HSD11B2 and depressive symptom measurement: It can be argued that the negative association between maternal distress and HSD11B2 expression found in this study supports the premise that acute stress upregulates while chronic stress downregulates HSD211B2, since major depressive disorders were measured (using the SCID) rather than situational distress and most participants that screened positive for antenatal depression have a history of depression prior to pregnancy.