DepressionNCT00525226
Evaluating the Effects of Stress in Pregnancy
An observational study of Depression and Panic Disorder, run by Emory University at 1 site in United States.
Trial 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. Read more about this study
- Who is it for?
- Ages 18 to 45 years, women onlyHealthy volunteers can take part
- Conditions the study is for
- Depression, Panic Disorder, Generalized Anxiety Disorder
- How many people
- 1,431 participants
- Where
- 1 siteUnited States
- Study dates
- Sep 2007to Jul 2012
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 45 years
- Women only
- Healthy volunteers accepted
- Adult
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.
Who may be able to join
- 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
Who cannot join
- 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
Trial locations and contacts
1 site in 1 country.
United States1 site
Emory University Women's Mental Health Program
Atlanta, Georgia, 30322
About this study
Official title: Perinatal Stress and Gene Influences: Pathways to Infant Vulnerability
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.
Read the 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.
- Conditions
- Depression, Panic Disorder, Generalized Anxiety Disorder, Post-Traumatic Stress Disorder, Obsessive Compulsive Disorder (OCD)
- Keywords
- Psychiatry, Psychology, Pregnancy, Stress, Anxiety
- Medical subject headings
- Depression, Panic Disorder, Generalized Anxiety Disorder, Stress Disorders, Post-Traumatic, Obsessive-Compulsive Disorder, Anxiety Disorders
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| 1 | Women who have experienced symptoms of depression or anxiety during pregnancy. |
What is being measured
The primary outcome is the main question the study is designed to answer.
Social and emotional development of infants who have mothers with depression and anxiety, during or soon after pregnancy
Measured: Measured at Year 1 post-pregnancy
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Sep 2007 (estimated)
- Study startSep 2007
- Primary completionJul 2012
- Study completionJul 2012
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (11)Papers the sponsor has linked to this study.
- Other trials for DepressionStudies of the same condition, open and under way.
- More trials run by Emory UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Cohort
- Time perspective
- Prospective
- Enrolment
- 1,431 participants (actual)
Sponsor and investigators
- Lead sponsor
- Emory University
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute of Mental Health (NIMH)
- Responsible party
- Principal investigator, Michael J. Owens, Emory University
- Investigators
- Zachary N. Stowe, MD, Principal investigator, Emory UniversityMichael J Owens, PhD, Principal investigator, Emory University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT00525226
- Sponsor's protocol ID
- IRB00004249
- Other IDs
- P50MH077928, DDTR B3-PDB
- Status last verified
- Nov 2013
- First submitted
- 4 Sep 2007
- Last updated
- 20 Nov 2013
- Results posted
- No
- Data monitoring committee
- Yes
Publications
Ji S, Long Q, Newport DJ, Na H, Knight B, Zach EB, Morris NJ, Kutner M, Stowe ZN. Validity of depression rating scales during pregnancy and the postpartum period: impact of trimester and parity. J Psychiatr Res. 2011 Feb;45(2):213-9. doi: 10.1016/j.jpsychires.2010.05.017. Epub 2010 Jun 9.
PubMed 20542520Miller AM, Hogue CJ, Knight BT, Stowe ZN, Newport DJ. Maternal expectations of postpartum social support: validation of the Postpartum Social Support Questionnaire during pregnancy. Arch Womens Ment Health. 2012 Aug;15(4):307-11. doi: 10.1007/s00737-012-0287-x. Epub 2012 May 16.
PubMed 22588510Newport DJ, Ji S, Long Q, Knight BT, Zach EB, Smith EN, Morris NJ, Stowe ZN. Maternal depression and anxiety differentially impact fetal exposures during pregnancy. J Clin Psychiatry. 2012 Feb;73(2):247-51. doi: 10.4088/JCP.10m06783. Epub 2011 Nov 29.
PubMed 22152400Schroeder JW, Conneely KN, Cubells JC, Kilaru V, Newport DJ, Knight BT, Stowe ZN, Brennan PA, Krushkal J, Tylavsky FA, Taylor RN, Adkins RM, Smith AK. Neonatal DNA methylation patterns associate with gestational age. Epigenetics. 2011 Dec;6(12):1498-504. doi: 10.4161/epi.6.12.18296.
