• major depression

    No Increase in Risk of Infant Mortality in Women Taking SSRIs During Pregnancy

    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.

    Dr. Lee Cohen in Ob-Gyn News: Using SSRIs in 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.

    Brief Scales for Identifying Postpartum Depression and Anxiety

    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.

    SSRIs and Pregnancy: Putting the Risks and Benefits into Perspective

    Prozac hit the market in 1988, the first selective serotonin reuptake inhibitor (SSRI) antidepressant approved by the FDA for the treatment of depression.  Because it was safer and more tolerable than the antidepressants that preceded it, Prozac was soon the most commonly prescribed antidepressant in the United States.

    Duloxetine and Pregnancy: Preliminary Data

    Duloxetine (sold in the United Sates under the brand name of Cymbalta) is a serotonin-norepinephrine reuptake inhibitor (SNRI) effective for major depressive disorder and generalized anxiety disorder (GAD).  Although used fairly commonly in women of child-bearing age, information regarding its reproductive safety has been lacking.

    Is There a Link Between Vitamin D Deficiency and Antenatal Depression?

    Several studies have shown that vitamin D deficiency is associated with depression.  A recent study has assessed the relationship between vitamin D levels and risk for antenatal depression in a cohort of African-American women.  Vitamin D deficiency is more common among African-American women than in Caucasians.  The active form of vitamin D is produced as a byproduct of natural sun exposure.  Because women with darker skin have more melanin, which blocks the sun’s rays and affects the skin’s ability to produce the active form of vitamin D, they typically have lower vitamin D levels.  

    Depression in Fathers: Toward a Better Understanding of Its Impact on the Child

    While much research has demonstrated that maternal depression may negatively affect the child, leading to increased risk of developmental delays, behavioral problems, and psychiatric illness. Less research, however, has detailed the impact of paternal depression; several recent studies have focused on better understanding the risk factors for paternal depression and how paternal depression affects children.

    Screening for Perinatal Depression: What Can We Learn From Australia?

    In 2009, the Australian government launched the National Perinatal Depression Initiative (NPDI) in order “to improve the prevention and early detection of antenatal and postnatal depression and to provide better support and treatment for expectant and new mothers experiencing depression.” Its scope is very much like the MOTHERS Act, which became law in the United States in 2010. Both initiatives seek to increase public awareness of perinatal depression, to provide support and treatment for pregnant and postpartum women with depression, to fund research in this area, and to implement training of health care professionals. 

    CBT for Depression During Pregnancy Improves Mothers’ Attentiveness to Her Infant

    During pregnancy, a woman develops increasing sensitivity and responsiveness to infants’ distress.  If depression during pregnancy occurs, this process may be disrupted.  Various studies are shown that women with depression are less responsive to an infant’s distress.  The major concern is that this diminished responsiveness may persist as long as one year after the child is born, and when it persists, it may negatively affect the child.  Decreased responsiveness of the mother to the infant’s cues may lead to emotional, cognitive and developmental problems in the child later on.

    Childhood Somatic Symptoms May Be Related to Early Exposure to Maternal Depression or Anxiety

    About 10-30% of children have functional somatic symptoms (FSS).  These are physical complaints, such as headaches, pain, fatigue, and dizziness, that cannot be explained medically. A new study suggests that when a child is exposed to depression or anxiety in the mother during the first year of life, he or she is more likely to report these somatic symptoms later on.

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