Project Title:	Prenatal Depression and Uterine Artery Blood Flow
Principal Investigator/Program Director:	Miguel Diego, Ph.D.
Other Investigators and Departments (or other Universities, if applicable):	Tiffany Field, Ph.D.
Community Based Organization-Collaborator (if applicable)	NA
Funding Source (e.g., NICHD, NCI, Dept of Education, Children’s Trust):	NIMH
Annual Direct Costs:	$200,000
Annual Facility and Administration Costs (F&A) and Rate, (e.g., 53%, 10%):	(53%)
Total Project Award (Combined Direct and F&A Costs):	$612,000
Dates of Award (if pending, indicated Pending):	Pending
Lay Abstract (in space below): Please be concise (space below will word wrap and expand)	Please include: (a) Specific Aims, Objectives, and/or Hypotheses of the study; (b) Participants (disease or disability, age, gender, child, family, etc), (c) Project type (eg., descriptive study, service demonstration project, case study, ethnographic study, clinical trial); (d) Brief description of methods and procedures; and (e) anticipated outcomes/benefits
Depression affects from 10 to 25% of all pregnant women. This represents a major health burden, as depression during pregnancy is associated with an increased risk for pregnancy complications including preeclampsia and may negatively affect fetal development. One potential mechanism for the effects of prenatal depression on perinatal outcomes involves uterine vasoconstriction resulting in placental hypoxia and reduced oxygen and nutrient delivery to the fetus. This may be induced by the elevated cortisol and norepinephrine levels noted in depressed women during pregnancy. Previous research indicates that prenatal cortisol increases norepinephrine induced uterine vasoconstriction, and maternal anxiety during pregnancy is associated with reduced uterine artery blood flow at 28-32 weeks gestation. Even though depression like anxiety is associated with adverse perinatal outcomes and elevated cortisol and norepinephrine levels, uterine artery blood flow has yet to be studied in depressed pregnant women. As such, the proposed project will derive uterine artery RI from Doppler ultrasound examinations as an index of uterine artery blood flow in 50 depressed and 50 non-depressed women during the second (18-20 weeks GA) and third trimesters (30-32 weeks GA) of pregnancy. Depression will be diagnosed using the Structured Clinical Interview for DSM-IV Disorders (SCID), and the Center for Epidemiological Studies Depression Scale (CES-D) and the State-Trait Anxiety Inventory (STAI) will be administered to assess depression and anxiety symptoms. Urine samples will be collected to assess prenatal cortisol and norepinephrine levels. Inasmuch as prenatal anxiety is associated with increased uterine artery RI during the third trimester of pregnancy, depressed women are also expected to exhibit increased uterine artery RI during pregnancy. Inasmuch as our pilot data suggests that the effects of prenatal depression on fetal development are apparent as early as 19-20 weeks gestation, depressed women are expected to exhibit increased uterine artery RI as early as the second trimester of pregnancy. The proposed study will also explore a potential underlying mechanism by using path analysis to explore whether the effects of maternal depression on uterine artery RI are mediated by elevated maternal cortisol and norepinephrine levels.
Abstracts and/or Publications Resulting from the Project: