychoneuroendocrinology. 2004 Oct;29(9):1119-28
references.pmid: 15219635