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.
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.
Women who smoke during pregnancy are at greater risk for certain complications, including placental previa, placental abruption, and premature rupture of the membranes, and premature delivery. Furthermore, infants of mothers who smoke during pregnancy are more likely to be small for gestational age and are at greater risk of sudden infant death syndrome (SIDS).
A high proportion (47%–63%) of women who quit smoking during pregnancy relapse during the postpartum period. Being able to identify those women at highest risk for relapse may help to devise strategies for preventing relapse.
In the November issue of Obstetrics & Gynecology, The American College of Obstetricians and Gynecologists (ACOG) has issued recommendations to providers regarding efforts to support smoking cessation in pregnant and postpartum women.
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. The most recent study was a meta-analysis published in the May 19th issue of the Journal of the American Medical Association.
While many women who smoke successfully quit smoking during pregnancy, most of these women return to smoking within 12 months of delivery. Several studies have suggested that certain factors may increase the risk of postpartum relapse, including unwanted pregnancy, multiparity, and stressful life events. Two recent studies indicate that postpartum depressive symptoms may also increase the risk of smoking relapse after delivery.
About 15% of women suffer from depression during pregnancy, and many reports have suggested that depression during pregnancy may have negative effects on the fetus. A new study from researchers at the University of Michigan indicates a link between depression during pregnancy and infant sleep problems.
Mood disorders and symptoms during pregnancy and the postpartum period are not uncommon and affect women across the world. In spite of relatively high rates of depression among childbearing women, there are often inadequate resources for treatment, particularly in poorer countries. In countries lacking resources, health care is often managed by community health workers or individuals with basic health care training who provide care to difficult-to-reach populations. There are often few mental health professionals, leaving many women without adequate treatment. In an attempt to provide treatment to a greater number of women, some investigators are attempting to train community health workers to provide some psychotherapy as part of their standard duties.
November, 2006 by LEE COHEN, M.D. Over the last year, several studies on possible neonatal effects of prenatal exposure to SSRIs have been reviewed in this column. These studies have raised concerns about potential risks, [...]
