Oxytocin and reactivity to infant signals in mothers postpartum depression

Postpartum depression is a serious mental health concern affecting 10-15% of
all mothers in Western societies. Postpartum depression does not only
negatively impact on the mother, but has also been associated with insensitive
caregiving and with poor child outcomes. One candidate that may play a crucial
role in the relation between depressed mood, maternal care, and child outcomes
is oxytocin, a hormone important for affiliation and parenting. Previous
studies have shown that oxytocin levels are lower in mothers with postpartum
symptoms and that intranasal oxytocin administration can positively affect the
perceived relationship with the child. However, still little is known about the
effects of oxytocin on caregiving behavior in mothers with postpartum
depression. Here, we propose to conduct a randomized double-blind
within-subject control study to test the effects of intranasal oxytocin on
caregiving behaviors of mothers with depressive symptoms in the postpartum
period.

In a randomized control trial (RCT) with mothers with postpartum depressive
symptoms the following main hypotheses will be tested:
• Oxytocin will promote more sensitive caregiving during mother-infant
interactions and while interacting with a life-like crying infant simulator.
• Oxytocin will reduce depressed mothers* stress reactivity while interacting
with their own infant and the crying infant simulator, as reflected in reduced
heart rate activity and cortisol.
• Oxytocin administration will result in a bias towards the recognition of
happy infant emotions.
Secondary objectives are 1) to examine whether oxytocin affects mothers* mood
and the perceived relationship with her child and 2) to examine the extent to
which effects of oxytocin are moderated by mothers* early childhood
experiences.

A randomized controlled-trial with a within-subject design. Mothers with
postpartum depression will be invited for two lab sessions during which they
will receive a nasal spray containing 24 IU oxytocin or a placebo.

24 IU intranasal oxytocin and placebo

There are no risks associated with the assessments used in this study. Possible
side effects of oxytocin are negligible. No adverse effects have been reported
in participants/patients. The burden for participants consists of spending time
on two lab sessions (approximately 75 minutes each), during which four saliva
samples will be collected, heart rate will be measured, questionnaires will be
completed, an infant emotion recognition task will be performed, and
mother-infant interactions will be observed. Although there is no direct
benefit to the participants from the proposed research, there are greater
benefits to society from the potential knowledge gained from this study. Once
we understand the neurobiological underpinnings of poor maternal sensitivity
among mothers with postpartum depression, better attempts can be made to
improve parenting and reduce the adverse effects of poor parenting. Moreover,
the study will reveal insight into the potential therapeutic effects of
oxytocin administration in mothers with depressive symptoms. Thus, the
importance of the benefits gained from this research outweighs the minimal
risks involved.