Year
2023
Degree Name
Doctor of Philosophy
Department
School of Medical, Indigenous and Health Sciences
Abstract
Approximately one in ten pregnant women experience depression during pregnancy (antenatal depression). It is essential that depression during pregnancy is effectively treated as unmanaged antenatal depression is associated with adverse effects for both mother and baby. After psychotherapy, selective serotonin reuptake inhibitors (SSRIs), including sertraline and fluoxetine are the most commonly prescribed treatments for depression during pregnancy. However, there is a lack of data showing the efficacy of SSRIs for the treatment of depression during pregnancy. Furthermore, there are concerns about the potential effects of in utero SSRI exposure on the developing child. Evidence suggest that SSRIs mediate their effects in part through epigenetic modifications such as those to DNA methylation, however it is not clear what role epigenetic modifications play in mediating SSRI effects in the maternal brain or whether there are epigenetic impacts on the developing offspring. Meanwhile there is strong evidence that exercise has antidepressant effects in those with mild-moderate depression, however, whether exercise has the same impact on depressive symptoms during pregnancy has not been established. Furthermore, it is not clear if women are aware of the potential benefits of exercise in pregnancy or if they are regularly conducting exercise during pregnancy. Therefore the overall aim of this thesis was to determine the effects of antidepressant (fluoxetine, sertraline) treatments during pregnancy on maternal and offspring behaviours and DNA methylation markers, whilst also determining whether exercise during pregnancy could be beneficial for the treatment of depression. Specifically, this this thesis had five aims:
1. To determine if there is evidence of DNA methylation alterations in the brains of offspring exposed to the commonly used SSRI, fluoxetine.
2. To determine whether the most widely prescribed SSRI in pregnancy, sertraline, causes changes in depressive and associated behaviours postnatally, in a rat model relevant to depression and whether there is any impact on DNA methylation markers.
3. To determine whether voluntary exercise during pregnancy in a rodent model relevant to depression, causes changes in depressive and associated behaviours postnatally, and whether there is any impact on DNA methylation markers.
4. To systematically review the clinical literature to identify and evaluate the effect of exercise/physical activity during pregnancy on antenatal + postnatal depressive symptoms.
5. Assess the attitudes and experiences of Australian women about conducting exercise during pregnancy, including its effects on mental health.
Recommended Citation
Jarbou, Noor Saleem Mohammed, Exploring the use of selective serotonin reuptake inhibitors and exercise as treatments for depression during pregnancy: molecular and behavioural approaches, Doctor of Philosophy thesis, School of Medical, Indigenous and Health Sciences, University of Wollongong, 2023. https://ro.uow.edu.au/theses1/1664
FoR codes (2008)
1004 MEDICAL BIOTECHNOLOGY, 1109 NEUROSCIENCES, 1115 PHARMACOLOGY AND PHARMACEUTICAL SCIENCES, 1199 OTHER MEDICAL AND HEALTH SCIENCES
Unless otherwise indicated, the views expressed in this thesis are those of the author and do not necessarily represent the views of the University of Wollongong.