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.
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.
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.
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.
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.
This is a small case report but is an important one, demonstrating the effectiveness of ultra-brief electroconvulsive therapy (ECT) for the treatment of severe postpartum depression. While most women with postpartum illness have mild to moderate illness, there are some women with severe depression that significantly impairs their ability to function and to care for their child. Women with severe PPD are also at higher risk for suicide.
A recent study from McGill University has assessed the prevalence and course of Post-Traumatic Stress Disorder (PTSD) following childbirth. The sample included 308 women who were assessed at four time points: 25-40 weeks gestation, 4-6 weeks postpartum, 3 and 6 months postpartum. Current and prior PTSD were assessed using the Structured Clinical Interview for DSM-IV (SCID-I) and the Modified PTSD Symptom Scale Self-Report (MPSS-SR).
Recent reports suggest that people with lower folate levels are at higher risk of major depression or may experience more severe depressive symptoms. Other studies indicate that in folate deficient patients, antidepressants may be less effective or may take longer to take effect. In addition, some clinical trials have shown that folate may have a therapeutic effect on depression, either when taken alone or in combination with an antidepressant.
While postpartum depression can affect all women, there are certain populations which appear to be at particularly high risk, including women of lower socioeconomic status. These women have limited access to resources and have multiple stressors including housing problems, financial strain, and being a single parent. Researchers recently piloted an intervention randomized controlled trial involving 540 participants at an inner-city hospital in East Harlem, New York. The primary goal of this psychoeducational intervention was to reduce the risk of postpartum depression among black and Latina mothers.
Post-traumatic stress disorder (PTSD) occurs in approximately 10% of all women at some point in their lifetime. PTSD tends to occur more commonly in women during their childbearing years, yet we have only recently begun to look more closely at the incidence of PTSD associated with childbirth.
