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. 

In January 2021, we will be offering a new online course entitled “Perinatal Psychiatry: In-Depth Modules for Enhance Approaches”.  This 6-week course will build on the basic information provided in the course we ran in November and will give attendees a chance to dive a little deeper into a selected number of topics.  

You can find out more about the class and 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




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Prenatal stress: Effects on fetal and child brain development.

Lautarescu A, Craig MC, Glover V.  Int Rev Neurobiol. 2020;150:17-40. 

Depressed mood and anxiety as risk factors for hypertensive disorders of pregnancy: a systematic review and meta-analysis.

Shay M, MacKinnon AL, Metcalfe A, Giesbrecht G, Campbell T, Nerenberg K, Tough S, Tomfohr-Madsen L.  Psychol Med. 2020 Oct;50(13):2128-2140. 

According to this meta-analysis, depression and/or anxiety during pregnancy were associated with an increased risk of hypertension during pregnancy  [RR = 1.39; 95% confidence interval (CI) 1.25-1.54].

Effects of a Brief Electronic Mindfulness-Based Intervention on Relieving Prenatal Depression and Anxiety in Hospitalized High-Risk Pregnant Women: Exploratory Pilot Study.

Goetz M, Schiele C, Müller M, Matthies LM, Deutsch TM, Spano C, Graf J, Zipfel S, Bauer A, Brucker SY, Wallwiener M, Wallwiener S.  J Med Internet Res. 2020 Aug 11;22(8):e17593. Free article.

Electronic mindfulness-based interventions (eMBIs) may be helpful for decreasing anxiety and/or depression; however, in this study, compliance to eMBI was related to lower symptoms of pregnancy-related stress among high-risk patients at baseline.

Effects of psychological treatment of mental health problems in pregnant women to protect their offspring: randomised controlled trial.

Burger H, Verbeek T, Aris-Meijer JL, Beijers C, Mol BW, Hollon SD, Ormel J, van Pampus MG, Bockting CLH.  Br J Psychiatry. 2020 Apr;216(4):182-188. 

Prenatally initiated CBT did not improve maternal symptoms or child outcomes among non-help-seeking women with antenatal depression or anxiety. 

Treatment resistant depression in women with peripartum depression.

Cepeda MS, Kern DM, Nicholson S.  BMC Pregnancy Childbirth. 2019 Sep 2;19(1):323.  Free article.

TRD occurs in approximately 5% of women with peripartum depression. The risk of TRD is higher in pregnant women with a history of depression. Women who went on to develop TRD had more psychiatric comorbidities and painful conditions than women who did not.

Risk factors for depression, anxiety, and PTSD symptoms in perinatal women during the COVID-19 Pandemic.

Liu CH, Erdei C, Mittal L.  Psychiatry Res. 2020 Nov 4:113552. 

Among the respondents, 36.4% reported clinically significant levels of depression, 22.7% for generalized anxiety, and 10.3% for PTSD.  Women with pre-existing mental health diagnoses based on their self-reported history were 1.6-to-3.7 more likely to report clinically significant symptoms.  



The impact of major depressive disorder and antidepressant medication before and during pregnancy on obstetric and neonatal outcomes; a nationwide population-based study.

Wolgast E, et al.  Eur J Ob Gynecol 2020, Nov 25.  

Women with MDD who used antidepressant medication prior to becoming pregnant are at increased risk for adverse obstetric and neonatal outcomes compared to women without MDD. The continuation of antidepressant medication during pregnancy slightly increased the risk for adverse obstetric and neonatal outcomes.

Socioeconomic status and psychotropic medicine use during pregnancy: a population-based study in British Columbia, Canada.

Hanley GE, Park M, Oberlander TF.  Arch Womens Ment Health. 2020 Oct;23(5):689-697. 

Women at the low end of the income distribution were more likely to have a diagnosis for all mental health conditions, except anxiety, which was more common in women of highest socioeconomic status.  While women in the lowest income quintile had lower odds of filling a prescription for a psychotropic medication, they were more likely to fill a prescription for an antipsychotic medication or to fill prescriptions from 3 or more different drug categories during pregnancy. 



Association between delivering live-born twins and acute psychiatric illness within 1 year of delivery.

Lewkowitz AK, López JD, Keller M, Rosenbloom JI, Macones GA, Olsen MA, Cahill AG.  Am J Obstet Gynecol. 2020 Sep 12:

Overall, diagnostic codes for psychiatric illness or substance misuse in emergency department visits or hospital admissions in the year after twin vs singleton delivery were similar. However, women who are low income or those who have public health insurance are at an increased risk of postpartum psychiatric morbidity

 Past Psychiatric Conditions as Risk Factors for Postpartum Depression: A Nationwide Cohort Study.

Johansen SL, Stenhaug BA, Robakis TK, Williams KE, Cullen MR.  J Clin Psychiatry. 2020 Jan 21.  Free article.

Among 336,522 pregnancies, 9.4% of women were diagnosed with postpartum depression (n = 31,610). Five percent of women with no depression history developed postpartum depression, compared to 65% of women with depression prior to and during pregnancy. 

Prevalence and factors associated with postpartum posttraumatic stress in a population-based maternity survey in England.

Harrison SE, Ayers S, Quigley MA, Stein A, Alderdice F.  J Affect Disord. 2020 Nov 16:

Factors associated with post-traumatic symptoms related to childbirth were higher levels of deprivation, not having a health professional to talk to about sensitive issues during pregnancy, and the baby being admitted for neonatal intensive care.

 Maximizing maternal health and value for money in postpartum depression screening: a cost-effectiveness analysis using the All Our Families cohort and administrative data in Alberta, Canada.

Premji S, McDonald SW, McNeil DA, Spackman E.  J Affect Disord. 2020 Nov 12.

This study estimates that screening may be most valuable when participation and compliance are maximized, where all women screened as being at high risk for depression attend referral for treatment. This leads to greater value for money and increased maternal health gains across the population. 



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Contraception for Women With Psychiatric Disorders.

McCloskey LR, Wisner KL, Cattan MK, Betcher HK, Stika CS, Kiley JW.  Am J Psychiatry. 2020 Nov 10.

Most women select combined oral contraceptives.  The impact of hormonal contraceptives on the risk for depression is controversial; however, clinical studies and randomized placebo-controlled trials of women with psychiatric disorders have generally reported similar or lower rates of mood symptoms in hormonal contraceptive users compared with nonusers. Hormonal contraceptives interact with clozapine, anticonvulsants, and St. John’s Wort.

Association of polycystic ovary syndrome or anovulatory infertility with offspring psychiatric and mild neurodevelopmental disorders: a Finnish population-based cohort study.

Chen X, Kong L, Piltonen TT, Gissler M, Lavebratt C.  Hum Reprod. 2020 Oct 1;35(10):2336-2347. Free article.

Maternal PCOs was associated with increased risk of neurodevelopmental disorders in offspring, even after controlling for maternal obesity and gestational diabetes.  

The associations of maternal polycystic ovary syndrome and hirsutism with behavioral problems in offspring.

Robinson SL, Ghassabian A, Sundaram R, Trinh MH, Bell EM, Mendola P, Yeung EH.  Fertil Steril. 2020 Feb;113(2):435-443. 

Maternal PCOS was associated with offspring anxiety, and hirsutism was related to other offspring behavioral problems.



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