This proposal will examine the role of antenatal depression in cardiometabolic risk in offspring.

Specific aims:

Aim 1:To assess whether antenatal depression is an independent predictor of body size and adiposity in

the offspring as determined by weight and length for age in infancy, and BMI, and central obesity in

childhood, and adolescence.

Hypothesis 1: Children of depressed mothers are about equally likely to be overweight but are more likely

to have central obesity than children of non-depressed mothers throughout infancy, childhood, and

adolescence.

Aim 2:To test whether antenatal depression is an independent predictor of glucose intolerance, blood

pressure, serum lip profile, and markers of inflammation in childhood and adolescence.

Hypothesis 2: Children of depressed mothers are more likely to develop glucose intolerance,

hypertension, undesirable serum lipid profiles and high levels of markers of inflammation than children

of non-depressed mothers throughout infancy, childhood, and adolescence.

Aim 3:To test whether maternal depression is associated with health behaviors linked to elevated

cardiometabolic risk, and whether these behaviors are mediators of the main effect of maternal depression

on cardiometabolic risk at adolescence.

Hypothesis 3: Depressed mothers are more likely to smoke, to have dietary patterns -characterized by

excessive caloric intake, unhealthy relative fat composition and excess salt-, and to do insufficient

physical activity than non-depressed mothers during pregnancy.

Hypothesis 4: Maternal unhealthy lifestyle partially mediates the effect of maternal antenatal depression

on the offspring cardiometabolic risk in infancy, childhood, and adolescence. This hypothesis is

contingent upon finding an association between antenatal depression and increased cardiometabolic risk

in the offspring.

Confounders: We will control for factors including maternal history of CVD and T2D, birthweight,

education, ethinicity, SES, discrimination, social network and support and neighborhood quality.

Mediation analysis: We will explore the indirect effect of maternal depression mediated by unhealthy

behaviours during pregnancy and will control for the effect of maternal postnatal depression.