The M.A.D.A.M Study. Mediators of Activity and Depression Amongst Mums.

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Postpartum depression (PPD) is characterised by low mood, irritability, fatigue, insomnia, change in appetite, anxiety, guilt, feelings relating to an inability to cope and worthlessness and thoughts of suicide. Postpartum depression (PPD) is estimated to affect 8-25% of women in the first 36 months after giving birth. Currently, psychosocial assessments (interview) and depression screening (self report questionnaire) during the perinatal period is routine clinical practice in New South Wales. Assessments aim to identify psychosocial risk factors for poor postnatal mental health (e.g. lack of support or recent stressors). There is little information regarding the genetic or biological indicators of PPD. Postpartum depression can have serious and prolonged effects on the mental and physical health of both the mother and child. Current studies support the positive influence of physical activity for treating PPD. This project aims to investigate the antenatal predictors of PPD and physical activity in adult women residing in the New England region. The aims of this research project are threefold: 1) To determine if there is an association with genetic variation and the incidence of PPD; 2) To evaluate the relationship between genetic variation and physical activity participation and; 3) To determine the relationship between theory driven predictors of physical activity and postpartum physical activity participation in women who live in rural areas. Variables including demographic information, medical information relating to pregnancy and labour, symptoms of postnatal depression, health related quality of life, emotional resilience, maternal social support, objectively measured physical activity, physical activity self-efficacy, social support for physical activity participation, ratio of perceived advantages and disadvantages of physical activity (decisional balance), biological markers of stress (including salivary cortisol and aAmylase) and potential genetic markers of vulnerability to depression (serotonin transporter gene polymorphisms and reelin gene (RELN) polymorphisms) will be assessed at two time points; participants second antenatal clinic visit (approximately 20 weeks gestation) and three months postnatal. Relationships between measured variables at each time point will be assessed using standard statistical techniques (e.g. Pearson correlation, Fishers Z score). Multiple regression analyses will be used to determine psychosocial and biological antenatal predictors (absolute and relative changes from pre to postnatal) of postnatal physical activity and symptoms of depression. The project outcomes aim to provide a mechanism for improved screening, contribute to the research relating to the prevention of PPD, and evaluate the predictors of physical activity.

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