Infants of mothers who remain depressed beyond the infants' first few postpartum months develop depressed behavior during early interactions with their mothers and experience later developmental delays. The proposed three-year investigation has two basic purposes: 1) to determine the combined effects of prematurity and maternal depression on infant development and 2) to identify those factors which predict continued depression in mothers past the first months following birth. The study involves the development of a risk index to determine the likelihood that mothers depressed during early infancy will continue to be depressed during middle infancy. For this study, 300 mothers will be assigned to one of four groups based on their reported depression and having a premature infant (30-36 weeks gestational age); 1500-2500g birthweight; and presence of respiratory distress syndrome (RDS). After approximately 30% attrition over the 6 month follow-up period these groups will each include about 50 mother-infant dyads and will represent the four possible combinations f depressed mothers with premature infants, non-depressed mothers with premature infants, depressed mothers with fullterm infants, and non- depressed mothers with fullterms. Mothers and infants will be seen at three periods: postpartum period, 3 months postpartum, and 6 months postpartum. Measures taken will include indices of depression, anxiety and social support for the mothers, as well as psychophysiological indices of catecholamines, EMG and EEG. Mother-infant interactions will be observed as well. Measures taken for the infants will include sleep/wake state behaviors, temperament, the Brazelton (at the neonatal period), and a urine sample for catecholamines. Most of the same measures will be taken at each period, although heart rate and cortisol levels will be assessed along with the interaction data at 3 and 6 months.