PubMed 22139580Monk C, Newport DJ, Korotkin JH, Long Q, Knight B, Stowe ZN. Uterine blood flow in a psychiatric population: impact of maternal depression, anxiety, and psychotropic medication. Biol Psychiatry. 2012 Sep 15;72(6):483-90. doi: 10.1016/j.biopsych.2012.05.006. Epub 2012 Jun 12.
PubMed 22695184Schroeder JW, Smith AK, Brennan PA, Conneely KN, Kilaru V, Knight BT, Newport DJ, Cubells JF, Stowe ZN. DNA methylation in neonates born to women receiving psychiatric care. Epigenetics. 2012 Apr;7(4):409-14. doi: 10.4161/epi.19551. Epub 2012 Apr 1.
PubMed 22419064Lusby CM, Goodman SH, Bell MA, Newport DJ. Electroencephalogram patterns in infants of depressed mothers. Dev Psychobiol. 2014 Apr;56(3):459-73. doi: 10.1002/dev.21112. Epub 2013 Jul 12.
PubMed 23852456McConathy J, Capello C, Jarkas N, Stowe ZN, Owens MJ. Preparation of antidepressants for use in preclinical research. Int J Neuropsychopharmacol. 2007 Dec;10(6):759-63. doi: 10.1017/S1461145706007474. Epub 2007 Jan 4.
PubMed 17201995Capello CF, Bourke CH, Ritchie JC, Stowe ZN, Newport DJ, Nemeroff A, Owens MJ. Serotonin transporter occupancy in rats exposed to serotonin reuptake inhibitors in utero or via breast milk. J Pharmacol Exp Ther. 2011 Oct;339(1):275-85. doi: 10.1124/jpet.111.183855. Epub 2011 Jul 20.
PubMed 21775476Bourke CH, Capello CF, Rogers SM, Yu ML, Boss-Williams KA, Weiss JM, Stowe ZN, Owens MJ. Prenatal exposure to escitalopram and/or stress in rats: a prenatal stress model of maternal depression and its treatment. Psychopharmacology (Berl). 2013 Jul;228(2):231-41. doi: 10.1007/s00213-013-3030-z. Epub 2013 Feb 24.
PubMed 23436130Smith AK, Newport DJ, Ashe MP, Brennan PA, Laprairie JL, Calamaras M, Nemeroff CB, Ritchie JC, Cubells JF, Stowe ZN. Predictors of neonatal hypothalamic-pituitary-adrenal axis activity at delivery. Clin Endocrinol (Oxf). 2011 Jul;75(1):90-5. doi: 10.1111/j.1365-2265.2011.03998.x.
PubMed 21521269
Study at a glance
From the registry record, last updated by the sponsor on 20 Nov 2013. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Perinatal Stress and Gene Influences: Pathways to Infant Vulnerability
- ClinicalTrials.gov ID
- NCT00525226
- Acronym / sponsor ID
- IRB00004249
- Conditions
- Depression, Panic Disorder, Generalized Anxiety Disorder, Post-Traumatic Stress Disorder, Obsessive Compulsive Disorder (OCD)
- Keywords
- Psychiatry, Psychology, Pregnancy, Stress, Anxiety
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 1,431 participants (actual)
- Lead sponsor
- Emory UniversityUniversity, hospital or other
- Collaborators
- National Institute of Mental Health (NIMH)
- Study start
- Sep 2007
- Primary completion
- Jul 2012 (actual)
- Study completion
- Jul 2012 (actual)
- First posted
- 5 Sep 2007 (estimated)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
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.
Study design
- Observational model
- Cohort
- Time perspective
- Prospective
- Number of arms
- 1
| Arm | Type | Receives |
|---|---|---|
| 1 | – | –Women who have experienced symptoms of depression or anxiety during pregnancy. |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- Female only
- Healthy volunteers
- Accepted
- Age groups
- Adult
- 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.
Key inclusion criteria (4 listed)
- 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
Key exclusion criteria (7 listed)
- 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)
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
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
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 20 Nov 2013.
- Background: PubMed 20542520Ji S, Long Q, Newport DJ, Na H, Knight B, Zach EB, Morris NJ, Kutner M, Stowe ZN. Validity of depression rating scales during pregnancy and the postpartum period: impact of trimester and parity. J Psychiatr Res. 2011 Feb;45(2):213-9. doi: 10.1016/j.jpsychires.2010.05.017. Epub 2010 Jun 9.
