The most important story of the week encompasses the first three articles.  In the first, Netsi and colleagues observe that persistent depressive symptoms in the mother are associated with behavioral and academic problems in the children and increased vulnerability to depression in adolescence.  However, Stein and colleagues have demonstrated that by intervening early and with treatment of the mother’s depression, it may be possible to diminish the impact of maternal depression on the child’s development.

 

Ruta Nonacs, MD PhD


Association of Persistent and Severe Postnatal Depression With Child Outcomes.

Netsi E, Pearson RM, Murray L, et al. JAMA Psychiatry, January 2018.

In this observational study of 9848 women with postpartum depression and their 8287 children, the children of women with persistent and severe depression are at increased risk for behavioral problems by age 3.5 years, as well as lower mathematics grades and depression during adolescence. Women with persistent postpartum depression are likely to experience significant depressive symptoms for at least 11 years after childbirth.


Postpartum Depression and Its Long-term Impact on Children.

Weissman MM. JAMA Psychiatry, January 2018.


Mitigating the effect of persistent postnatal depression on child outcomes through an intervention to treat depression and improve parenting: a randomised controlled trial.

Stein A, Netsi E, Lawrence PJ, Granger C, et al. Lancet Psychiatry, January 2018.

Women with current major depressive disorder that had persisted for at least 3 months and had infants at 35 or more weeks of gestation and without serious neonatal complications were recruited and randomly assigned to receive either parenting video-feedback therapy (VFT) intervention versus a control treatment of progressive muscle relaxation (PMR).  Both interventions were added to cognitive behavioural therapy (CBT) for persistent postpartum depression. The two groups of children did not differ in terms of cognitive development, language development, behaviour problems, and attachment security at age 2 years and child development outcomes were in the normal range.


Effect of maternal postpartum depression on offspring’s growth.

Farías-Antúnez S, Xavier MO, Santos IS.  J Affect Disord. 2017 Dec 8;228:143-152.

In this review of 20 articles, researchers found that the child’s first-year growth was the most affected by exposure to maternal depression. Children of depressed mothers had a higher chance of being underweight and stunted in the first year of life. Maternal depression was also associated with child’s linear growth impairment after the first year.


Mania triggered by sleep loss and risk of postpartum psychosis in women with bipolar disorder.

Lewis KJS, Di Florio A, Forty L, Gordon-Smith K, Perry A, Craddock N, Jones L, Jones I.  J Affect Disord. 2018 Jan 1;225:624-629.

Women who reported  a history of manic episodes triggered by sleep loss were twice as likely to have experienced an episode of postpartum psychosis (OR = 2.09, 95% CI = 1.47-2.97, p < 0.001) compared to women who did not report this. There was no significant association between depression triggered by sleep loss and postpartum psychosis.  In clinical practice, a history of mania following sleep loss could be a marker of increased vulnerability to PP, and should be discussed with BD women who are pregnant or planning to conceive.


Anxiety, depression and relationship satisfaction in the pregnancy following stillbirth and after the birth of a live-born baby: a prospective study.

Gravensteen IK, Jacobsen EM, Sandset PM, Helgadottir LB, Rådestad I, Sandvik L, Ekeberg Ø.  BMC Pregnancy Childbirth. 2018 Jan 24;18(1):41.

Women who had experienced a stillbirth were about five times more likely to experience depression or anxiety after the birth of a live-born child than women who had not previously had a stillbirth.


A systematic review of psychological treatments for clinical anxiety during the perinatal period.

Loughnan SA, Wallace M, Joubert AE, Haskelberg H, Andrews G, Newby JM.  Arch Womens Ment Health. 2018 Jan 24.