Project Title:	Prenatal Depression Mechanisms and Interventions
Principal Investigator/Program Director:	Tiffany Field, Ph.D.
Other Investigators and Departments (or other Universities, if applicable):	Miguel Diego, Ph.D.
Community Based Organization-Collaborator (if applicable)	NA
Funding Source (e.g., NICHD, NCI, Dept of Education, Children’s Trust):	NCCAM
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
Prenatal depression has been associated with prematurity. In our path analysis study on prenatally depressed women, prenatal cortisol was the strongest predictor of prematurity. In our pregnancy massage study with prenatally depressed women, massage was associated with reduced prenatal cortisol and prematurity. In the proposed study we would test a potential path analysis model for the effects of massage therapy, namely that massage (stimulation of pressure, receptors) reduces depression and enhances vagal activity which, in turn, reduces cortisol and increases gestational age (reduces premature deliveries) in depressed women. The second novel aspect of this study would be an assessment of yoga as a more cost-effective form of self-massage. Inasmuch as yoga also stimulates pressure receptors, it might be expected to have effects and underlying mechanisms that are similar to those of massage therapy. Depressed pregnant women (N=120) and a non-depressed control group (N=40) would be recruited at their first prenatal ultrasound visit (at approximately 18-22 weeks gestation). The depressed women would be randomly assigned to a massage therapy, yoga or standard treatment control group (N=40 each group). The treatment (massage/yoga) protocols would be taught to the women and their significant others. As in our previous study, the massage group would receive two 20-minute massages per week by their significant other, and for the yoga group, the significant other would be asked to practice yoga with the pregnant woman twice per week on the same schedule as the massage group. The women would be diagnosed depressed on the SCID and would be assessed at the first ultrasound visit and again at the neonatal period on self-report measures of depression (CES-D) and anxiety (STAI), vagal activity and cortisol. Their neonates would be assessed on the primary outcome measure of gestational age and the secondary measures of vagal activity, cortisol, and performance on the Brazelton Neonatal Behavior Assessment Scale. We would expect that 1) massage therapy and yoga would be equally as effective in increasing gestational age (reducing prematurity), and 2) the two therapies would have similar underlying mechanisms based on a similar path analysis model of decreased depression and increased vagal activity leading to decreased cortisol and, in turn, increased gestational age.
Abstracts and/or Publications Resulting from the Project: