Having a newborn child to the neonatal intensive care unit (NICU) is stressful to parents. It would be easy to imagine that in this environment, women may be more vulnerable to postpartum depression (PPD). A recent study assessed the incidence of PPD in a total of 131 mothers with infant admitted to the NICU.
We write often here about the negative effects of postpartum depression on the child. Â Most of the studies thus far have focused on behavior and cognitive development; a recent study from researchers at JohnsHopkinsUniversity suggests that being exposed to maternal depression during the first year of life may negatively affect the physical development of the child as well.
Postpartum psychosis is a rare but serious psychiatric illness, occurring in about 1 to 2 per 1000 women after delivery. Because postpartum psychosis carries significant risks for both the mother and her child, most women with this illness are psychiatrically hospitalized. Electroconvulsive therapy (ECT) is an effective treatment for postpartum psychosis and may reduce the risks associated with medication exposure in the nursing infant; however, very few research studies have focused on the use of ECT in this setting and it is less commonly used in the United States than in other countries. A recent study explores the safety and advantages of ECT for the treatment of women hospitalized for postpartum psychosis.
For women the postpartum period is a time of increased vulnerability to mood disorders. Recent estimates indicate that about 20% of women will suffer from significant depressive symptoms during the year after the birth of a child. Despite a significant push over the last decade to identify and effectively treat women with mood disorders during pregnancy and the postpartum period, treatment rates in this population remain unacceptably low. Furthermore, questions still remain regarding the optimal timing of screening and the best instruments to be used in this setting.
While postpartum depression (PPD) is typically considered to be a woman’s illness, a number of studies have suggested that, although men do not experience any of the dramatic physiologic or hormonal changes that go along with pregnancy, new fathers may also suffer from PPD. Several recent studies yield information on how to better identify new fathers at risk for depression.
The Edinburgh Postnatal Depression Scale (EPDS) was designed to screen women for postnatal depression. Cox and Holden (2003) state that the EPDS was not designed to measure anxiety. However, recent emphasis on the importance of recognizing symptoms of perinatal anxiety disorders, coupled with findings in research, have led to the suggestion that the EPDS may be used as a multidimensional tool to screen for anxiety disorders in addition to depression during the perinatal period (Matthey et al, 2012).
A significant number of women experience anxiety symptoms during pregnancy, with about 8.5% of women meeting criteria for generalized anxiety disorder. Other anxiety disorders are less common.  The estimated prevalence of panic disorder during pregnancy is 1-2%.  The estimated prevalence of obsessive-compulsive disorder is 0.2-1.2%. While we use certain tools, including the Edinburgh Postnatal Depression Scale (EPDS) to screen for depression during pregnancy, what are the best tools for indentifying women with clinically significant anxiety symptoms?
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.Â
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.
