There are many approaches to predicting which women are likely to develop postpartum depression (PPD). Most of these utilize standardized questionnaires and/or screening by health care providers. While these approaches may be effective, they tend to be costly and labor-intensive. A new study pilots the use of social media in predicting which women at risk for postpartum mood disorders.
Women are strongly encouraged to take prenatal vitamins, and there is significant data to indicate multiple benefits to the child, including decreased risk of various congenital defects and certain types of childhood cancers. Less understood is the impact of these supplements on the mother’s mental status and her risk for mood disorder during the perinatal period. A group of researchers from Alberta, Canada has recently examined the risk for postpartum depressive symptoms in women enrolled in the Alberta Pregnancy Outcomes and Nutrition (APrON) study, specifically examining the nutrients ingested through supplements to determine whether any individual supplementary nutrients may modulate the risk of postpartum depressive symptoms.
This is a topic we do not typically cover on our site, but it is clearly an important one. The U.S. Preventive Services Task Force (USPSTF) has updated its recommendations on screening for family and intimate partner violence (IPV). These guidelines, published in the Annals of Internal Medicine, recommend that all women of reproductive age be screened for intimate partner violence. The review provides some information on which screening instruments to use and reviews interventions to reduce the risk of IPV.
While much attention has focused on the impact of maternal psychiatric illness on the well-being of the child, less is known about the impact of psychiatric illness in the father. A large population-based study from Norway examines the association between symptoms of psychological distress in expectant fathers and socioemotional and behavioral outcomes in their children at 36 months of age.
In our weekly clinical rounds, we recently discussed how motherhood is such a unique and personal experience for each woman. Often it is assumed that this transition into a new role is easy when for many it is not. How we assess a woman's experiences during the postpartum period is often limited to just her mood. I recently came across a new self-report instrument, The Being a Mother Scale (BaM-13) developed by Stephen Matthey which attempts to assess the “wider domain of the woman’s experience of motherhood” rather than just the presence or absence of a postpartum mood disorder.
Most women have some nausea or vomiting, or "morning sickness", during the first trimester of pregnancy. Some women, however, have a more severe and persistent pattern of nausea and vomiting called hyperemesis gravidarum (HG). A new study demonstrates, not so surprisingly, that depression is more common in women suffering from HG.
While there has been a great deal of attention paid to the risks of exposure to antidepressants, particularly the selective serotonin reuptake inhibitors (SSRIs), during pregnancy, there has been comparatively little information on the risk of stillbirth and infant mortality in this population. In a recent population-based cohort study utilizing data from all Nordic countries (Denmark, Finland, Iceland, Norway, and Sweden), researchers assessed the risk of stillbirth and infant mortality associated with the use of SSRIs during pregnancy.
Over the last decade, attention in the medical literature has gathered logarithmically to focus on potentially efficacious treatments for perinatal depression. Studies of relevant databases, editorials, and various reviews have addressed the reproductive safety concerns of antidepressant treatments, particularly selective serotonin reuptake inhibitors (SSRIs) on one hand, and the impact of untreated maternal psychiatric illness on fetal and maternal well-being on the other.
While most agree that there is a need for improved detection of anxiety and mood disorders in pregnant and postpartum women, there remain questions regarding the best instruments to use for screening. The Edinburgh Postnatal Depression Scale (a questionnaire consisting of 10 items) has long been used to screen women for postpartum depression (PPD); however, it is unclear how well these questions could be incorporated into larger surveillance programs, such as the CDC-sponsored Pregnancy Risk Assessment Monitoring System (PRAMS) which was designed to assess health behaviors and to screen for health problems, including depression and anxiety, in pregnant and postpartum women.
In our clinic, we often see women who come in for the treatment of depression and/or anxiety after the cessation of breastfeeding. Many question if breastfeeding may protect against postpartum depression and if the cessation of breastfeeding is a trigger for postpartum depression and/or anxiety. However, the research examining the association between postpartum depression and breastfeeding has been somewhat difficult to interpret.
