Reducing maternal prenatal depression to improve child cardiovascular health

减少母亲产前抑郁症，改善儿童心血管健康

• 批准号: 10326353
• 负责人: Elysia Poggi Davis
• 金额: $ 58.26万
• 依托单位: UNIVERSITY OF DENVER (COLORADO SEMINARY)
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-01-15 至 2025-12-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10326353
• 关键词: Address; Adult; Age; American Heart Association; Arterial Fatty Streak; Barker Hypothesis; Behavior; Behavioral Mechanisms; Birth; Blood; Blood Pressure; Body fat; Body mass index; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Child; Child Behavior; Child Mental Health; Childhood; Clinical Trials; Cognitive; Data; Deposition; Development; Diabetes Mellitus; Diet; Eating; Eating Behavior; Emotional; Endothelium; Epidemiology; Epigenetic Process; Exposure to; Fatty acid glycerol esters; Feeding behaviors; Feeds; Food; Gestational Age; Goals; Health; Health Promotion; Health behavior; Hypertension; Immune; Impairment; Informal Social Control; Insulin; Intervention; Knowledge; Lead; Life; Longevity; Longitudinal Studies; Low Birth Weight Infant; Low income; Maternal Behavior; Mediating; Mediator of activation protein; Metabolic; Modeling; Mothers; Neurosecretory Systems; Nursery Schools; Obesity; Organizational Policy; Outcome; Palate; Participant; Physical activity; Physiological; Physiology; Pregnant Women; Premature Birth; Prevalence; Prevention; Randomized Controlled Trials; Research; Risk; Risk Factors; Sampling; Signal Transduction; Sleep; Stress; System; Testing; Time; Work; adverse birth outcomes; antepartum depression; arterial stiffness; associated symptom; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; depressive symptoms; dietary; early childhood; efficacious intervention; emotion regulation; ethnic diversity; feeding; follow-up; food quality; improved; intrauterine environment; longitudinal design; maternal depression; next generation; obesity in children; obesogenic; offspring; postnatal; preference; prenatal; prenatal intervention; protective factors; psychosocial; racial diversity; rapid infant weight gain; reduce symptoms; sedentary lifestyle; symptomatic improvement; trial design; waist circumference; Address; Adult; Age; American Heart Association; Arterial Fatty Streak; Barker Hypothesis; Behavior; Behavioral Mechanisms; Birth; Blood; Blood Pressure; Body fat; Body mass index; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Child; Child Behavior; Child Mental Health; Childhood; Clinical Trials; Cognitive; Data; Deposition; Development; Diabetes Mellitus; Diet; Eating; Eating Behavior; Emotional; Endothelium; Epidemiology; Epigenetic Process; Exposure to; Fatty acid glycerol esters; Feeding behaviors; Feeds; Food; Gestational Age; Goals; Health; Health Promotion; Health behavior; Hypertension; Immune; Impairment; Informal Social Control; Insulin; Intervention; Knowledge; Lead; Life; Longevity; Longitudinal Studies; Low Birth Weight Infant; Low income; Maternal Behavior; Mediating; Mediator of activation protein; Metabolic; Modeling; Mothers; Neurosecretory Systems; Nursery Schools; Obesity; Organizational Policy; Outcome; Palate; Participant; Physical activity; Physiological; Physiology; Pregnant Women; Premature Birth; Prevalence; Prevention; Randomized Controlled Trials; Research; Risk; Risk Factors; Sampling; Signal Transduction; Sleep; Stress; System; Testing; Time; Work; adverse birth outcomes; antepartum depression; arterial stiffness; associated symptom; cardiovascular disorder risk; cardiovascular health; cardiovascular risk factor; depressive symptoms; dietary; early childhood; efficacious intervention; emotion regulation; ethnic diversity; feeding; follow-up; food quality; improved; intrauterine environment; longitudinal design; maternal depression; next generation; obesity in children; obesogenic; offspring; postnatal; preference; prenatal; prenatal intervention; protective factors; psychosocial; racial diversity; rapid infant weight gain; reduce symptoms; sedentary lifestyle; symptomatic improvement; trial design; waist circumference

