Abstract
Low-income African-American women report elevated prenatal depressive symptoms more often (42 %) than the national average (20 %). In the USA in 2012, 16.5 % of African-American women experienced a premature birth (less than 36 completed gestational weeks) compared to 10.3 % of white women. In addition, 13 % of African-American women had a low-birth weight infant (less than 2,500 g) compared to 7 % of white women. Variation in the neuropeptide, oxytocin has been implicated in perinatal depression, maternal behavior, regulation of stress responses, and may be associated with this health disparity. The purpose of this investigation was to examine factors associated with prenatal depressive symptoms, including plasma oxytocin levels and birth weight, in a sample of urban African-American women. Pregnant African-American women (N = 57) completed surveys and had blood drawn twice during pregnancy at 15–22 weeks and 25–37 weeks. In addition, birth data were collected from medical records. A large number of participants reported elevated prenatal depressive symptoms at the first (n = 20, 35 %) and the second (n = 19, 33 %) data points. Depressive symptoms were higher in multigravidas (t(51) = −2.374, p = 0.02), women with higher anxiety (r(47) = 0.71, p = 0.001), women who delivered their infants at an earlier gestational age (r(51) = −0.285, p = 0.04), and those without the support of the infant’s father (F(4, 48) = 2.676, p = 0.04). Depressive symptoms were also higher in women with low oxytocin levels than in women with high oxytocin levels (F(2, 47) = 3.3, p = 0.05). In addition, women who had low oxytocin tended to have infants with lower birth weights (F(2, 47) = 2.9, p = 0.06). Neither prenatal depressive symptoms nor prenatal oxytocin levels were associated with premature birth. Pregnant multigravida African-American women with increased levels of anxiety and lacking the baby’s father’s support during the pregnancy are at higher risk for prenatal depressive symptoms. Prenatal depressive symptoms are associated with low oxytocin levels and lower infant birth weights. Further research is needed to understand the mechanisms between prenatal depressive symptoms, oxytocin, and birth weight in order to better understand this health disparity.
Similar content being viewed by others
References
Aktan NM (2012) Social support and anxiety in pregnant and postpartum women: a secondary analysis. Clin Nurs Res 21(2):183–194
American College of Obstetricians and Gynecologists (2010) Committee on Obstetric Practice. Committee opinion no. 453: screening for depression during and after pregnancy. Obstet Gynecol 115(2 Pt 1):394–395
AssayDesigns. (2006) Oxytocin enzyme immunoassay kit. Assay Designs, Inc, Ann Arbor.
Beck CT (2008) Postpartum mood and anxiety disorders: case studies, research, and nursing care. 2nd ed. Washington D.C., Association of Women's Health, Obstetric and Neonatal Nurses.
Boyd RC, Le HN, Somberg R (2005) Review of screening instruments for postpartum depression. Arch Womens Mental Health 8(3):141–153
Canady RB, Stommel M, Holzman C (2009) Measurement properties of the centers for epidemiological studies depression scale (CES-D) in a sample of African American and non-Hispanic White pregnant women. J Nurs Meas 17(2):91–104
Chaudron LH, Szilagyi PG, Tang W et al (2010) Accuracy of depression screening tools for identifying postpartum depression among urban mothers. Pediatrics 125(3):609–617
Dailey DE, Humphreys JC (2011) Social stressors associated with antepartum depressive symptoms in low-income African American women. Public Health Nurs 28(3):203–212
Davalos DB, Yadon CA, Tregellas HC (2012) Untreated prenatal maternal depression and the potential risks to offspring: a review. Arch Womens Mental Health 15(1):1–14
Fagan J, Lee Y (2010) Perceptions and satisfaction with father involvement and adolescent mothers’ postpartum depressive symptoms. J Youth Adolesc 39(9):1109–1121
Feldman R, Weller A, Zagoory-Sharon O, Levine A (2007) Evidence for a neuroendocrinological foundation of human affiliation: plasma oxytocin levels across pregnancy and the postpartum period predict mother-infant bonding. Psychol Sci 18(11):965–970
Feldman R, Zagoory-Sharon O, Weisman O et al (2012) Sensitive parenting is associated with plasma oxytocin and polymorphisms in the OXTR and CD38 genes. Biol Psychiatry 72(3):175–181
Field T, Diego M, Hernandez-Reif M et al (2003) Pregnancy anxiety and comorbid depression and anger: effects on the fetus and neonate. Depression Anxiety 17(3):140–151
Field T, Diego M, Hernandez-Reif M (2006) Prenatal depression effects on the fetus and newborn: a review. Infant BehavDev 29(3):445–455
Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T (2005) Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 106(5):1071–1083
Gimpl G, Fahrenholz F (2001) The oxytocin receptor system: structure, function, and regulation. Physiol Rev 81(2):629–683. http://physrev.physiology.org/content/81/2/629.full-text.pdf+html
Gordon I, Zagoory-Sharon O, Leckman JF, Feldman R (2010) Oxytocin and the development of parenting in humans. Biol Psychiatry 68(4):377–382
Gouin JP, Carter CS, Pournajafi-Nazarloo H et al (2010) Marital behavior, oxytocin, vasopressin, and wound healing. Psychoneuroendocrinology 35(7):1082–1090
Hamilton BE, Martal JA, Ventura MA. Births: Preliminary data for 2012. National Vital Statistics Report. 2013;62(3). http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_03.pdf
Heinrichs M, Domes G (2008) Neuropeptides and social behaviour: effects of oxytocin and vasopressin in humans. Prog Brain Res 170:337–350
Holditch-Davis D, Miles MS, Weaver MA et al (2009) Patterns of distress in African-American mothers of preterm infants. J Dev Behav Pediatr 30(3):193–205
Kinsella MT, Monk C (2009) Impact of maternal stress, depression and anxiety on fetal neurobehavioral development. Clin Obstet Gynecol 52(3):425–440
Levine A, Zagoory-Sharon O, Feldman R, Weller A (2007) Oxytocin during pregnancy and early postpartum: individual patterns and maternal-fetal attachment. Peptides 28(6):1162–1169
Marcus SM, Flynn HA, Blow FC, Barry KL (2003) Depressive symptoms among pregnant women screened in obstetrics settings. J Women's Health 12(4):373–380
Mezulis AH, Hyde JS, Clark R (2004) Father involvement moderates the effect of maternal depression during a child’s infancy on child behavior problems in kindergarten. J Fam Psychol 18(4):575–588
Myers ER, Aubuchon-Endsley N, Bastian LA et al (2013) Efficacy and safety of screening for postpartum depression. Rockville (MD).
