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. 

A few reminders.  We will continue to offer our Wednesday virtual rounds.  You can sign up HERE.  This is a great opportunity to discuss clinical issues with members of our center and other colleagues in the reproductive psychiatry community.

In addition, registration is open for our live course in women’s mental health coming up in October:  Psychiatric Disorders in Women: Diagnostic and Treatment Considerations Across the Female Lifespan.  This is a repeat of the one-day seminar preceding the annual psychopharmacology conference at MGH:  However, due to the current circumstances surrounding the COVID pandemic, we will be offering this class virtually this year.  Although this is a disappointment for many of us who look forward to meeting up with our colleagues every year, it will allow us to meet new colleagues who cannot make it to Boston in the fall.

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



Meeting Maternal Mental Health Needs During the COVID-19 Pandemic.

Hermann A, Fitelson EM, Bergink V.  JAMA Psychiatry. 2020 Jul 15.

 The Effects of Antepartum Depressive Symptoms on Postcesarean Opioid Consumption.

Walker Z, Perkins C, Harper L, Jauk V, Szychowski JM, Mazzoni S.Am J Perinatol. 2020 Jul 18. 

Women with depression during pregnancy were more likely to use tobacco and have general anesthesia for cesarean delivery, but groups were otherwise similar. Women with antenatal depression reported higher daily and average pain during the postpartum period (2.4 vs. 1.7 average; p < 0.001). Women with antenatal depression used more morphine milligram equivalents (MME) each day during their postpartum hospitalization.

The feasibility of acupuncture as an adjunct intervention for antenatal depression: a pragmatic randomised controlled trial.

Ormsby SM, et al.  J Affect Disord, JUly 2020.

Findings demonstrated significantly reduced end of intervention depression, stress and psychological distress scores among acupuncture recipients when compared to a comparator group receiving progressive muscle relaxation and usual care controls.




Prenatal SSRI antidepressant use and maternal internalizing symptoms during pregnancy and postpartum: Exploring effects on infant temperament trajectories for boys and girls.

Erickson NL, Hancock GR, Oberlander TF, Brain U, Grunau RE, Gartstein MA.  J Affect Disord. 2019 Nov 1;258:179-194. 

Prenatal SSRI treatment, and both prenatal and postpartum internalizing symptoms, exert unique effects on infant temperament. Overall, the present study suggests sex-dependent fetal programming effects that should be further evaluated 

Evolution and characteristics of the use of valproate in women of childbearing age with bipolar disorder: results from the FACE-BD cohort.

Samalin L, et al.  J Affect Disor, July 2020.

In this French study, of the 1018 included women 16-50 years old, 26.9% were treated with valproate with a mean daily dosage of 968 mg. The prevalence of BD women using valproate was 32.6% before May 2015 and 17.3% after May 2015 (p<0.001).

Lithium exposure during pregnancy increases fetal growth.

Poels EM, Sterrenburg K, Wierdsma AI, Wesseloo R, Beerthuizen A, van Dijke L, Lau C, Hoogendijk WJ, Marroun HE, van Kamp IL, Bijma HH, Bergink V.  J Psychopharmacol. 2020 Jul 20.

Lithium use during pregnancy was associated with an average increase in head circumference of 1.77 mm (95% confidence interval: 0.53, 3.01), in abdominal circumference of 5.54 mm (95% CI: 3.95, 7.12) and in femur length of 0.59 mm (95% CI: 0.22, 0.96) at 18-22 weeks gestation. Furthermore, lithium use during pregnancy was associated with an average increase in birth weight of 142.43 grams (95% CI: 58.01, 226.89), whereas it was associated with an average decrease of 1.41 weeks in gestational duration (95% CI: -1.78, -1.05).



Postnatal depression and its association with adverse infant health outcomes in low- and middle-income countries: a systematic review and meta-analysis.

Dadi FA, et al. BMC Pregnancy and Childbirth, July 2020.

This study reviewed 58 studies on postpartum depression prevalence (among 63,293 women) and 17 studies (among 32,454 infants) on infant health outcomes.  PPD prevalence was higher in the low-income countries (Pooled prevalence (PP)?=?25.8%; 95%CI: 17.9–33.8%) than in the middle-income countries (PP?=?20.8%; 95%CI: 18.4–23.1%) and reached its peak in five to ten weeks after birth. Poor obstetric history and social support, low economic and educational status, and history of exposure to violence were associated with an increased risk of PPD. The risk of having adverse infant health outcomes was 31% higher among depressed compared to non-depressed postnatal mothers (Pooled relative risk (PRR)?=?1.31; 95%CI: 1.17–1.48). 

Is postnatal depression a distinct subtype of major depressive disorder? An exploratory study.

O’ Brien S, Sethi A, Gudbrandsen M, Lennuyeux-Comnene L, Murphy DGM, Craig MC.  Arch Womens Ment Health. 2020 Jul 15. 

This study explored whether women with a history of postpartum depression (PPD) have specific differences in brain activation associated with sex hormone changes during the late luteal phase of the menstrual cycle, compared to parous women with either a past history of MDD outside of the postnatal period, or no history of MDD (‘never depressed’) using blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) during an emotional faces task.



No articles this week



Buprenorphine Medication for Opioid Use Disorder: A Study of Factors Associated With Postpartum Treatment Retention.

Ray-Griffith S, Tharp E, Coker JL, Catlin D, Knight B, Stowe ZN.  Am J Addict. 2020 Jul 16.

Women in the treatment dropout group had lower buprenorphine doses at delivery and a higher percentage of benzodiazepine positive urine drug test.  

Sex Differences in Early Cognitive Development After Prenatal Exposure to Opioids.

Skumlien M, Ibsen IO, Kesmodel US, Nygaard E.  J Pediatr Psychol. 2020 Jun 1;45(5):475-485. Free article.

These findings indicate poorer cognitive and language development in boys, as compared to girls, after prenatal opioid exposure.



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. 

Baseline mood symptoms were independently associated with earlier formula introduction and cessation of breastfeeding. 



The association between weight-promoting medication use and weight gain in postmenopausal women: findings from the Women’s Health Initiative.

Stanford FC, Cena H, Biino G, Umoren O, Jimenez M, Freeman MP, Shadyab AH, Wild RA, Womack CR, Banack HR, Manson JE.  Menopause. 2020 Jul 13.

Women with overweight or obesity at baseline were more likely to be taking antidepressants, beta-blockers, and/or insulin. 



DNA methylation of HPA-axis genes and the onset of major depressive disorder in adolescent girls: a prospective analysis.

Humphreys KL, Moore SR, Davis EG, MacIsaac JL, Lin DTS, Kobor MS, Gotlib IH.  Transl Psychiatry. 2019 Oct 3;9(1):245. doi: 10.1038/s41398-019-0582-7.

Variation in methylation in genes related to the HPA axis may predict the development of MDD in adolescent girls.

Associations Between Maternal Postpartum Depression, Infant Social Behavior With a Stranger, and Infant Cognitive Development.

Smith-Nielsen J, Lange T, Wendelboe KI, von Wowern RK, Vaever MS.  Infancy. 2019 Jul;24(4):663-670.

More symptoms of maternal depression were associated with more infant social withdrawal. The association between maternal depressive symptoms and cognitive scores was at most partially mediated by infant social withdrawal in the test situation (<29.6%). 



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