Every week we review the most recent publications in women’s mental health, covering topics related to premenstrual symptoms, perinatal mood and anxiety disorders, use of medications in pregnant and breastfeeding women, perinatal substance use, and menopausal mental health.
Singal and colleagues use a medical database to look at the early development of children exposed to antidepressants during pregnancy. While the study shows some differences between exposed and unexposed children, the differences are small. Most importantly, it is impossible using this type of study design to rule out other environmental factors which may affect development. We will discuss this study in greater detail during the upcoming week.
For more detailed descriptions of many of these topics, you can sign up to receive our weekly CWMH NEWSLETTER which comes out every Thursday.
Ruta Nonacs, MD PhD
PMS AND PMDD |
| No articles this week |
INFERTILITY AND MENTAL HEALTH |
| No articles this week |
PSYCHIATRIC ILLNESS DURING PREGNANCY |
| A systematic review of non-invasive neurostimulation for the treatment of depression during pregnancy.
Konstantinou GN, Vigod SN, et al. J Affect Disord, May 2020. In all but one published study (1 rTMS), non-invasive neurostimulation resulted in either response or remission of antenatal depression. Adolescent antecedents of maternal and paternal perinatal depression: a 36-year prospective cohort. Thomson KC, Romaniuk H, Greenwood CJ, Letcher P, Spry E, Macdonald JA, McAnally HM, Youssef GJ, McIntosh J, Hutchinson D, Hancox RJ, Patton GC, Olsson CA. Psychol Med. 2020 Apr 28:1-8. After adjustment for potential confounders, the odds of self-reporting perinatal depression in both women and men were consistently higher in those with a history of persistent mental health problems across adolescence and young adulthood than those without (OR women 5.7, 95% CI 2.9-10.9; OR men 5.5, 95% CI 1.03-29.70). Coping During Pregnancy Following Exposure to a Natural Disaster: The QF2011 Queensland Flood Study Chen T, Laplante DR, et al. J Affect Disord, April 2020. High disaster exposure is associated with increased levels of subjective distress. Problem-focused and dysfunctional coping increases subjective distress levels. Emotion-focused coping reduces levels of subjective distress. Baskin R, Galligan R. Eur Eat Disord Rev. 2019 Sep;27(5):462-480. A strong level of evidence supports an association between disordered eating during pregnancy and depressive and anxiety symptoms during pregnancy. |
MEDICATIONS AND PREGNANCY |
| In Utero Antidepressants and Neurodevelopmental Outcomes in Kindergarteners.
Singal D, Chateau D, Struck S, Lee JB, Dahl M, Derksen S, Katz LY, Ruth C, Hanlon-Dearman A, Brownell M. Pediatrics. 2020 May;145(5). Linkable administrative data were used to create a population-based cohort of 266?479 mother-child dyads of children born in Manitoba, Canada, between 1996 and 2014, with follow-up through 2015. Exposed women had ?2 SSRI or SNRI dispensations during pregnancy (n = 2055); unexposed mothers did not have a dispensation of an SSRI or SNRI during pregnancy (n = 10?017). The Early Development Instrument (EDI) was used to assess developmental health in kindergarten children. History of postpartum depression as a contributor to the severity of NAS. Nellhaus EM, Nieuwenhuizen L, Egleton R, Hansen Z, Chaffin D, Loudin S, Davies TH. Addict Behav. 2019 Feb;89:78-84. |
POSTPARTUM PSYCHIATRIC ILLNESS |
| Postpartum Depression Risk Following Prenatal Diagnosis of Major Fetal Anomalies.
Herrera C, Byrne J, et al. Obstet Gynecol, May 2020. 912 women had a prenatal diagnosis of an anomalous fetus and postpartum EPDS screening, and 82 (9%) screened positive. Positive screening was more common with multiple fetal anomalies (15.3% vs 8.0%, P=.004) or aneuploidy (17.1% vs 8.6%, P=.02). Pregnancies complicated by fetal death (N=79, 8.6%), neonatal death (N=52, 5.7%), and termination for anomaly (N=69, 7.6%) were significantly more likely to screen positive than those with neonatal survival to discharge (all OR >2, P<.001). Leboffe E, Pietragallo H et al. Obstet Gynecol, May 2020. Rates of PPD increased after the 2015 guidelines, when controlling for age, year, delivery complications, and geographic region (adjusted odds ratio, 1.04; 95% confidence interval, 1.01-1.07). ACOG guidelines did not significantly increase rates of PPD in a subanalysis of women without prior history of mood disorders (odds ratio, 1.02; 95% confidence interval, 0.98- 1.05). Lee WS, Mihalopoulos C, Chatterton ML, Chambers GM, Highet N, Morgan VA, Sullivan EA, Austin MP. Adm Policy Ment Health. 2019 May;46(3):277-287. The Australian initiative was associated with a decreasein post-birth psychiatric disorders hospital admissions; this suggests earlier detection of psychiatric disorders resulting in early care of women at risk during their perinatal period. |
MEDICATIONS AND BREASTFEEDING |
| No articles this week |
PERINATAL SUBSTANCE USE |
| No articles this week |
MATERNAL MENTAL HEALTH AND CHILD OUTCOMES |
| Parenting stress and family resilience affect the association of adverse childhood experiences with children’s mental health and attention-deficit/hyperactivity disorder.
Uddin J, Alharbi D, et al. J Affect Disord, May 2020. Adverse childhood experiences (ACE) are associated with children’s mental health and increased risk for ADHD. Parenting stress significantly mediates the effects of ACE on mental health and ADHD outcomes. The effect of ACE is weaker among those have higher levels of family resilience and connection. Eilertsen EM, Hannigan LJ, McAdams TA, Rijsdijk FV, Czajkowski N, Reichborn-Kjennerud T, Ystrom E, Gjerde LC. J Atten Disord. 2020 Apr 26. Maternal prenatal depression influences symptoms of ADHD in offspring. However, the effect was weak and a substantial portion of the association could be accounted for by shared genetic influences. Jami ES, Eilertsen EM, Hammerschlag AR, Qiao Z, Evans DM, Ystrøm E, Bartels M, Middeldorp CM. Am J Med Genet B Neuropsychiatr Genet. 2020 May 1. The results of this study suggest that parental effects on offspring internalizing problems are predominantly due to transmitted genetic variants, rather than the indirect effect of parental genes via the environment. Gjerde LC, Eilertsen EM, Eley TC, McAdams TA, Reichborn-Kjennerud T, Røysamb E, Ystrom E. Child Dev. 2020 Mar;91(2):456-470. Child internalizing and externalizing problems were assessed at ages 1.5, 3, and 5, and modeled using multilevel analyses with repeated measures nested within siblings, nested within mothers. Maternal pre- and postnatal anxiety were no longer associated with child internalizing or externalizing problems after adjusting for maternal depression and familial confounding. Maternal anxiety when the children were in preschool age, however, remained significantly associated with child internalizing but not externalizing problems. |
MENOPAUSE AND MENTAL HEALTH |
| No articles this week |
OTHER TOPICS IN WOMEN’S MENTAL HEALTH |
| No articles this week |
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