An Overview of the National Institutes of Health Roundtable on Maternal Mental Health Research
In September 2024, the National Institutes of Health hosted a virtual Women’s Health Roundtable Series with a special session on maternal mental health (MMH) research titled: Elevating Women’s Voices to Improve Maternal Mental Health.
MMHLA’s Executive Director, Adrienne Griffen, MPP, attended the maternal mental health research session and has written the summary below to help you quickly explore the session’s topics with links to dive deeper if you choose.
It was an enriching and valuable session with several presentations that we hope can support you in your work.
In summary, this roundtable session covered:
High-priority research areas related to maternal mental health.
Information on how NIH-supported research advances the development of and access to screening, diagnostics, and preventive and treatment interventions to improve maternal mental health.
Analysis of how maternal mental health research can reduce the burden of mental illnesses that contribute to maternal morbidity and mortality.
Gaps in women’s mental health research.
Introductory Presentation
Advancing Women’s Mental Health Research: Does Sex Matter in Research?
By: Vivian Ota Wang, PhD | National Institutes of Health
Dr. Wang started by asking a very simple question: Does sex matter in research? Her response: Of course, it does! Sex should be considered as a fundamental issue when creating research projects. Women experience health and disease differently than men and follow different pathways to the same disease. Moreover, society, policy, and biology influence women’s health.
According to Dr. Wang, there are two times in a woman’s life that are sentinel in terms of her health: mid-life, which is a pivotal time for chronic disease onset, and pregnancy, which she described as a “stress test” on a woman’s health. She also pointed out that neurobiological and mental health disorders disproportionately impact women, leading NIH to expand funding pathways for women’s mental health research.
Keynote Presentation
From Biology to Breakthrough: The Story of Brexanolone and Zuranolone
Samantha Meltzer-Brody, MD, MPH | University of North Carolina
Dr. Meltzer-Brody shared information and insights about brexanolone and zuranolone — the only FDA-approved pharmaceuticals designed specifically to treat postpartum depression (PPD). Both drugs had rapid onset of action, with positive changes in affect and symptom reduction that were sustained throughout the entire study period.
The table below summarizes the differences between brexanolone and zuranolone as noted in clinical trials.
Zuranolone (Zurzuvae)
Approved by FDA in 2023
14-day oral treatment (once daily)
Rapid onset of action (day 3)
Response was sustained throughout the entire study period (45 days)
Primary side effect is sedation but less intense than brexanolone
Brexanolone (Zulresso)
Approved by FDA in 2019
60-hour infusion
Rapid onset of action (hour 12)
Response was sustained throughout the entire study period (30 days)
Primary side effect is sedation
Must be administered in medically-supervised setting
Will be discontinued in January 2025.
Dr. Meltzer-Brody noted that PPD can be caused by a variety of factors including hormonal changes, genetics, epigenetics, inflammation, and external stressors. She concluded her presentation with a call for future research that evaluates brexanolone’s possibility of addressing postpartum psychosis and that investigates the underlying mechanism of action for both brexanolone and zuranolone.
Note: MMHLA receives funding from Sage Therapeutics®, which brought Zulresso and Zurzuvae to market.
Clinical Perspectives on Maternal Mental Health Research
2Gen Perspective on Maternal Mental Health Prevention and Intervention
Catherine Monk, PhD | Columbia University
Dr. Monk spoke about the developmental origins of health, explaining how the first nine months of life in utero can shape the rest of a person’s life. She described how parenting begins before birth, highlighting the impact of prenatal exposures and prenatal programming.
Dr. Monk stated that the biggest impediment to recovery from perinatal mood and anxiety disorders is access to treatment, which is why she and other researchers are focusing on preventing these illnesses from occurring. Three programs — PREPP, ROSEs, and Mothers & Babies — have proven effective at preventing perinatal mood and anxiety disorders.
mHealth Mindfulness-Based Intervention for Pregnant Black and Latina Women at Risk for Postpartum Depression
Ai Kubo, PhD, MPH and Lyndsay Amman Avalos, PhD, MPH
Dr. Kubo and Dr. Avalos spoke about their current study, Healthy Mama and Baby, which is being conducted through Kaiser Permanente Northern California and is focused on preventing postpartum depression among Black and Latina mothers.
