On the list this week, there are a fair number of articles which look at the impact of maternal depression on children’s well-being.  No real surprises, but more evidence that depression during pregnancy and during the postpartum period can have significant impact on the child’s well-being.  

Nomura and colleagues looked at the impact of prenatal depression in women who were affected by Superstorm Sandy while pregnant, noting that exposure to this traumatic event amplified the effects of prenatal depression and was associated with lower emotion regulation and greater distress in infants at 6 months of age.

Hakanen and colleagues demonstrate differential effects of depression and anxiety on maternal and infant behavior.  Generalized anxiety during the third trimester of pregnancy was associated with higher maternal intrusiveness.  In contrast, depressive symptoms at 6 months postpartum were associated with lower maternal structuring behavior and with the child’s lower involvement with the mother.

For more detailed descriptions of many of these topics, you can read the CWMH NEWSLETTER which comes out every Thursday.  You can sign up for our newsletter HERE.

Ruta Nonacs, MD PhD



No articles this week


A Comparison of Postpartum Depression in Mothers Conceived by Assisted Reproductive Technology and Those Naturally Conceived.

Amirchaghmaghi E, Malekzadeh F, Chehrazi M, Ezabadi Z, Sabeti SH.  Int J Fertil Steril. 2020 Jan;13(4):277-281. 

The mean EPDS score in mothers who naturally conceived was 8.38 ± 0.35 in comparison with mothers who conceived via ART (7.59 ± 0.63). The proportions of women who reported PPD were 26.0% for the control group and 20.4% for the ART group. There was no statistically significant difference in PPD between the control and ART groups (P=0.26).


Association of sleep quality during pregnancy with stress and depression: a prospective birth cohort study in China.

Gao M, Hu J, Yang L, Ding N, Wei X, Li L, Liu L, Ma Y, Wen D.  BMC Pregnancy Childbirth. 2019 Nov 27;19(1):444. Free Article

Poor sleep quality (PSQI scores ?5) was associated with antenatal stress status (odds ratio [OR]: 2.60, 95% CI: 1.79, 3.77), antenatal depression (OR: 3.42, 95% CI: 2.48, 4.72), and postpartum depression (OR: 2.40, 95% CI: 1.58, 3.64) after adjusting maternal age, BMI, gestational age, smoking, educational level, annual household income and social support. 

Innovations in the Treatment of Perinatal Depression: the Role of Yoga and Physical Activity Interventions During Pregnancy and Postpartum.

Eustis EH, Ernst S, Sutton K, Battle CL.  Curr Psychiatry Rep. 2019 Dec 4;21(12):133. 

High quality, rigorous, randomized controlled trials are needed. Future research is also needed to examine the optimal dose of these interventions and how to best increase sustained engagement.

Obstructive sleep apnea is associated with depressive symptoms in pregnancy.

Redhead K, Walsh J, Galbally M, Newnham JP, Watson SJ, Eastwood P.  Sleep. 2019 Nov 29. 

During late pregnancy women with OSA had eight times the odds of having depressive symptoms. Furthermore, an interaction was found between OSA and history of depression. Specifically, in women with no history of depression, OSA increases depressive symptoms. In women with a history of depression, OSA has an even stronger effect on depressive symptomology. This suggests screening for OSA in pregnancy may identify women prone to future depressive episodes and allow for targeted interventions.

Prevalence of self-reported mental disorders in pregnancy and associations with adverse neonatal outcomes: a population-based cross-sectional study.

Mongan D, Lynch J, Hanna D, Shannon C, Hamilton S, Potter C, Gorman C, McCambridge O, Morrow R, Mulholland C.  BMC Pregnancy Childbirth. 2019 Nov 8;19(1):412. Free Article

Among 140,569 singleton pregnancies registered using NIMATS, 18.9% of these pregnancies, the mother reported a history of at least one mental disorder. After adjustment for potential confounding factors, significant associations were demonstrated between self-reported maternal mental disorder and preterm birth (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.25-1.37), low infant birth weight (OR 1.29, 95% CI 1.21-1.38) and APGAR score?<?7 at 1?min (OR 1.14, 95% CI 1.10-1.19) and 5?min (OR 1.23, 95% CI 1.12 to 1.34).

Maternal and child delivery charges, postpartum charges, and utilization of care among women with bipolar disorder: a cohort study.

Hoffman MC, Rinehart DJ, Jochens LK, Valdez C, Durfee J, Mazzoni SE.  Arch Womens Ment Health. 2019 Nov 13. 

Compared with women with no known mental health diagnosis, women with bipolar disorder (BD) had higher delivery charges, higher cumulative charges in the 2 years postpartum, greater utilization of inpatient and emergency psychiatric care services, higher rates of preterm birth  (15.5% v. 6.9%), and higher rates of low birthweight (20.8% v. 6.4%). Compared with women with and without other mental health diagnoses, women with BD have the highest care utilization and charges. 



Psychotropic Treatment During Pregnancy: Research Synthesis and Clinical Care Principles.

Betcher HK, Wisner KL.  J Womens Health (Larchmt). 2019 Dec 3. 