Ozsoy S, Esel E, Kula M (2009) Serum oxytocin levels in patients with depression and the effects of gender and antidepressant treatment. Psychiatry Res 169(3):249–252
Pedersen CA, Ascher JA, Monroe YL, Prange AJ Jr (1982) Oxytocin induces maternal behavior in virgin female rats. Science 216(4546):648–650
Perry DF, Ettinger AK, Mendelson T, Le HN (2011) Prenatal depression predicts postpartum maternal attachment in low-income Latina mothers with infants. Infant Behav Dev 34(2):339–350
Prevost M, Zelkowitz P, Tulandi T et al (2014) Oxytocin in pregnancy and the postpartum: relations to labor and its management. Front Public Health 2:1
Radloff L (1977) The CESD scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401
Rodgers CS, Lang AJ, Twamley EW, Stein MB (2003) Sexual trauma and pregnancy: a conceptual framework. J Women's Health 12(10):961–970
Rubin LH, Carter CS, Drogos L, Pournajafi-Nazarloo H, Sweeney JA, Maki PM (2010) Peripheral oxytocin is associated with reduced symptom severity in schizophrenia. Schizophr Res 124(1–3):13–21
Scantamburlo G, Hansenne M, Fuchs S et al (2007) Plasma oxytocin levels and anxiety in patients with major depression. Psychoneuroendocrinology 32(4):407–410
Segre LS, O'Hara MW, Arndt S, Stuart S (2007) The prevalence of postpartum depression: the relative significance of three social status indices. Soc Psychiatry Psychiatr Epidemiol 42(4):316–321
Skrundz M, Bolten M, Nast I, Hellhammer DH, Meinlschmidt G (2011) Plasma oxytocin concentration during pregnancy is associated with development of postpartum depression. Neuropsychopharmacol Off Publ Am Coll Neuropsychopharmacol 36(9):1886–1893
Smith LE, Howard KS (2008) Continuity of paternal social support and depressive symptoms among new mothers. J Fam Psychol 22(5):763–773
Spielberger CD (1983) State-Trait Anxiety Inventory for adults: manual and sample. Consulting Psychologists Press, Inc: Mind Garden, Inc.
Tandon SD, Cluxton-Keller F, Leis J, Le HN, Perry DF (2012) A comparison of three screening tools to identify perinatal depression among low-income African American women. J Affect Disord 136(1–2):155–162
Uvnas-Moberg K (2003) The Oxytocin Factor. A Merloyd Lawrence Book, Cambridge
Uvnas-Moberg K, Carter CS (1998) Introduction to psychoneuroendocrinology volume: is there a neurobiology of love? Psychoneuroendocrinology 23(8):749–750
Uvnas-Moberg K, Arn I, Magnusson D (2005) The psychobiology of emotion: The role of the oxytocinergic system. Int J Behav Med 12(2):59–65
Webster J, Linnane JW, Dibley LM, Hinson JK, Starrenburg SE, Roberts JA (2000) Measuring social support in pregnancy: can it be simple and meaningful? Birth 27(2):97–101
Weisman O, Granat A, Gilboa-Schechtman E et al (2010) The experience of labor, maternal perception of the infant, and the mother’s postpartum mood in a low-risk community cohort. Arch Womens Mental Health 13(6):505–513
Zachariah R (2009) Social support, life stress, and anxiety as predictors of pregnancy complications in low-income women. Res Nurs Health 32(4):391–404
Acknowledgments
Thank you to the women who participated in this study. The National Institutes of Health (NR 010176, Dr. Garfield and NR 010608, Dr. Giurgescu) and the Irving Harris Foundation (postdoctoral fellowship, Dr. Garfield) supported this study.
Conflict of interest
The authors have reported that they have no relationships relevant to the contents of this paper to disclose and no competing financial interests exist.
Author information
Authors and Affiliations
Corresponding author
Additional information
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Rights and permissions
About this article
Cite this article
Garfield, L., Giurgescu, C., Carter, C.S. et al. Depressive symptoms in the second trimester relate to low oxytocin levels in African-American women: a pilot study. Arch Womens Ment Health 18, 123–129 (2015). https://doi.org/10.1007/s00737-014-0437-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00737-014-0437-4