The goal of the study is to evaluate the impact of mindfulness-based interventions, delivered through a mobile app, as an effective non-pharmaceutical treatment for perinatal depression. The researchers note that tech-enabled platforms offer an easily accessible and low-cost opportunity to reach perinatal patients.
Prevention of Perinatal Depression in Birthing People with a History of Adverse Childhood Experience: A Type 2 Hybrid Effectiveness Trial
Sheehan Fisher, PhD | Northwestern University
Dr. Fisher stated that in order to prevent illness we must be able to predict who will be impacted, pointing out that individuals who have experienced multiple Adverse Childhood Experiences (ACEs) are at increased risk for perinatal depression.
His current research is assessing the impact of the ROSEs prevention program, coupled with trauma-informed care, for individuals who are at increased risk for experiencing perinatal depression because of high ACEs scores.
Promoting Perinatal Mental Health Services Grounded in Lived Experience
Nicole Christian Braithwaite, MD, Reproductive Psychiatrist
Dr. Braithwaite clearly stated the stark disparity that Black women face: they are both more likely to experience perinatal mood and anxiety disorders than their white counterparts, and also less likely to be able to access care. Moreover, Black women and infants have worse outcomes even when they have access to care because of systemic racism and bias in society and in the healthcare system. Dr. Braithwaite punctuated these statistics with her own lived experience with perinatal mood and anxiety disorders, which fuels her work.
Innovative Models of Maternal Mental Health Care
Mississippi Delta Center of Excellence in Maternal Health
Mary Shaw, PhD, MEd, MCHEES | Jackson State University
Dr. Shaw discussed how the Mississippi Delta Center of Excellence in Maternal Health is exploring opportunities to advance maternal mental health care in under-served Mississippi Delta communities, especially among low-income Black women living in rural areas. She emphasized that mental health care in this region must be accessible, affordable, and acceptable.
Dr. Shaw is evaluating a community-care model, which provides 3-4 postpartum visits either in the home or via telehealth, with the second visit focusing on maternal mental health screening.
Investigating Maternal Mental Health and Child Mental Health Experiences of the Syndemic of COVID and Underlying Systemic Conditions
Wanjikũ Njoroge, MD | University of Pennsylvania
Dr. Njorage provided an update on her current study, Prenatal to Preschool (P2P): The Pandemic’s Impact on Mothers and Children, Focusing on Syndemic Effects on Black Families. This study is assessing the combined and complicated impact of racism and the COVID-19 pandemic on Black children and their mothers.
The goal of this research is to characterize the experiences of women and children impacted by the syndemic, thus filling research gaps that would help identify specific maternal and environmental factors and mechanisms that influence early child development and mental health.
Disparities in Utilization and Delivery Outcomes for Women with Perinatal Mood and Anxiety Disorders: A Groundwork for State Policymaking and Reflections on Lived Experience
Kara Zivin, PhD, MS, MA, MFA | University of Michigan
Dr. Zivin began her presentation by sharing her personal story of an overdose attempt at 8 months of pregnancy. She then transitioned to sharing information about a suite of NIH-funded interrelated studies that examine the impacts of federal and state behavioral health policy changes on clinical and economic outcomes among childbearing individuals and infants.
Dr. Zivin concluded by sharing specific policy recommendations that include coordinating care, enhancing insurance coverage, measuring outcomes, and addressing workforce shortages.
The National Strategy to Improve Maternal Mental Health Care
Nima Sheth, MD, MPH | Substance Abuse and Mental Health Services Administration (SAMHSA)
Dr. Sheth discussed the work of the National Task Force on Maternal Mental Health, which launched in September 2023 and published a report to Congress on the status of maternal mental health in the United States as well as a National Strategy to Improve Maternal Mental Health Care.
Dr. Sheth provided a deep dive into the section of the National Strategy that included recommendations about using data and research to improve outcomes and accountability.