- Background: PubMed 22588510Miller AM, Hogue CJ, Knight BT, Stowe ZN, Newport DJ. Maternal expectations of postpartum social support: validation of the Postpartum Social Support Questionnaire during pregnancy. Arch Womens Ment Health. 2012 Aug;15(4):307-11. doi: 10.1007/s00737-012-0287-x. Epub 2012 May 16.
- Background: PubMed 22152400Newport DJ, Ji S, Long Q, Knight BT, Zach EB, Smith EN, Morris NJ, Stowe ZN. Maternal depression and anxiety differentially impact fetal exposures during pregnancy. J Clin Psychiatry. 2012 Feb;73(2):247-51. doi: 10.4088/JCP.10m06783. Epub 2011 Nov 29.
- Background: PubMed 22139580Schroeder JW, Conneely KN, Cubells JC, Kilaru V, Newport DJ, Knight BT, Stowe ZN, Brennan PA, Krushkal J, Tylavsky FA, Taylor RN, Adkins RM, Smith AK. Neonatal DNA methylation patterns associate with gestational age. Epigenetics. 2011 Dec;6(12):1498-504. doi: 10.4161/epi.6.12.18296.
- Background: PubMed 22695184Monk C, Newport DJ, Korotkin JH, Long Q, Knight B, Stowe ZN. Uterine blood flow in a psychiatric population: impact of maternal depression, anxiety, and psychotropic medication. Biol Psychiatry. 2012 Sep 15;72(6):483-90. doi: 10.1016/j.biopsych.2012.05.006. Epub 2012 Jun 12.
- Background: PubMed 22419064Schroeder JW, Smith AK, Brennan PA, Conneely KN, Kilaru V, Knight BT, Newport DJ, Cubells JF, Stowe ZN. DNA methylation in neonates born to women receiving psychiatric care. Epigenetics. 2012 Apr;7(4):409-14. doi: 10.4161/epi.19551. Epub 2012 Apr 1.
- Background: PubMed 23852456Lusby CM, Goodman SH, Bell MA, Newport DJ. Electroencephalogram patterns in infants of depressed mothers. Dev Psychobiol. 2014 Apr;56(3):459-73. doi: 10.1002/dev.21112. Epub 2013 Jul 12.
- Background: PubMed 17201995McConathy J, Capello C, Jarkas N, Stowe ZN, Owens MJ. Preparation of antidepressants for use in preclinical research. Int J Neuropsychopharmacol. 2007 Dec;10(6):759-63. doi: 10.1017/S1461145706007474. Epub 2007 Jan 4.
- Background: PubMed 21775476Capello CF, Bourke CH, Ritchie JC, Stowe ZN, Newport DJ, Nemeroff A, Owens MJ. Serotonin transporter occupancy in rats exposed to serotonin reuptake inhibitors in utero or via breast milk. J Pharmacol Exp Ther. 2011 Oct;339(1):275-85. doi: 10.1124/jpet.111.183855. Epub 2011 Jul 20.
- Background: PubMed 23436130Bourke CH, Capello CF, Rogers SM, Yu ML, Boss-Williams KA, Weiss JM, Stowe ZN, Owens MJ. Prenatal exposure to escitalopram and/or stress in rats: a prenatal stress model of maternal depression and its treatment. Psychopharmacology (Berl). 2013 Jul;228(2):231-41. doi: 10.1007/s00213-013-3030-z. Epub 2013 Feb 24.
- Background: PubMed 21521269Smith AK, Newport DJ, Ashe MP, Brennan PA, Laprairie JL, Calamaras M, Nemeroff CB, Ritchie JC, Cubells JF, Stowe ZN. Predictors of neonatal hypothalamic-pituitary-adrenal axis activity at delivery. Clin Endocrinol (Oxf). 2011 Jul;75(1):90-5. doi: 10.1111/j.1365-2265.2011.03998.x.
- Click here for the Women's Mental Health Program Web siteLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Zachary N. Stowe, MD principal investigator
Emory University
Michael J Owens, PhD principal investigator
Emory University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Depression and Panic Disorder, run by Emory University at 1 site in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 20 Nov 2013. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
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). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT00525226, which also lists 11 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 20 Nov 2013.