Antenatal and postpartum depression together affect roughly 15% of mothers, and may have serious consequences for the health and well-being of the entire family. Despite significant advances in understanding major depression, the specific causes of antenatal and postpartum depression remain less understood. Like major depression, antenatal and postpartum depression appear to arise from interacting environmental and biological factors. A large volume of work implicates poverty and lack of social support as environmental determinants of major depression and postpartum depression. However, there has been little investigation into the impact of experiences of personal threat, such as violent abuse or racial discrimination, on the incidence of antenatal or postpartum depression. Among biological factors, disorders of the hypothalamic-pituitary-adrenal stress response have been implicated in depression. During normal pregnancy, cortisol levels are elevated, and the placenta contributes large quantities of corticotropin-releasing hormone (CRH) to matemal circulation. The implications of these high levels of stress hormones for onset of depression during and immediately following pregnancy are poorly understood. We predict that antenatal and postpartum depression are influenced by these endocrine factors as well as by the psychosocial environment. We hypothesize that: 1) Physical and/or sexual abuse in childhood, in adulthood, and/or during pregnancy are associated with antenatal and postpartum depression. 2) Experience of racial discrimination is associated with antenatal and postpamam depression among women of color. 3) Levels of CRH during pregnancy are associated with a history of depression, are correlated with antenatal depression, and predict postpartum depression; 4) Elevated morning cortisol and/or depressed evening cortisol levels in the first three postpartum months are associated with postpartum depression. Few studies have had the size or the data needed to investigate both biologic and environmental predictors of depression before, during, and after pregnancy. Project Viva and Project Access are two ongoing cohort studies of pregnant women and their children in Boston, supported by the National Institutes of Health and the March of Dimes to assess psychosocial and hormonal predictors of pregnancy outcome and child health. To date, they have enrolled over 2800 women; by the end of the project, the proposed project will include 3,500 participants. These ongoing longitudinal cohort studies will provide a cost-effective and unique resource with which to determine factors predicting depression during pregnancy and the postpartum. ? ?