Is Pregnancy Brain a Real Thing?
During pregnancy, many women complain that they feel more forgetful or less sharp than before their pregnancy.
Understanding the Link between Trauma History and Risk of Perinatal Depression
While we are becoming more attentive to screening for depressive symptoms during pregnancy and the postpartum period, we may not always ask about a history of trauma, especially when a woman has had what most would consider an “uncomplicated” pregnancy. A recent study, however, indicates that a history of trauma may be a risk factor for depression during pregnancy.
Levetiracetam (Keppra) and Pregnancy
While it is well-established that several of the older anticonvulsants, including valproate (Depakote), carry a significant teratogenic risk, less is known about the reproductive safety of the newer antiepileptic drugs (AEDs). A new report from the U.K. and Ireland Epilepsy and Pregnancy Registers suggests that the risk of malformations associated with levetiracetam (LVT, Keppra) use during pregnancy is low.
Antenatal Exposure to Depression or Anxiety Increases the Risk of Adolescent Depression
Many studies have demonstrated an increased risk for depression among the children of mothers with depression. Exactly how this vulnerability to depression is transmitted to the child is not precisely understood. Genetic factors clearly play an important role, but there are other important factors which contribute to the intergenerational transmission of depression. For example, many studies have shown that postpartum depression may contribute to parenting styles which increase a child’s likelihood of developing depression later on. While the child appears to be particularly sensitive to the effects of maternal depression during the first year of life, it appears that older children are also affected by maternal depression and are more likely to suffer from depression and other psychiatric symptoms than children with non-depressed mothers.
Antenatal Exposure to Opioids May Increase the Risk of Neural Tube Defects
Previous studies have suggested a link between opioid exposure and increased risk of certain congenital malformations.
Complementary and Alternative Medicine Therapies for the Treatment of Perinatal Depression: A Review
In an excellent and thoughtful review article, Kristina Deligiannidis and Marlene Freeman (from the MGH Center for Women’s Mental Health) summarize data on the efficacy of complementary and alternative medicine therapies for the treatment of perinatal depression. This is one of the most thorough reviews on CAM and provides thoughtful, evidence-based recommendations regarding the use of these treatments for women with perinatal depression. It is definitely worth tracking down a copy of this review, but if you can’t find it, here is a summary.
Prenatal Exposure to Antiepileptic Drugs Associated with Worse Developmental Outcomes
We have previously written about studies which indicate that prenatal exposure to antiepileptic drugs (AEDs), particularly valproic acid, may adversely affect the developing fetus. Numerous studies have documented long-term effects of antiepileptic exposure on cognitive functioning: prenatal exposure to AEDs has been associated with lower IQs, as well as lower scores on tests of executive functioning, memory, verbal and nonverbal abilities, in children at 6 yeas of age (Meador KJ et al, 2012). These deficits were the most prominent in children exposed to valproic acid.
Eating Disorders and Their Impact on Pregnancy Outcomes
Eating disorders are relatively common among women of reproductive age, yet the literature on the effects of maternal eating disorders (ED) on pregnancy outcomes is relatively sparse. There has been concern that eating disorders may negatively affect gestational weight gain. Previous studies have demonstrated an association between maternal anorexia nervosa (AN) (both active and past) and lower infant birthweight (as compared to women with no history of ED); however, calculations of the magnitude of this effect have been inconsistent.
More Data on the Use of Atypical Antipsychotics During Pregnancy
Despite the use of the newer “atypical” antipsychotic agents to treat a spectrum of psychiatric disorders, including schizophrenia, bipolar disorder, major depression, PTSD and other anxiety disorders, three is relatively little data on the reproductive safety of these newer atypical agents.
New FDA Pregnancy Category Labeling: Still Waiting…
This is a very nice article published by the College of Psychiatric and Neurologic Pharmacists discussing the limitations of the current FDA pregnancy category labeling system.