Kujawa leads study to predict postpartum depression by examining brain function throughout pregnancy

cartoon of woman holding child's hand in a doorway, looking out to rain cloud and sunshine split by yellow pathway

By Jenna Somers

woman with light brown hair in gray blazer and white blouse
Autumn Kujawa

A five-year, nearly $3.6 million grant from the National Institute of Mental Health will support Autumn Kujawa, associate professor of psychology and human development at Vanderbilt Peabody College of education and human development, and her team in examining changes in brain processes throughout pregnancy to understand whether and to what extent these changes predict postpartum depression. Establishing an understanding of the early predictors for postpartum depression could support the development of timely and targeted treatments for high-risk patients during pregnancy to address symptoms before they develop or when they begin to appear.

Postpartum depression has profound negative effects on mothers, their children, and the mother-child relationship, creating an urgent need to better understand risk and to help to inform prevention efforts. Previous research by Kujawa and others demonstrates that, outside of pregnancy, low activation of positive emotions systems and reward responsiveness in the brain predict future depressive symptoms. When functioning normally, these systems also support social motivation in mother-infant relationships. However, pregnancy can greatly affect the function of positive emotions systems and reward responsiveness due to rapid hormonal fluctuations and increased stress associated with dramatic changes in roles, expectations, and relationships. With this understanding, Kujawa theorizes that low positive emotions systems functioning during pregnancy could predict increased risk for postpartum depression.

“If we can better understand some of these mechanisms of peripartum depression, we might be able to adapt interventions from our study with mothers and older children for pregnant and postpartum people to focus on increasing positive emotions, particularly in the context of caregiving and establishing a relationship with a new baby,” Kujawa said. “We’re also interested in the timing for predicting risk—how early in pregnancy can we observe markers of risk for later symptoms? That could help to determine when to administer assessments and intervene.”

Kujawa and her team will conduct longitudinal assessments with 300 pregnant participants across the peripartum period (15 weeks gestation to five weeks postpartum) to examine trajectories of positive emotions systems function, whether it influences mother-infant interactions, and explore biological and social processes shaping risk for postpartum depression. At 15 weeks postpartum, mothers and infants will participate in an observed free play interaction to assess mutual enjoyment. Depressive symptoms and diagnoses will be assessed from 15 weeks gestation through 25 weeks postpartum.

Importantly, Kujawa’s work could add valuable insight to current mental health practices during the prenatal and postpartum periods and inform novel treatment methods. Traditionally, during these periods, depressive symptoms are screened using the Edinburgh Postnatal Depression Scale. While useful for assessing symptoms and referring patients for treatment, the screening does not offer information about underlying causes and personalized approaches to intervention. Kujawa’s work aims to do both, which could possibly allow mental health professionals to intervene before depressive symptoms develop or become severe.