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. 

Welcome to the first weekly roundup of 2021, and there are more new articles than ever.

While historically we have seen many articles investigating the impact of prenatal exposure to antidepressants on children’s development, there are a number of articles on this list that look at the impact of maternal depression on the developing fetus. Wolgast and colleagues observe that while antidepressant exposure may increase the risk of some adverse outcomes, including preterm birth, women with histories of depression — but no use of antidepressants during pregnancy — also have an increased risk of adverse outcomes.

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



Pubertal development and risk of premenstrual disorders in young adulthood.

Lu D, Aleknaviciute J, Bjarnason R, Tamimi RM, Valdimarsdóttir UA, Bertone-Johnson ER.  Hum Reprod. 2020 Dec 2:de

Compared to individuals with normative menarche, individuals with late menarche had a lower risk of PMDs (OR 0.73, 95% CI 0.59 to 0.91), while individuals with early menarche had comparable odds (OR 0.98, 95% CI 0.81 to 1.18). 

Association Between Smoking and Premenstrual Syndrome: A Meta-Analysis.

Choi SH, Hamidovic A.  Front Psychiatry. 2020 Nov 26.  Free article.

Smoking was associated with an increased risk for premenstrual symptoms, the effect size estimate was higher for Premenstrual Dysphoric Disorder (PMDD) [OR = 3.15 (95% CI: 2.20-4.52), p < 0.0001] than for PMS [OR = 1.27 (95% CI: 1.16-1.39), p < 0.0001]. 



No articles this week



Screening for perinatal depression with the Patient Health Questionnaire depression scale (PHQ-9): A systematic review and meta-analysis.

Wang L, Kroenke K, Stump TE, Monahan PO.  Gen Hosp Psychiatry. 2020 Dec 21;68:74-82.

In 35 studies comparing the EPDS with the PHQ-9 in perinatal women, the PHQ-9 appears to be a viable option for perinatal depression screening with operating characteristics similar to the legacy EPDS.

Indirect psychiatric consultation for perinatal bipolar disorder: A scoping review.

Wendt AC, Stamper G, Howland M, Cerimele JM, Bhat A.  Gen Hosp Psychiatry. 2020 Nov 25;68:19-24.

Varied strategies for structured assessment exist and are influenced by practice setting. There remains uncertainty about optimal strategies for screening and management of perinatal bipolar disorder. 

The contribution of group prenatal care to maternal psychological health outcomes: A systematic review.

Buultjens M, Farouque A, Karimi L, Whitby L, Milgrom J, Erbas B.Women Birth. 2020 Dec 24.

In this review of nine studies, it appears that group prenatal care may lead to improvements in some markers of psychological health outcomes.

Prevalence of anxiety and depression symptoms in pregnant women with type 2 diabetes and the impact on glycaemic control.

Ásbjörnsdóttir B, Vestgaard M, Do NC, Ringholm L, Andersen LLT, Jensen DM, Damm P, Mathiesen ER.  Diabet Med. 2020 Dec 27.

In women with type 2 diabetes, 40% had anxiety and/or depression symptoms in early pregnancy. Women with these symptoms obtained less optimal glycaemic control in late pregnancy but similar gestational weight gain as the remaining women.

A comparison of two measures to screen for mental health symptoms in pregnancy and early postpartum: the Matthey Generic Mood Questionnaire and the Depression, Anxiety, Stress Scales short-form.

Price DAM, Middleton MM, Matthey PS, Goldfeld PS, Kemp PL, Orsini MF.  J Affect Disord. 2020 Nov 14.



 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, Lilliecreutz C, Sydsjö G, Bladh M, Josefsson A.  Eur J Obstet Gynecol Reprod Biol. 2020 Nov 25;257:42-50.

Women with MDD and antidepressant medication prior to becoming pregnant are at increased risk for adverse obstetric and neonatal outcomes compared to women without an MDD. Continuation of antidepressant medication during pregnancy somewhat increased the risk for adverse obstetric and neonatal outcomes.


Clinical characteristics of bipolar disorders with postpartum depressive onset.

Tebeka S, Godin O, Mazer N, Bellivier F, Courtet P, Etain B, Gard S, Leboyer M, Llorca PM, Loftus J, Olié E, Passerieux C, Polosan M, Schwan R, Belzeaux R, Dubertret C; FondaMental Advanced Centers of Expertise in Bipolar Disorders (FACE-BD) Collaborators.

Prog Neuropsychopharmacol Biol Psychiatry. 2020 Dec 18.

Reduced postpartum hippocampal volume is associated with positive mother-infant caregiving behavior.

Moses-Kolko EL, Banihashemi L, Hipwell AE.  J Affect Disord. 2020 Dec 9;281:297-302. 

Traumatic memories of childbirth relate to maternal postpartum posttraumatic stress disorder.

