This study explores the interplay of maternal depressive symptoms and use of antidepressant medication during gestation on the intranatal development of the infant limbic-hypothalamic-pituitary axis (LHPA). Infant neurologic markers at two weeks of age are also examined. Patterns of infant sleep within these groups are also explored.

In the study, pregnant women were screened for depressive symptoms using the Edinburgh Postnatal Depression Scale (EPDS), and their symptom severity was assessed longitudinally with the Beck Depression Inventory. Women were divided into 6 risk groups: low/stable, intermediate, and high/increasing depression based upon longitudinal symptom severity and medication use. The infant neuroendocrine system was examined using cord blood ACTH and cortisol. These infants were examined at 2 weeks of age using Neonatal Intensive Care Unit Neurobehavioral Scale (NNNS).

Infants born to women of the high/increasing depression group had significant elevations in cord blood ACTH at birth. On NNNS examination at two weeks, these infants were more hypotonic and less attentive. They habituated to stimuli more quickly and had fewer visual signs and higher skin reactivity. Infants born to women using antidepressants had further elevations in cord blood ACTH, and were found to be more tremulous and excitable during NNNS examination. Infants born to women with higher depression severity demonstrating aberrations in their early sleep patterns and sleep entrainment.

Maternal depression risk and antidepressant use may construe a different developmental pathway for development of the infant neuroendocrine axis which may impact early neonatal neurologic development.