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.
Ruta Nonacs, MD PhD
PMS AND PMDD |
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INFERTILITY AND MENTAL HEALTH |
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PSYCHIATRIC ILLNESS DURING PREGNANCY |
| When is the best time to screen for perinatal anxiety? A longitudinal cohort study – PubMed
Early pregnancy was the optimal time to screen for anxiety to identify women with anxiety disorders and women wanting treatment at any time during pregnancy or postnatally.
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MEDICATIONS AND PREGNANCY |
| Intrauterine Exposure to Antidepressants or Maternal Depressive Symptoms and Offspring Brain White Matter Trajectories From Late Childhood to Adolescence – PubMed
Prenatal exposure to maternal depressive symptoms was negatively associated with white matter microstructure in childhood, but these differences attenuated during development, suggesting catch-up growth.
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POSTPARTUM PSYCHIATRIC ILLNESS |
| Antenatal depression across trimesters as a risk for postpartum depression and estimation of the fraction of postpartum depression attributable to antenatal depression: A systematic review and meta-analysis of cohort studies – PubMed |
| Eighty-eight (88) cohort studies with a combined sample size of 1,042,448 perinatal women contributed to the meta-analysis. About 37% pregnant women who had antenatal depression (AD), later had PPD. Those with AD had four times higher odds of developing PPD (OR: 4.58; 95% CI = 3.52-5.96). The odds of having PPD were higher when AD was observed in the first or third trimester compared to the second trimester. About 12.8% of PPD cases were attributable to AD.
Prioritizing Maternal Mental Health in Addressing Morbidity and Mortality Concrete programmatic and policy changes are needed to reduce perinatal stress and address trauma, standardize the collection of social determinant of health data among perinatal patients, increase access to reproductive psychiatry curricula among prescribers, reduce perinatal mental health and obstetrical deserts, institute paid parental leave, and support seamless integration of perinatal and behavioral health care. Moreover, instead of focusing on a relatively minor portion of the contributors to health that current medical practice targets, fortifying the social foundation strengthens the prospects for the health of families for our current and future generations.
Maternal mental health conditions drive climbing death rate in US, research says | CNN The maternal mortality rate in the US is two- to threefold greater than in other high-income countries, and it has only increased in recent years, according to the review, which was published Wednesday in the journal JAMA Psychiatry. More than 80% of pregnancy-related deaths in the US are preventable.
This comprehensive review explores and analyzes various aspects of PPD screening and intervention practices.
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| Sleep, circadian activity patterns and postpartum depression: A systematic review and meta-analysis of actigraphy studies – PubMed
Postpartum total sleep at night was the indicator that was most closely related to the psychological functioning of women after childbirth. The results of the systematic review indicated that postpartum total sleep at night was related to postpartum fatigue, and the results of the meta-analysis suggested that total sleep at night was most strongly linked with postpartum depression.
In this live video-based 12-week interactive psychotherapy group focused on maternal symptoms and maternal-infant relationships, there were significant pre- to post-group reductions in maternal depressive and post-traumatic symptoms, supporting proceeding to larger-scale implementation and evaluation of the intervention, with adaptation of dyadic exercises.
Associations of pelvic floor dysfunction and postnatal mental health: a systematic review – PubMed The majority of studies reviewed (44 studies) reported associations between pelvic floor dysfunction and adverse postnatal mental health conditions.
Participants were randomized to the Happy Mother-Healthy Baby program, based on cognitive behavioral therapy, consisting of six one-on-one intervention sessions in pregnancy delivered by non-specialist providers, or to enhanced care alone. The researchers found an 81% reduced odds of having either a major depressive episode (MDE) or moderate-to-severe anxiety for women randomized to the intervention (adjusted odds ratio (aOR) = 0.19, 95% CI 0.14-0.28). Overall, 12% of women in the intervention group developed MDE at 6 weeks postpartum, versus 41% in the control group. We found reductions of 81% and 74% in the odds of postnatal MDE (aOR = 0.19, 95% CI 0.13-0.28) and of moderate-to-severe anxiety (aOR = 0.26, 95% CI 0.17-0.40), respectively.
Genetic Markers Associated with Postpartum Depression: A Review – PubMed The serotonin gene (5-HTTLPR) and oxytocin genes (OXTR) have the most significant associations with PPD among other genes.
Sage offers details on launch of new postpartum depression pill
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MEDICATIONS AND BREASTFEEDING |
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PERINATAL SUBSTANCE USE |
| Group prenatal care for pregnant women with opioid use disorder: Preliminary evidence for acceptability and benefits compared with individual prenatal care – PubMed |
| G-PNC was successfully implemented among women with varying backgrounds (e.g., racial, ethnic, marital status) who self-selected into the group. All G-PNC participants reported that they were satisfied to very satisfied with the program. Increased rates of breastfeeding initiation, breastfeeding at hospital discharge, receipt of the Tdap vaccine, and postpartum visit attendance at 1-2 weeks and 4-8 weeks were observed in the G-PNC group compared with the I-PNC group. Fewer G-PNC reported postpartum depression symptomatology.
Prenatal tobacco exposure (PTE) and tobacco-cannabis coexposure (PTCE) co-occur with negative maternal emotional functioning (termed prenatal risks) and together increase risk for child regulatory problems at early school age (ESA).
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MATERNAL MENTAL HEALTH AND CHILD OUTCOMES |
| Epigenome-wide association studies of prenatal maternal mental health and infant epigenetic profiles: a systematic review – PubMed
Exposure to prenatal maternal depression and anxiety or treatment for such was not consistently associated with epigenetic changes in infants in this systematic review and meta-analysis.
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| Maternal social support during and after pregnancy and child cognitive ability: examining timing effects in two cohorts – PubMed
Higher maternal perceived social support during pregnancy was associated with higher performance on the WISC, independent of sociodemographic factors and concurrent maternal symptoms of depression and anxiety. In ALSPAC, pregnancy emerged as a sensitive period for the effects of perceived social support on child cognitive ability, with a stronger effect of social support during pregnancy than after pregnancy on child cognitive ability.
Maternal anxiety and/or depression and ADHD during pregnancy were associated with increased risk of child anxiety (odds ratios = 2.99 and 3.64, respectively) at 8 years of age, remaining significant in the multivariable analysis adjusted for covariates.
Prenatal maternal depression held an adverse association with child language. Moreover, the risk was greater for girls than boys. Prenatal depression was significantly and negatively associated with child verbal intelligence quotient and performance intelligence quotient. In contrast, postnatal depression or anxiety were not unique predictors of child outcomes.
Domestic violence as a risk factor of maternal filicide – PubMed Traumatic early childhood experiences predispose people to a stress-response system that is more prone to inactivity and impulsivity. This can cause women in domestic violence relationships to stay, limit their options for family planning, become increasingly depressed, not seek community support, and risk impulsive action of harming their child. This risk can be mitigated by building stable relationships with their medical team, treating depression, connecting with home visitation programs, and being empowered to access contraception.
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MENOPAUSE AND MENTAL HEALTH |
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OTHER TOPICS IN WOMEN’S MENTAL HEALTH |
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