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. 

This week highlights the work of Marlene Freeman, the associate director of our program.  One of the articles looks at a prenatal supplement containing methylfolate which appears to have efficacy for preventing depressive relapse and for treating depressive symptoms during pregnancy in women with histories of major depression.  

Another article looks at sex differences with regard to treatment of treatment refractory depression with ketamine.  Although there was no evidence of differential efficacy of ketamine for the treatment of depression between women and men, women were more likely to have side effects (nausea and headaches)

And Dr. Freeman has also provided an article on the perils of practicing perinatal psychiatry in the midst of a pandemic.  She will be joining Dr. Lee Cohen again this Wednesday for another session of our virtual rounds.  

Join us for rounds on Wednesdays from 2-3 PM EST.  Health care professionals can register HERE.  

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


No articles this week


No articles this week


Neuroendocrine and immune markers of maternal stress during pregnancy and infant cognitive development.

Nazzari S, Fearon P, Rice F, Ciceri F, Molteni M, Frigerio A.  Dev Psychobiol. 2020 Mar 31.

Higher maternal diurnal cortisol and CRP levels were independently associated with lower infant cognitive development scores, while adjusting for infant gender and gestational age, maternal IQ, caregiving, depressive, or anxiety symptoms.

A prenatal supplement with methylfolate for the treatment and prevention of depression in women trying to conceive and during pregnancy.

Freeman MP, Savella GM, Church TR, Góez-Mogollón L, Sosinsky AZ, Noe OB, Kaimal A, Cohen LS.  Ann Clin Psychiatry. 2019 Feb;31(1):4-16.

In women with MDD who discontinued antidepressant proximate to conception, treatment with EmbraceHR was associated with lower rates of depressive relapse (27.3% P = .005) than expected from a historical comparison group and no significant changes in MADRS scores. In participants who depressed at study entry, treatment with EmbraceHR resulted in significant improvements in depressive symptoms (P = .001), with 5 (83.3%) improving >50% and 1 improving 33.3%. 


Dispensing patterns of selective serotonin reuptake inhibitors before, during and after pregnancy: a 16-year population-based cohort study from the Netherlands.

Molenaar NM, Lambregtse-van den Berg MP, Bonsel GJ.  Arch Womens Ment Health. 2020 Feb;23(1):71-79. Free Article

Dispensing rates of SSRIs in Denmark steadily increased over the last 16 years, especially during pregnancy, caused by an increase in the proportion of women continuing their medication during pregnancy.

Prevalence of benzodiazepines and benzodiazepine-related drugs exposure before, during and after pregnancy: A systematic review and meta-analysis.

Bais B, Molenaar NM, Bijma HH, Hoogendijk WJG, Mulder CL, Luik AI, Lambregtse-van den Berg MP, Kamperman AM.  J Affect Disord. 2020 Mar 5;269:18-27.

The worldwide prevalence of benzodiazepine use/prescriptions during pregnancy was 1.9%. Highest prevalence was found in the third trimester (3.1%;). Lorazepam was the most frequently used/prescribed benzodiazepine (1.5%).  Highest prevalence was found in Eastern Europe (14.0%).


Postpartum psychiatric disorders and subsequent live birth: a population-based cohort study in Denmark.

Liu X, Plana-Ripoll O, Ingstrup KG, Agerbo E, Skjærven R, Munk-Olsen T.  Hum Reprod. 2020 Mar 29. 

This study indicates that postpartum psychiatric disorders have a significant impact on subsequent live birth, as women experiencing these disorders have a decreased likelihood of having more children. 


No articles this week


Maternal Cotinine Levels and Red Blood Cell Folate Concentrations in the Periconceptual Period.

Yusuf KK, Wilson R, Mbah A, Sappenfield W, King LM, Salihu HM.  South Med J. 2020 Apr;113(4):156-163.

Higher levels of smoking, as measured using cotinine levels, was associated with lower folate  levels. Prepregnancy maternal body mass index, stress, and depression also were associated with folate levels.


Female infants are more susceptible to the effects of maternal antenatal depression; findings from the Pelotas (Brazil) Birth Cohort Study.

Netsi E, Coll CVN, Stein A, Silveira MF, Bertoldi AD, Bassani DG, Wehrmeister FC, Domingues MR.  J Affect Disord. 2020 Apr 15;267:315-324. Free Article

For severe depression (EPDS?17) there was an increased risk for lower APGAR scores (OR 1.63) and being small for gestational age (OR 1.77), with an increased risk for female offspring in particular to be in the lower weight centiles, to be SGA (OR 3.74) and in the lower 10th centile for length (OR 2.19).

The programming role of maternal antenatal inflammation on infants’ early neurodevelopment: A review of human studies: Special Section on “Translational and Neuroscience Studies in Affective Disorders” Section Editor, Maria Nobile MD, PhD.

Nazzari S, Frigerio A.  J Affect Disord. 2020 Feb 15;263:739-746.

Maternal inflammation during pregnancy is a frequently proposed mechanism underlying the link between maternal antenatal physical (e.g. infections, immune disease, obesity) and/or psychological (e.g. depression, anxiety) conditions and child outcomes. However, data regarding the extent to which maternal inflammation is directly associated with offspring’s early development and health in humans is more limited.  

Maternal psychological distress and child weight at 24 months: investigating indirect effects through breastfeeding in the All Our Families cohort.

Shay M, Tomfohr-Madsen L, Tough S.  Can J Public Health. 2020 Mar 25.

In a sample of 1582 mother-child pairs, there was no direct relationship between psychological distress and child overweight status. Both anxiety and depression were associated with decreased duration of breastfeeding. Breastfeeding duration mediated the association between maternal prenatal psychological distress and child overweight status at 24 months, for both anxiety and depression.

Correlates of prenatal and postnatal mother-to-infant bonding quality: A systematic review.

Tichelman E, Westerneng M, Witteveen AB, van Baar AL, van der Horst HE, de Jonge A, Berger MY, Schellevis FG, Burger H, Peters LL.  PLoS One. 2019 Sep 24;14(9).


No articles this week


COVID-19 From a Psychiatry Perspective: Meeting the Challenges.

Freeman MP.  J Clin Psychiatry. 2020 Mar 31;81(2). Free Article

Sex differences in response to ketamine as a rapidly acting intervention for treatment resistant depression.

Freeman MP, Papakostas GI, Hoeppner B, Mazzone E, Judge H, Cusin C, Mathew S, Sanacora G, Iosifescu D, DeBattista C, Trivedi MH, Fava M.  J Psychiatr Res. 2019 Mar;110:166-171.

Although there was no evidence of differential efficacy of ketamine for the treatment of depression between women and men, women were more likely to have side effects (nausea and headaches).

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