Every week we review the most recent publications in women’s mental health, covering topics related to premenstrual symptoms, perinatal mood and anxiety disorders, use of medications in pregnant and breastfeeding women, perinatal substance use, and menopausal mental health. 

For more detailed descriptions of many of these topics, you can sign up to receive our weekly CWMH NEWSLETTER which comes out every Thursday.  

And don’t forget to visit ESSENTIAL READS – a curated selection of up-to-date and clinically relevant articles in women’s mental health.

Ruta Nonacs, MD PhD


No articles this week



No articles this week



Lack of psychotropic medication changes among mood disordered women across the peripartum period.

Standeven LR, Payne JL, Pangtey M, Osborne LM.  Hum Psychopharmacol. 2021 Mar 7:e2764. 

In this naturalistic study, more medication adjustments for depression occurred during the postpartum than during pregnancy, a finding which may indicate that antenatal depression is undertreated.

Scaling Up Maternal Mental healthcare by Increasing access to Treatment (SUMMIT) through non-specialist providers and telemedicine: a study protocol for a non-inferiority randomized controlled trial.

Singla DR, Meltzer-Brody SE, Silver RK, Vigod SN, et al.  Trials. 2021 Mar 5;22(1):186. Free article.

SUMMIT is a pragmatic, non-inferiority test of the comparable effectiveness of two types of providers (specialist vs. non-specialist) and delivery modes (telemedicine vs. in-person) of a brief, behavioral activation (BA) treatment for perinatal depressive and anxiety symptoms. 

Anxiety and depression are risk factors for recurrent pregnancy loss: a nested case-control study.

Wang Y, Meng Z, Pei J, Qian L, Mao B, Li Y, Li J, Dai Z, Cao J, Zhang C, Chen L, Jin Y, Yi B.  Health Qual Life Outcomes. 2021 Mar 8;19(1):78.  Free article.

Either depression or anxiety alone could increase the risk of subsequent recurrent pregnancy loss. Anxiety and depression had a synergistic effect after the first miscarriage which increased the development of subsequent recurrent pregnancy loss.



No articles this week



Genome-wide gene expression changes in postpartum depression point towards an altered immune landscape.

Mehta D, Grewen K, Pearson B, Wani S, Wallace L, Henders AK, Binder EB, Frokjaer VG, Meltzer-Brody S, Wray NR, Stuebe AM.  Transl Psychiatry. 2021 Mar 4;11(1):155.

This study aimed to identify genes associated with PPD. To do this, researchers investigated genome-wide gene expression profiles of pregnant women during their third trimester of pregnancy and tested the association of gene expression with perinatal depressive symptoms. They identified 71 genes significantly associated with postpartum depression scores at 2 months.Functional annotation of differentially expressed genes revealed an enrichment of immune response-related biological processes, pointing toward the role of an altered immune transcriptomic landscape as a vulnerability factor for PPD.

Perception of infant sleep problems: the role of negative affectivity and maternal depression.

Burdayron R, Butler BP, Béliveau MJ, Dubois-Comtois K, Pennestri MH.  J Clin Sleep Med. 2021 Mar 4. 

High levels of maternal depression combined with high levels of infant negative affectivity may contribute to mothers’ perceptions of infant sleep problems, independent of infant sleep duration and awakenings. 

Early and late-onset postpartum depression exhibit distinct associated factors: the IGEDEPP prospective cohort study.

Tebeka S, Le Strat Y, Mandelbrot L, Benachi A, Dommergues M, Kayem G, Lepercq J, Luton D, Ville Y, Ramoz N; IGEDEPP Groups, Mullaert J, Dubertret C.  BJOG. 2021 Mar 3.

Stressful life events during pregnancy have a dose-response relationship with both early (at 2 months postpartum) and late-onset (at 1 year) PPD.

Comparing the effectiveness of home visiting paraprofessionals and mental health professionals delivering a postpartum depression preventive intervention: a cluster-randomized non-inferiority clinical trial.

Tandon SD, Johnson JK, Diebold A, Segovia M, Gollan JK, Degillio A, Zakieh D, Yeh C, Solano-Martinez J, Ciolino JD.  Arch Womens Ment Health. 2021 Mar 3.