Maternal depression, anxiety, stress, and maternal-infant attachment in the neonatal intensive care unit.

Bonacquisti A, Geller PA, Patterson CA.  J Reprod Infant Psychol. 2019 Dec 4:1-14.

NICU mothers reported elevated rates of depressive, anxiety, and stress symptoms. Maternal-infant attachment was negatively associated with anxiety and stress symptoms. Both depressive and anxiety symptoms were higher during NICU admission compared to 2-4 months later, and depressive symptoms during NICU admission predicted depressive symptoms 2-4 months later.

Introducing Mother Baby Connections: a model of intensive perinatal mental health outpatient programming.

Geller PA, Posmontier B, Horowitz JA, Bonacquisti A, Chiarello LA.  J Behav Med. 2018 Oct;41(5):600-613.

Mother Baby Connections (MBC) is an innovative interdisciplinary, attachment-focused, intensive, outpatient perinatal mental health program recently launched at Drexel University.



No articles this week


Effects of Parental Opioid Use: Outcomes of Children of Parents in Medication-Assisted Treatment Compared to Healthy Controls.

Betcher HK, Vande Voort JL, Croarkin PE, Gandhi KD, Shekunov J, Larrabee BR, Limbeck MG, Rummans TA, Romanowicz M.  Prim Care Companion CNS Disord. 2019 Aug 15;21(4).  Free Article

Compared to controls (n = 120), children of parents receiving buprenorphine-assisted treatment (n = 24) were more likely to be born premature (odds ratio [OR] = 3.3, P = .035), to have jaundice after birth (OR = 2.7, P = .034), to have enuresis/encopresis (P < .001), and to be the victims of abuse or neglect (OR = 19.7, P = .0005). Children of parents with opioid use disorders were also more likely to utilize emergency services (OR = 4.0, P = .046) and were less likely to be covered by private insurance compared to state-funded insurance (OR = 0.2, P = .0013).


Influence of in utero exposure to maternal depression and natural disaster-related stress on infant temperament at 6 months: The children of Superstorm Sandy.

Nomura Y, Davey K, Pehme PM, Finik J, Glover V, Zhang W, Huang Y, Buthmann J, Dana K, Yoshida S, Tsuchiya KJ, Li XB, Ham J.  Infant Ment Health J. 2019 Mar;40(2):204-216. Free  Article

Prenatal depression was associated with lower emotion regulation and greater distress in infants at 6 months of age. Stratification and interaction analyses suggested that the adverse effects of prenatal maternal depression on problematic temperament were amplified by in utero exposure to Superstorm Sandy. This study underscores the importance of providing prenatal screening and treatment for maternal depression during pregnancy while also identifying high-risk families who may have suffered from disaster-related trauma. 

Negative impact of maternal antenatal depressive symptoms on neonate’s behavioral characteristics.

Gressier F, Letranchant A, Glatigny-Dallay E, Falissard B, Sutter-Dallay AL.  Eur Child Adolesc Psychiatry. 2019 Jul 11. 

Researchers noted a significant association between higher depressive symptoms on the CES-D during the 8th month of pregnancy and lower scores on several different domains of the Neonatal Behavioral Assessment Scale – NBAS, specifically “habituation”, “orientation”, “motor system”, and “autonomic stability”, independently of other variables, including pre/postnatal anxiety and postnatal depressive symptoms.

How maternal pre- and postnatal symptoms of depression and anxiety affect early mother-infant interaction?

Hakanen H, Flykt M, Sinervä E, Nolvi S, Kataja EL, Pelto J, Karlsson H, Karlsson L, Korja R.  J Affect Disord. 2019 Oct 1;257:83-90. 

Generalized anxiety at the third trimester of pregnancy was associated with higher maternal intrusiveness. Depressive symptoms at 6 months postpartum were associated with lower maternal structuring behavior and with the child’s lower involvement with the mother.

The Mood, Mother, and Infant Study: Associations Between Maternal Mood in Pregnancy and Breastfeeding Outcome.

Stuebe AM, Meltzer-Brody S, Propper C, Pearson B, Beiler P, Elam M, Walker C, Mills-Koonce R, Grewen K.  Breastfeed Med. 2019 Oct;14(8):551-559.

Having a diagnosis of depression or anxiety disorder did not impact breastfeeding outcomes; however, depressive symptoms were independently associated with earlier formula introduction and cessation of breastfeeding. History of childhood trauma, disordered eating symptoms and poor sleep quality were also associated with earlier formula introduction.

Postpartum bonding at the beginning of the second year of child’s life: the role of postpartum depression and early bonding impairment.

Faisal-Cury A, Bertazzi Levy R, Kontos A, Tabb K, Matijasevich A.  J Psychosom Obstet Gynaecol. 2019 Aug 22:1-7. 

Bonding impairment (BI) 12-15?months was associated with having an occupation outside of the home (OR?=?2.82; 95% CI 1.00-7.94), unplanned pregnancy (OR?=?3.46; 95% CI 1.01-11.8), and presence of BI at 6-8?months (OR= 13.0; 95% CI 3.76-45.4). Maternal depression was only marginally associated with BI at 12-15?months. 



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