PROJECT SUMMARY/ABSTRACT It is critical to understand risk and protective factors for health to optimize developmental outcomes and inform prevention of poor health behaviors across the lifespan. Research using longitudinal designs, multiple levels of analysis, and experimental clinical trials are needed. Cardiovascular disease (CVD) is the leading cause of death worldwide. The origins of adult CVD begin prenatally: High prenatal maternal depressive symptoms robustly predict offspring CVD risk. However, knowledge on risk and protective factors for CVD for offspring of mothers with high depressive symptoms has been correlational. There is a lack of experimental work using a randomized controlled trial (RCT) design to understand potential mechanisms that contribute to children's CVD risk following exposure to high maternal prenatal depressive symptoms across multiple levels (e.g., maternal and child behaviors, physiology) over time. Although efficacious interventions to diminish depressive symptoms among pregnant women exist, research has not investigated whether reducing prenatal maternal depressive symptoms can reduce offspring cardiovascular risk. The current study proposes to leverage a RCT of an effective psychosocial intervention for prenatal maternal depression to test whether reducing prenatal maternal depressive symptoms improves offspring cardiovascular health at ages 3-4 years. We hypothesize that the prenatal intervention operates by reducing both prenatal and postnatal depressive symptoms to improve child outcomes. This study will identify intervention targets for offspring of mothers with high prenatal depressive symptoms to reduce cardiovascular risk. These goals will be accomplished by building on a RCT (R01MH109662) of an established psychosocial intervention that effectively reduces maternal prenatal depressive symptoms. We propose to leverage this unique opportunity to follow up mothers and children who participated in this RCT to test whether this intervention improves offspring cardiovascular health. This project increases rigor of the existing correlational research by using an experimental RCT design. The following 3 aims will be addressed. Aim 1: To test whether reducing prenatal maternal depressive symptoms improves the quality of food the mother feeds her child, maternal feeding behaviors, and modeling of eating behaviors at 3 years. Aim 2: To test whether reducing prenatal maternal depressive symptoms improves child diet, eating behaviors, sleep, and physical activity at 3 years. Aim 3: To test whether reducing prenatal maternal depressive symptoms reduces child CVD risk at 3 and 4 years, including BMI, waist circumference, body fat, blood pressure, and arterial stiffness. This project will provide the strongest evidence to date for a mechanistic model of prenatal maternal depressive symptoms' influence on child cardiovascular health. Importantly, the project will also provide evidence for whether effective psychosocial interventions to reduce prenatal maternal depressive symptoms should be used to reduce the burden of CVD in the next generation.

项目摘要/摘要 了解健康的风险和保护因素至关重要，以优化发展结果并告知 预防整个生命周期的健康行为不良。使用纵向设计，多个级别的研究 分析和实验临床试验。心血管疾病（CVD）是 全球死亡。成人CVD的起源从产前开始：高产前产妇抑郁症状 坚固地预测后代CVD风险。但是，关于CVD的风险和保护因素的知识 具有高抑郁症​​状的母亲是相关的。缺乏实验性工作 随机对照试验（RCT）设计，以了解有助于儿童CVD的潜在机制 暴露于多个级别的高产前产前抑郁症状后的风险（例如 随着时间的流逝，儿童行为，生理学）。尽管有效的干预措施减轻了抑郁症状 在孕妇存在中，研究尚未研究是否减少产前产妇抑郁症 症状可以减少后代心血管风险。当前的研究建议利用 产前孕产妇抑郁症的有效社会心理干预测试是否减少产前产妇 抑郁症状改善了3-4岁的后代心血管健康。我们假设 产前干预通过减少产前和产后抑郁症状以改善儿童而进行 结果。这项研究将确定产前抑郁症高的母亲的后代的干预目标 降低心血管风险的症状。这些目标将通过在RCT上构建来实现 （R01MH109662）已建立的社会心理干预措施，可有效地降低母亲产前 抑郁症状。我们建议利用这个独特的机会来跟进母亲和孩子 参加此RCT，以测试这种干预措施是否改善了后代心血管健康。这个项目 通过使用实验性RCT设计，增加了现有相关研究的严格性。以下3 目标将被解决。目标1：测试减少产前母体抑郁症状是否改善 母亲为孩子喂养的食物质量，孕产妇的喂养行为以及饮食行为的建模3 年。目标2：测试减少产前产妇抑郁症状是否可以改善儿童饮食，进食 行为，睡眠和体育活动3年。目标3：测试是否减少产前产妇 抑郁症状会在3和4年中降低儿童CVD风险，包括BMI，腰围，体内脂肪， 血压和动脉僵硬。该项目将为迄今为止提供最有力的证据 产前产妇抑郁症状对儿童心血管健康的影响的模型。重要的是， 项目还将提供证据证明是否有效的社会心理干预措施减少产前产妇 应使用抑郁症状来减轻下一代CVD的负担。