Neither intervention arm (home visiting paraprofessionals or mental health professionals) was superior to usual care in decreasing depressive symptoms across the sample.  Post hoc analyses suggest a positive intervention effect for women exhibiting mild depressive symptoms at baseline. 

Steroid Hormone Sensitivity in Reproductive Mood Disorders: On the Role of the GABAA Receptor Complex and Stress During Hormonal Transitions.

Schweizer-Schubert S, Gordon JL, Eisenlohr-Moul TA, Meltzer-Brody S, Schmalenberger KM, Slopien R, Zietlow AL, Ehlert U, Ditzen B.  Front Med (Lausanne). 2021 Jan 18;7:479646. Free Article. Review.



No articles this week



No articles this week



Systematic Review and Meta-analysis of Genetically Informed Research: Associations between Parent Anxiety and Offspring Internalizing Problems.

Ahmadzadeh YI, Schoeler T, Han M, Pingault JB, Creswell C, McAdams TA.

J Am Acad Child Adolesc Psychiatry. 2021 Mar 2: S0890-8567(21)00142-8. 

Initial literature, derived from homogenous populations, suggests that prenatal anxiety exposure does not cause offspring internalizing outcomes. However, postnatal anxiety exposure may be causally associated with concurrent offspring internalizing, via non-genetic pathways.

The effect of prenatal adversity on externalizing behaviors at 24 months of age in a high-risk sample: Maternal sensitivity as a moderator.

Schuetze P, Molnar D, Eiden RD, Shisler S, Zhao J, Colder CR, Huestis MA.  Infant Ment Health J. 2020 Jul;41(4):530-542. 

In the absence of high prenatal risk, responsive and sensitive parenting by the mother can reduce risk for externalizing behaviors in an otherwise high-risk sample.

Association of prenatal attachment and early childhood emotional, behavioral, and developmental characteristics: A longitudinal study.

Arguz Cildir D, Ozbek A, Topuzoglu A, Orcin E, Janbakhishov CE.  Infant Ment Health J. 2020 Jul;41(4):517-529.

Prenatal attachment scores significantly correlated with social and emotional competency scores and ADSI total scores at early childhood and development at 21 to 30 months.  



The short-term effects of estradiol, raloxifene, and a phytoestrogen in women with perimenopausal depression.

Schmidt PJ, Wei SM, Martinez PE, Ben Dor RR, Guerrieri GM, Palladino PP, Harsh VL, Li HJ, Wakim P, Nieman LK, Rubinow DR.  Menopause. 2021 Jan 18. 

This study did not identify significant therapeutic benefits of transdermal estradiol (TE), Rimostil (a phytoestrogen), or raloxifene compared with placebo in perimenopausal depression. However, improvements in depression ratings were observed between TE compared with Rimostil. Cognitive testing at week 8 showed that none of the three active treatment groups performed better than placebo.

Steroid Hormone Sensitivity in Reproductive Mood Disorders: On the Role of the GABAA Receptor Complex and Stress During Hormonal Transitions.

Schweizer-Schubert S, Gordon JL, Eisenlohr-Moul TA, Meltzer-Brody S, Schmalenberger KM, Slopien R, Zietlow AL, Ehlert U, Ditzen B.  Front Med (Lausanne). 2021 Jan 18;7:479646. Free PMC. Review.



Assessment of Cesarean Delivery and Neurodevelopmental and Psychiatric Disorders in the Children of a Population-Based Swedish Birth Cohort.

Zhang T, Brander G, Mantel Ä, Kuja-Halkola R, Stephansson O, Chang Z, Larsson H, Mataix-Cols D, Fernández de la Cruz L.  JAMA Netw Open. 2021 Mar 1;4(3):e210837. 

While previous studies have documented a relationship between Cesarean delivery and increased risk for neurodevelopmental problems and psychiatric disorders in children, this study suggests that any association between Cesarean delivery and increased risk of neurodevelopmental disorders in the children is most likely explained by unmeasured familial confounding.

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