Investigation of the urban-social exposome on maternal depression

Project Summary/Abstract Maternal depression affects approximately one in six new mothers worldwide. Left untreated, there is an increased risk of adverse child development, self-harm, partner/marriage dissolution, and self-medicating, which can lead to disastrous effects on the mother, child, and family. Despite its prevalence, the multifactorial etiology of maternal depression and the underlying biology is poorly understood. Emerging evidence indicates that stress (i.e., social exposome) and the built environment (i.e., urban exposome) may be causal factors in depression through affecting key biological pathways such as inflammation, hormones and steroids, and tryptophan metabolism. Indeed, our preliminary data links PM2.5 exposure (i.e., particulate matter with diameter <2.5 μm) with maternal depression and demonstrates that psychosocial stress during pregnancy exacerbates maternal depression. However, a study of the complex interactions between the multi-level, built environment and psychosocial factors that describe urban living during pregnancy—built environment (i.e., PM2.5, NO2, noise, light-at-night, greenness, temperature, noise, and population density) and multiple stress constructs (i.e., negative life events, salivary cortisol, and coping mechanism)—have not been robustly investigated. We will address this gap using rigorous epidemiologic and statistical methods. We will leverage the Programming Research in Obesity, GRowth, Environment and Social Stressors (PROGRESS) longitudinal birth cohort, which includes a comprehensive questionnaire and biological measures of psychosocial stress, high temporally- and geo-spatially resolved built environment measures, and longitudinal maternal depression phenotyping and biospecimen collection from pregnancy until 14 years postpartum. To address multiple mental health constructs, we will characterize maternal depression across this critical decade of maternal life using a validated questionnaire (longitudinal EPDS collected 12 times) and the gold standard in clinical depression diagnosis (SCID-5). We will use state-of-the-art satellite remote and ground sensing models to investigate the impact of the urban exposome during pregnancy on the risk of maternal depression (postpartum, depression progression over 14 years, and clinical depression up to 14 years post pregnancy). We will then determine the role of the social exposome alone and in combination with the urban exposome on maternal depression risk. We will use our metabolomics platform to simultaneously measure key neuro-immuno-endocrine metabolites in a single assay to identify metabolic changes that link the urban–social exposome with depression. Our population of 600 mothers in Mexico City with high but variable exposures to the urban–social exposome provides a unique opportunity to investigate the complexity of modifiable risk factors of urban life and early biomarkers of maternal depression. This will significantly enhance our knowledge of when, where, and how to intervene to reduce the risk and incidence of depression.