Thiel F, Berman Z, Dishy GA, Chan SJ, Seth H, Tokala M, Pitman RK, Dekel S.  J Anxiety Disord. 2020 Nov 26;77:102342. 

Associations between estrogen and progesterone, the kynurenine pathway, and inflammation in the post-partum.

Sha Q, Achtyes E, Nagalla M, Keaton S, Smart L, Leach R, Brundin L.  J Affect Disord. 2020 Oct 29;281:9-12. 

Estrogen was coupled with a pro-inflammatory profile and neurotoxic kynurenine metabolites, whereas progesterone was linked to an anti-inflammatory profile in the postpartum period.

Implementing a standardized screening protocol for parental depression, anxiety, and PTSD symptoms in the Neonatal Intensive Care Unit.

Moreyra A, Dowtin LL, Ocampo M, Perez E, Borkovi TC, Wharton E, Simon S, Armer EG, Shaw RJ.  Early Hum Dev. 2020 Nov 16.

Standardized screening protocol assessed parental mental health symptoms including depression, anxiety and trauma in parents of children admitted to the NICU.  Positive screens on any of the three measures resulted in a mental health referral. Approximately 27% of parents had a positive screen that resulted in a mental health referral. The standardized screening protocol was found to be feasible, widely accepted, and effective in establishing referrals for in house mental health services.

Screening for intimate partner violence in the early postpartum period: Maternal and child health and social outcomes from birth to 5-years post-delivery.

Taillieu TL, Brownridge DA, Brownell M.  Child Abuse Negl. 2020 Dec 15.

A positive IPV screen was associated with poorer maternal and child health, increased child and family services contact, and children being more developmentally vulnerable in the 5-years after delivery.

 Physical and mental health of women exposed to intimate partner violence in the 10 years after having their first child: an Australian prospective cohort study of first-time mothers.

Brown SJ, Conway LJ, FitzPatrick KM, Hegarty K, Mensah FK, Papadopoullos S, Woolhouse H, Giallo R, Gartland D.  BMJ Open. 2020 Dec 21.  Free  article.

Both recent and past exposure to IPV are associated with poor maternal physical and mental health 10 years after a first birth.

Internet-based interventions for postpartum depression: A systematic review and meta-analysis.

Mu TY, Li YH, Xu RX, Chen J, Wang YY, Shen CZ.  Nurs Open. 2020 Dec 29. 

Most of the seven eligible studies reviewed in this report were randomized controlled trials. The random-effects model indicated that Internet-based interventions significantly improved postpartum depression.



No articles this week



Prenatal Substance Exposure and Developmental Trajectories of Internalizing Symptoms: Toddlerhood to Preadolescence.

Min MO, Albert JM, Lorincz-Comi N, Minnes S, Lester B, Momotaz H, Powers G, Yoon D, Singer LT.  Drug Alcohol Depend. 2021 Jan 1;218:108411

Prenatal tobacco exposure was associated with suboptimal developmental trajectories of internalizing symptoms in the context of prenatal poly-drug exposure,

Association between gestational cannabis exposure and maternal, perinatal, placental, and childhood outcomes.

Ayonrinde OT, Ayonrinde OA, Van Rooyen D, Tait R, Dunn M, Mehta S, White S, Ayonrinde OK.  J Dev Orig Health Dis. 2020 Dec 7:1-10. Review.




Paternal Depression as a Risk Factor for Neurodevelopmental Disorders in Offspring: Implications for Maternal Depression and Its Treatment During Pregnancy.

Andrade C.  J Clin Psychiatry. 2020 Dec 1;81(6):20f13785. 

Genetic variables, or environmental adversities engendered by behaviors related to paternal depression, may drive the risk for the adverse neurodevelopmental outcomes, including increased risk for autism spectrum disorders.

Association of Prenatal Maternal Anxiety With Fetal Regional Brain Connectivity.

De Asis-Cruz J, Krishnamurthy D, Zhao L, Kapse K, Vezina G, Andescavage N, Quistorff J, Lopez C, Limperopoulos C.  JAMA Netw Open. 2020 Dec 1;3(12):e2022349. Free article.

An association was found between prenatal maternal anxiety and disturbances in fetal brain functional connectivity, suggesting altered fetal programming.



No articles this week



Dietary Quality and Dietary Inflammatory Potential During Pregnancy and Offspring Emotional and Behavioral Symptoms in Childhood: An Individual Participant Data Meta-analysis of Four European Cohorts.

Polanska K, Kaluzny P, Aubert AM, Bernard JY, Duijts L, El Marroun H, Hanke W, Hébert JR, Heude B, Jankowska A, Mancano G, Mensink-Bout SM, Relton C, Shivappa N, Suderman M, Trafalska E, Wesolowska E, Garcia-Esteban R, Guxens M, Casas M, Phillips CM.  Biol Psychiatry. 2020 Oct 24:S0

Maternal low-quality and proinflammatory diet may increase the risk of emotional and behavioral symptoms in children.



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