Medications and Pregnancy: A Focus on the Pharmacokinetics
We have an abundance of articles which address the impact of psychotropic medications on pregnancy. Much less research, however, has focused on how pregnancy may affect how these medications work. Physiologic changes take place during pregnancy which may affect the absorption, distribution, metabolism, and elimination of medications. These pharmacokinetic changes may result in lower psychotropic drug levels and, in some cases, loss of clinical effectiveness. A recent review summarizes how pregnancy [...]
New Guidelines Limit Testosterone Supplements for Women
Both men and women produce testosterone. The big difference is that the levels are much lower in women, around 15 to 40 ng/dL. In women, testosterone levels begin to decline gradually after the age of 20. In postmenopausal women, testosterone levels are between 0 and 20 ng/dL. Various symptoms have been attributed to falling levels of testosterone in midlife women, including lower sex drive, decreased muscle mass and bone density, decline in cognitive functioning, and depression. Some refer to this constellation of symptoms as “female androgen insufficiency syndrome”; others debate the clinical validity of this diagnosis in women.
PTSD in Veterans Increases Risk of Preterm Birth
Posttraumatic stress disorder (PTSD) is relatively common among pregnant and postpartum women. The lifetime prevalence of PTSD for women is about 10%. PTSD is most prevalent among women of childbearing age and PTSD symptoms are common during pregnancy. Earlier this year, we reported on a study which observed that women with a diagnosis of PTSD had an increased risk of preterm birth. The risk was particularly high in those women with diagnoses of both PTSD and a major depressive episode; these women had a 4-fold increased risk of preterm birth.
Postpartum Depression and Positive Parenting Practices
How does postpartum depression affect a mother’s ability to care for and parent her child? Various studies have demonstrated that depressed mothers may be less attuned to their children’s needs, either being less responsive to the baby or, in some cases, too intrusive. Researchers have speculated that this mismatch between mother and baby may contribute to problems with infant bonding, delays in development and emotional dysregulation.
New Research from the CWMH: Omega-3 Fatty Acids Increase Gestational Length
Women with psychiatric disorders represent an at-risk population for premature delivery and other obstetrical complications. This study assesses the association between omega-3 fatty acid use and length of gestation. In an unadjusted model, there was a significant increase of between 4 and 5 days (0.65 weeks; 0.00-1.25) in gestational length among the omega-3 users, although this difference was not significant after controlling for the exposures of smoking and antidepressant use. Freeman [...]
SSRI Exposure during Pregnancy: What’s Enough Data?
The following post was first published in OB/GYN News.