PMS AND PMDD

Serum markers of HPA axis and immune function did not vary by menstrual cycle phase nor PMDD status. However, sertraline treatment in the luteal phase was associated with higher ALLO levels predicting lower cortisol peak in response to mild laboratory stress, suggesting that sertraline treatment may normalize HPG-HPA axis interactions among individuals with PMDD.

INFERTILITY AND MENTAL HEALTH

PSYCHIATRIC ILLNESS DURING PREGNANCY

Participants exhibited the highest levels of depressive symptoms at 3rd trimester, and substantial variability in depressive symptom trajectories over time. Lower resting respiratory sinus arrhythmia (RSA), an index of parasympathetic nervous system functioning, in the 3rd trimester was associated with higher concurrent depressive symptoms.

The study findings suggest that app-based digital phenotyping is a feasible and acceptable method of conducting research and health care delivery among perinatal women. The Mom2B app was perceived as an efficient and practical tool that facilitates engagement in research as well as allows users to monitor their well-being and receive general and personalized information related to the perinatal period.

Findings suggest maternal-placental transfer of omega-3 may represent one pathway by which maternal metabolic and mental health impacts infant development. Stratified models revealed an association between prenatal maternal depressive symptoms with lower cord blood omega-3 levels, but only among individuals with pre-pregnancy overweight or obesity.

Estrogen fluctuations must be conceptualized in the context of multiple dramatic and interacting changes inherent in pregnancy and after birth, including progesterone, corticosteroids, inflammation, circadian biology and psychosocial challenges. Individuals who develop PPD have increased sensitivity to epigenetic alteration at estrogen-responsive genes, and these changes are highly predictive of PPD.

Higher maternal resilience during perinatal periods was found to reduce mental health disorders. Pregnant women were more resilient to mental health disorders than postpartum women. Tolerance of uncertainty and a positive cognitive appraisal, women’s self-behavior and family functioning, and protective psychosocial resources such as dispositional optimism, parental sense of mastery, self-esteem, gratitude, and forgiveness were found to be the most common mechanisms of resilience among perinatal women.

Neither maternal depression nor lower levels of oxytocin during pregnancy predicted difficult infant temperament; rather, it was predicted by non-Caucasian ethnicity. When all other variables were free to vary, adult attachment avoidance mediated an association between maternal depression during pregnancy and difficult infant temperament.

Did psychotherapy use and out-of-pocket costs for delivering women change after passage of the Mental Health Parity and Addiction Equity Act (MHPAEA) and the Patient Protection and Affordable Care Act (ACA)?

MEDICATIONS AND PREGNANCY

With the rate of pregnancies exposed to valproic acid remaining high over the past 15 years, experts suggest imposing a formal valproic acid safety program, training for psychiatrists about managing patients’ preconception care, and reducing off-label use in women of childbearing age.

POSTPARTUM PSYCHIATRIC ILLNESS

Screening positive for PPD was associated with subsequent acute care utilization but not 12-month preventive care. Primary care providers may need to proactively follow-up after acute care visits to ensure both infant health and maternal needs are met, connecting mothers to resources as needed.

Promoting cardiovascular health (CVH) during pregnancy may decrease risk for postpartum psychological distress, according to results of a study published in the Journal of the American Heart Association.

MEDICATIONS AND BREASTFEEDING

This small study found that most patients using lithium postpartum have been taking lithium long-term and are not breastfeeding. Lithium exposure in breastmilk appears to be tolerated by healthy infants.

PERINATAL SUBSTANCE USE

Buprenorphine and naloxone associated with similar or better outcomes versus buprenorphine alone.

MATERNAL MENTAL HEALTH AND CHILD OUTCOMES

Antenatal depression (AD) is associated with alterations in 15 metabolic measures, which collectively improve the prediction of AD over its risk factors, and birth, neurodevelopmental and mental health outcomes of the child over AD. These metabolic measures may become biomarkers identifying at-risk mothers and children for personalized interventions.

Lower maternal heart rate variability (HRV) was associated with higher self-reported maternal depression and anxiety. Additionally, mothers with lower HRV had infants with lower HRV. Maternal HRV was also associated with higher infant theta-beta ratios, but not alpha asymmetry.

Maternal ACEs may be associated with epigenetic aging later in life, including during pregnancy, supporting a role for maternal ACEs in offspring development and health later in life.

MENOPAUSE AND MENTAL HEALTH

OTHER TOPICS IN WOMEN’S MENTAL HEALTH

Twenty-one states had a ratio of less than 1 psychiatrist offering peripartum treatment per 5000 births. South Dakota, Montana, and Mississippi demonstrated the lowest density, while New York, Connecticut, and Rhode Island demonstrated the highest; many states were estimated to require dozens to hundreds of additional specialists to fully meet projected needs.