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Background: Research suggests that prenatal depression is associated with disrupted maternal responses to infant stimuli, with depressed women not showing the bias towards distressed infants observed in non depressed women (Pearson, 2010). The current study examined depression related differences in women’s self reported responses to infant stimuli, early in pregnancy, investigating if maternal responses in pregnancy are more associated with a reduced comforting response, or a heightened avoidant response. Method: Women in this study were referred by community midwives as part of a cohort study. Pregnant women with clinical depression (n=38), and comparison non-depressed women (n=67), were exposed to images of distressed, neutral and happy infant faces. The women were asked to rate how they responded to the images, along three scales: wanting to comfort, wanting to turn away, and feelings of anxiety. Results: Women with depression showed significantly different response patterns to women without depression. Women with depression were substantially more likely to be in the highest quartile for ratings of wanting to turn away from distressed infant faces (odds ratio 4.15, p<.01, 95% confidence intervals (CI) = 1.63-10.5). They were also substantially less likely to be in the highest quartile for wanting to comfort a distressed infant face (odds ratio .22, p<.01, 95% confidence intervals (CI) = .09-.54). Conclusions: The findings from this study are consistent with both a heightened avoidant and a reduced comforting response towards distressed infants in depressed pregnant women. This study provides further evidence that depression disrupts maternal preparations at a conscious level. Keyword: Depression; Maternal Responsiveness; Self Report; Pregnancy; Prenatal; Perinatal.

The SEATON cohort comprising 2000 pregnant women recruited 1997-99 was established to test if maternal nutrition during pregnancy affects the likelihood of children developing asthma. At 32 weeks gestation mothers’ diets were assessed by food frequency questionnaire. 1,924 live singleton births comprised the birth cohort with follow-up at 6 months, 1, 2, 5 and 10 years (the latter the focus of this thesis). Children’s diets were assessed at 5 and 10 years. Their asthmatic status was assessed by International Study of Asthma and Allergies in Childhood questionnaire. Children participating at 5 or 10 years were also invited for measurement of spirometry and allergy. Cross-sectionally at 10 years 934 children (48% boys) participated by return of questionnaire, 449 also took part in the in-depth assessment. Higher maternal vitamin D intakes were associated with decreased odds of ‘doctor diagnosed asthma’, ‘wheeze ever’ and ‘wheeze in the last year’ in the children. Contrary to findings at 5 years no association between maternal vitamin E intake and asthma outcomes was seen. Longitudinally over the 10 years of the study, higher maternal vitamin D and E intakes during pregnancy were both associated with a decreased likelihood of ‘doctor diagnosed asthma’, ‘active asthma’ and ‘wheeze in the last year’ in the children. In conclusion, reduced maternal vitamin D and E intakes during pregnancy are associated with an increased likelihood of childhood asthma during the first ten years of life. Vitamin E appears to be associated with early asthma and wheeze possibly reflecting a role in affecting early airway remodelling processes. Associations with vitamin D were seen consistently over different time-points, possibly having its effect in an immunomodulatory fashion. Intervention trials are required to ascertain if intervention during pregnancy actually reduces childhood asthma rates.