Researchers to study how pregnant women with depression respond to antidepressants

Using a combination of biomarkers and mood assessments, researchers will study how pregnant women who are experiencing depression respond to different antidepressants in a clinical trial funded by a grant from the National Institutes of Health to UTHealth Houston. Depression affects approximately 12% of pregnant women, according to the Centers for Disease Control and Prevention.

The goal of the study, led by Laura Goetzl, MD, and Sudhakar Selvaraj, MD, PhD, of McGovern Medical School at UTHealth Houston, is to develop a new testing paradigm to rapidly identify women who are responders to antidepressants. At the same time, the researchers will investigate how those antidepressants might affect the developing baby's brain.

Goetzl, a professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at McGovern Medical School, will examine maternal blood samples before and after the start of antidepressant medication to determine the effect of treatment on messages from the fetal brain found in maternal blood. These messages are found within small particles called extracellular vesicles that are released from the fetal brain, cross the placenta, and enter the maternal blood stream, carrying proteins and other biomarkers. Goetzl will also test maternal blood from the third trimester to identify markers for risk of neonatal withdrawal, or neonatal abstinence syndrome, from the antidepressant.

We will be able to predict which moms are going to respond and which aren't by looking at the messages that came from their brain and how their brain is responding to the medication. The novel thing about our research is that we can also separate out signals coming specifically from the baby's brain in the mom's blood. This gives us a noninvasive window into what's happening in the baby's brain before and after starting anti-depressant medication."

Laura Goetzl, MD, Vice Chair, Department for Translational Research, UTHealth Houston

Mothers on an antidepressant will be evaluated through specific questionnaires and mood scales to see if their depression gets better while taking the medication, while their blood-based markers will simultaneously be measured throughout the treatment during pregnancy.

"Pregnancy mental health is a largely ignored area," said Selvaraj, associate professor and director of the Depression Research Program at the Louis A. Faillace, MD, Department of Psychiatry and Behavioral Sciences with McGovern Medical School. "Depression during pregnancy is a very serious problem that affects the mother and the baby, and most women do not receive sufficient evaluation or treatment. If there is a marker that can tell which prescribed medication works, then we can do proper treatment and reduce any problems."