Depression and socioeconomic stressors in expectant parents with fetal congenital anomalies.

OBJECTIVE: Congenital anomalies are increasingly diagnosed before birth, which may lead to psychological distress in expectant parents. While the presence of significant symptoms of depression and stress in these parents is established, understanding their context within parents' other life stressors has not been fully investigated. We sought to characterize the socioeconomic profile and depression symptoms of expectant parents in a quaternary care academic hospital's fetal care clinic. METHODS: This prospective observational study enrolled pregnant persons and their partners in our fetal care clinic. The Edinburgh Postpartum Depression Scale (EPDS), Tool Assessing Patient Stress (TAPS), and a sociodemographic survey were utilized to assess parent psychological distress and socioeconomic stressors. Results were analyzed by the severity of the fetal anomaly. EPDS was repeated at two weeks postpartum. RESULTS: 21.7% of pregnant subjects and 25.0% of co-parents had a positive screen on the EPDS at enrollment during their pregnancy. Mothers' EPDS scores correlated with the severity of the fetal anomaly. Many parents reported socioeconomic stressors including: living remotely from the medical center, low household income, food insecurity, unemployment, or other employment concerns, and difficulty affording living expenses. Most also reported factors that can mitigate psychological distress including social support and participation in a religion or faith. CONCLUSIONS: Expectant parents with fetal anomalies should be screened for depression as well as social and economic risk factors that place them and their infants at higher risk for poor health outcomes. Further work is needed to determine the optimum interventions for addressing their depression symptoms and reducing socioeconomic stressors.

Sorption, uptake, and biotransformation of 17ß-estradiol, 17α-ethinylestradiol, zeranol, and trenbolone acetate by hybrid poplar.

Hormonally active compounds may move with agricultural runoff from fields with applied manure and biosolids into surface waters where they pose a threat to human and environmental health. Riparian zone plants could remove hormonally active compounds from agricultural runoff. Therefore, sorption to roots, uptake, translocation, and transformation of 3 estrogens (17ß-estradiol, 17α-ethinylestradiol, and zeranol) and 1 androgen (trenbolone acetate) commonly found in animal manure or biosolids were assessed by hydroponically grown hybrid poplar, Populus deltoides x nigra, DN-34, widely used in riparian buffer strips. Results clearly showed that these hormones were rapidly removed from 2 mg L(-1) hydroponic solutions by more than 97% after 10 d of exposure to full poplar plants or live excised poplars (cut-stem, no leaves). Removals by sorption to dead poplar roots that had been autoclaved were significantly less, 71% to 84%. Major transformation products (estrone and estriol for estradiol; zearalanone for zeranol; and 17ß-trenbolone from trenbolone acetate) were detected in the root tissues of all 3 poplar treatments. Root concentrations of metabolites peaked after 1 d to 5 d and then decreased in full and live excised poplars by further transformation. Metabolite concentrations were less in dead poplar treatments and only slowly increased without further transformation. Taken together, these findings show that poplars may be effective in controlling the movement of hormonally active compounds from agricultural fields and avoiding runoff to streams.