The two lead articles take a look at the use of two anticonvulsants during pregnancy, lamotrigine (Lamictal) and pregabalin (Lyrica); the data are reassuring with regard to the reproductive safety of these medications.

Pariente G, Leibson T, Shulman T, Adams-Webber T, Barzilay E, Nulman I.  Pregnancy Outcomes Following In Utero Exposure to Lamotrigine: A Systematic Review and Meta-Analysis.  CNS Drugs. 2017 Apr 22.

Meta-analysis shows no increase in risk for major malformations in children exposed to lamotrigine monotherapy.

Patorno E, Bateman BT, Huybrechts KF, MacDonald SC, Cohen JM, Desai RJ, Panchaud A, Mogun H, Pennell PB, Hernandez-Diaz S.  Pregabalin use early in pregnancy and the risk of major congenital malformations.  Neurology. 2017 Apr 26.

Pregabalin use in pregnancy was not associated with birth defects in a cohort using data from the Medicaid Analytic eXtract.

Maternal Depressive Symptoms, Perceived Stress, and Fetal Growth.

Grobman WA, Wing DA, Albert P, Kim S, Grewal J, Guille C, Newman R, Chien EK, Owen J, D’Alton ME, Wapner R, Sciscione A, Grantz KL.  J Ultrasound Med. 2017 Apr 10.

More severe depressive symptoms and greater perceived stress, as quantified by the EPDS and the PSS, respectively, are not associated with alterations in fetal growth as measured using ultrasound.

Beyond Screening: A Stepped Care Pathway for Managing Postpartum Depression in Pediatric Settings.

Olin SS, McCord M, Stein REK, Kerker BD, Weiss D, Hoagwood KE, Horwitz SM.  J Womens Health (Larchmt). 2017 Apr 14.

Strategies which could be used in pediatric primary care settings to identify and manage postpartum dood and anxiety disorders.

Pregnancy and the Acceptability of Computer-Based Versus Traditional Mental Health Treatments.

Hantsoo L, Podcasy J, Sammel M, Epperson CN, Kim DR.  J Womens Health (Larchmt). 2017 Apr 20.

While computer-based therapies were acceptable to most pregnant women in this sample, traditional talk therapy was the preferred option.

Moderate-Severe Vasomotor Symptoms Are Associated with Moderate-Severe Depressive Symptoms.

Worsley R, Bell RJ, Gartoulla P, Robinson PJ, Davis SR.  J Womens Health (Larchmt). 2017 Mar 6. Women with moderate-severe VMS were more likely to have moderate-severe depressive symptoms (odds ratio [OR] 2.80). These women were also more likely to use psychotropic medications, to smoke, and to engage in binge drinking.

Trajectories of maternal depressive symptoms in the early childhood period and family-wide clustering of risk.

Madigan S, Wade M, Plamondon A, Jenkins JM.J Affect Disord. 2017 Jun;215:49-55.

Starting at two months postpartum, three distinct trajectories were observed: 84% demonstrated low-stable levels of depressive symptoms, 9.5% had high-decreasing scores, and 6.5% had moderate-increasing scores. Socioeconomic status and marital conflict differentiated the low-stable group from the high-decreasing and moderate-increasing group.  At 54 months, clustering of family risks was prevalent for the moderate-increasing depression group, including higher marital conflict and household chaos, lower parental positivity, and heightened levels of child psychopathology.

The prevalence of antenatal and postnatal co-morbid anxiety and depression: a meta-analysis.

Falah-Hassani K, Shiri R, Dennis CL.  Psychol Med. 2017 Apr 17:1-13.

Effect of breastfeeding on postpartum depressive symptoms among adolescent and young adult mothers.

Sipsma HL, Ruiz E, Jones K, Magriples U, Kersahw T.  J Matern Fetal Neonatal Med. 2017 Apr 16:1-18.

Postpartum depressive symptoms were not associated with breastfeeding duration or breastfeeding at 6 months. However, early breastfeeding difficulties were associated with depressive symptoms and predicted lower rates of breastfeeding at 6 months.

The role of maternal anxiety and depressive disorders prior to and during pregnancy and perinatal psychopathological symptoms for early infant diseases and drug administration.

Krause L, Einsle F, Petzoldt J, Wittchen HU, Martini J.  Early Hum Dev. 2017 Apr 8;109:7-14.

In the mother, severe psychopathology during pregnancy were associated with inflammatory diseases and anti-infective medication, whereas anxiety and depressive disorders prior to and during pregnancy were related to gastrointestinal complaints (diarrhea, colic complaints) and corresponding medication.


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