title: Maternal depression and anxiety differentially impact fetal exposures during pregnancy.
abstract: OBJECTIVE
  To examine the association between severity of maternal depression and anxiety during pregnancy and the maternal use of medicinal agents and habit-forming substances.
  
  
  METHODS
  Participants in a prospective study of prenatal DSM-IV depressive and anxiety disorders at the Emory Women's Mental Health Program who completed weekly documentation of prenatal drug exposure and ≥ 3 administrations of the Hamilton Depression Rating Scale (HDRS) or Hamilton Anxiety Rating Scale (HARS) were included. The primary outcome measures were the HDRS and HARS. Correlation coefficients were computed for cumulative drug exposure with HDRS area under the curve (AUC) and HARS AUC. Data collection was completed between January 2007 and June 2010.
  
  
  RESULTS
  Among 195 participants, both HDRS AUC and HARS AUC were negatively correlated with prenatal vitamin exposure (r = -0.22 [P = .002] and r = -0.26 [P = .0003], respectively) and positively correlated with tobacco (r = 0.21 [P = .003] and r = 0.20 [P = .006], respectively) and hypnotic (r = 0.28 [P < .0001] and r = 0.19 [P = .008], respectively) exposure. Only HDRS AUC correlated with exposure to antiemetics (r = 0.14 [P = .05]), opioid analgesics (r = 0.14 [P = .05]), and all prescription drugs (r = 0.16 [P = .02]). Only HARS AUC correlated with benzodiazepine exposure (r = 0.17 [P = .02]).
  
  
  CONCLUSIONS
  Both prenatal depression and anxiety are associated with decreased prenatal vitamin compliance and increased use of hypnotics and tobacco, but only depression is associated with exposure to a broader array of medications targeting physical symptoms that often accompany depression. These findings confirm and extend previous studies, underscoring the importance of addressing prenatal depression and anxiety.
authors.affiliation: Department of Psychiatry, Emory University School of Medicine, Atlanta, GA, USA. jeff.newport@emory.edu
authors.forename: D Jeffrey
authors.initials: DJ
authors.lastname: Newport
authors.forename: Shuang
authors.initials: S
authors.lastname: Ji
authors.forename: Qi
authors.initials: Q
authors.lastname: Long
authors.forename: Bettina T
authors.initials: BT
authors.lastname: Knight
authors.forename: Elizabeth B
authors.initials: EB
authors.lastname: Zach
authors.forename: Elizabeth N
authors.initials: EN
authors.lastname: Smith
authors.forename: Natalie J
authors.initials: NJ
authors.lastname: Morris
authors.forename: Zachary N
authors.initials: ZN
authors.lastname: Stowe
mesh_terms: D001008:Anxiety Disorders / Q000175:diagnosis / Q000188:drug therapy*; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008425:Maternal Behavior / Q000523:psychology*; D011247:Pregnancy; D055553:Prescription Drugs / Q000627:therapeutic use*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D014029:Tobacco Use Disorder / Q000150:complications; D014815:Vitamins / Q000627:therapeutic use
chemical_list: D055553:Prescription Drugs; D014815:Vitamins