While the majority of pregnant women experience nausea and/or vomiting during the first trimester of pregnancy, a smaller subset of women — around 1% — experience more severe and intractable vomiting, or hyperemesis gravidarum (HG). If left untreated, prolonged hyperemesis can lead to weight loss, dehydration, nutrient deficiencies and electrolyte disturbances. We do […]
While different countries may have different attitudes toward the consumption of alcohol during pregnancy, the American Academy of Pediatrics (AAP) has taken a firm stand against the use of alcohol during pregnancy. In the report entitled “Fetal Alcohol Spectrum Disorders,” published in the November 2015 issue of Pediatrics, the AAP identified prenatal exposure to […]
The following post was first published in OB/GYN News. Please see our OB/GYN News archives here. Publish date: July 3, 2017 Over the last 2 decades, there has been a growing interest in establishing a rich evidence base for treatment of psychiatric illness in pregnancy and the postpartum period. It seems as if a week does […]
Happy Fourth of July! This week there are several articles on the use of antipsychotics during pregnancy (Tosato et al and Park et al). The highlight of this week is an article from Man and colleagues which did not show an association between prenatal antidepressant exposure and risk for ADHD in children. A Systematized […]
It is estimated that suicide accounts for about 10% of all maternal deaths. While we have a fair amount of information to help us predict which women are at risk for depression during pregnancy and the postpartum period, few studies have identified risk factors for suicide in this vulnerable population. Suicidal ideation is fairly […]
Over the last decade, there has been increased interest around the country in establishing consistent screening for perinatal depression across a range of clinical settings. Approximately 40 states have instituted guidelines and recommendations regarding screening for postpartum depression. These positive developments, in part, follow recommendations from both the U.S. Preventive Services Task Force and the […]
In 2015, we first reported on SAGE-547 (SAGE Therapeutics), a new medication for the treatment of severe postpartum depression. SAGE-547, now called brexanolone, is a new type of antidepressant: a formulation of allopregnanolone, which is an endogenous, naturally occurring neuroactive steroid and a metabolite of progesterone. Data from the most recent study of brexanolone was […]
While many women are at risk for postpartum depression, we continue to struggle in providing adequate support and care to women in this setting, especially socioeconomically disadvantaged women. In a randomized clinical trial including 230 Head Start mothers, those receiving problem-solving education (PSE) were 60% less likely to develop postpartum depression than those receiving […]
While we use lithium less commonly now than we have in the past, lithium is still one of the very best mood stabilizers we have. And with regard to its reproductive safety, we have studies going back nearly 50 years. In the 1970s, reports from the International Register of Lithium Babies suggested a […]
This roundup has some really interesting and clinically relevant articles. The first one, from Palomo and colleagues, evaluates risk for cardiovascular malformations in children prenatally exposed to lithium. Yang and colleagues look at neonatal discontinuation symptoms in children exposed to SNRIs and SSRIs and conclude that they are more related to prematurity than to exposure […]
