Ketamine is the hot new antidepressant.  It has been shown to work quickly in patients with severe depression and can rapidly reduce suicidal ideation.  However, these studies have not been conducted in perinatal women; this group of women is typically excluded from clinical trials because there is typically very little information on the reproductive safety of new drugs.

 

Ma and colleagues looked at the capacity of ketamine to reduce risk of postpartum depression in women giving birth.  In a randomized controlled trial, these researchers found that women receiving IV ketamine immediately after delivery were less likely to experience postpartum depression than women receiving standard postpartum care.  This is an interesting finding; we will take a closer look at the study next week.

 

Prophylactic use of ketamine reduces postpartum depression in Chinesewomen undergoing cesarean section.

Ma JH, Wang SY, Yu HY, Li DY, Luo SC, Zheng SS, Wan LF, Duan KM.  Psychiatry Res. 2019 Mar 16. 

 

Ruta Nonacs, MD PhD


PSYCHIATRIC ILLNESS DURING PREGNANCY

 

Maternal stress and placental function, a study using questionnaires and biomarkers at birth.

Dahlerup BR, Egsmose EL, Siersma V, Mortensen EL, Hedegaard M, Knudsen LE, Mathiesen L.  PLoS One. 2018 Nov 15.

 

Maternal Stress During Pregnancy Is Associated with Decreased Cortisol and Cortisone Levels in Neonatal Hair.

van der Voorn B, Hollanders JJ, Kieviet N, Dolman KM, de Rijke YB, van Rossum EFC, Rotteveel J, Honig A, Finken MJJ.  Horm Res Paediatr. 2018 Dec 12:1-9. 

 

Promoting the well-being of mothers with multidisciplinary psychosocial interventions in the perinatal period.

Cauli G, Iapichino E, Rucci P, Quartieri Bollani M, Marconi AM, Bassi M, Gala C. J Affect Disord. 2019 Mar 1;246:148-156.

Depressive or anxiety symptoms were found in 91 (28.6%) women, 89 (28.0%) had low risk of PPD and 138 (43.4%) had no risk of PPD. 

 

Early versus late wake therapy improves mood more in antepartum versus postpartum depression by differentially altering melatonin-sleep timing disturbances.

Parry BL, Meliska CJ, Lopez AM, Sorenson DL, Martinez LF, Orff HJ, Hauger RL, Kripke DF.  J Affect Disord. 2019 Feb 15.


POSTPARTUM PSYCHIATRIC ILLNESS

 

Recurrence of depression in the perinatal period: Clinical features and associated vulnerability markers in an observational cohort.

Molenaar NM, Brouwer ME, Kamperman AM, Burger H, Williams AD, Hoogendijk WJG, Bockting CLH, Lambregtse-van den Berg MP.  PLoS One. 2019 Feb 22. Free Article

 

Prophylactic use of ketamine reduces postpartum depression in Chinesewomen undergoing cesarean section.

Ma JH, Wang SY, Yu HY, Li DY, Luo SC, Zheng SS, Wan LF, Duan KM.  Psychiatry Res. 2019 Mar 16. 

The prevalence of postpartum blues and postpartum depression were significantly lower in the ketamine group than in the control group. 

 

Imbalance between Omega-6 and Omega-3 Polyunsaturated Fatty Acids in Early Pregnancy Is Predictive of Postpartum Depression in a Belgian Cohort.

Hoge A, Tabar V, Donneau AF, Dardenne N, Degée S, Timmermans M, Nisolle M, Guillaume M, Castronovo V.  Nutrients. 2019 Apr 18;11(4). Free Article

Women with an omega-3 index <5% had a 5-fold increased risk of depressive episode than did those with an omega-3 index ?5% (OR 5.22 (95%CI 1.24-21.88)). A low n-3 PUFA status, alone and combined with high n-6 PUFA status, in early pregnancy was associated with a greater risk of PPD. 

 

Vitamin D Deficiency and Antenatal and Postpartum Depression: A Systematic Review.

Aghajafari F, Letourneau N, Mahinpey N, Cosic N, Giesbrecht G.

Nutrients. 2018 Apr 12;10(4). Free Article

While the results of this systematic review vary, they indicate a significant association between vitamin D status and antenatal and postpartum depression.

 

Association between Postpartum Nutritional Status and Postpartum Depression Symptoms.

Lin YH, Chen CM, Su HM, Mu SC, Chang ML, Chu PY, Li SC.

Nutrients. 2019 May 28;11(6). Free Article

 

Association between vitamin D deficiency and antepartum and postpartum depression: a systematic review and meta-analysis of longitudinal studies.

Wang J, Liu N, Sun W, Chen D, Zhao J, Zhang W.  Arch Gynecol Obstet. 2018 Dec;298(6):1045-1059. 

Lower vitamin D levels were associated with postpartum depression but not antenatal depression.  


MATERNAL MENTAL HEALTH AND CHILD OUTCOMES

 

Attachment, Mothering and Mental Illness: Mother-Infant Therapy in an Institutional Context.

Masciantonio S, Hemer SR, Chur-Hansen A.  Cult Med Psychiatry. 2018 Mar;42(1):112-130.

 

Maternal experiences of trauma and hair cortisol in early childhood in a prospective cohort.

Slopen N, Roberts AL, LeWinn KZ, Bush NR, Rovnaghi CR, Tylavsky F, Anand KJS.  Psychoneuroendocrinology. 2018 Dec;98:168-176. 

Maternal lifetime trauma exposures are associated with offspring hair cortisol concentrations. 

 

Dynamic and bidirectional associations between maternal stress, anxiety, and social support: The critical role of partner and family support.

Racine N, Plamondon A, Hentges R, Tough S, Madigan S.  J Affect Disord. 2019 Mar 30;252:19-24.

Increases in both partner and family support may be powerful protective factors for decreasing mental health difficulties in pregnancy and the postpartum period.


OTHER TOPICS IN WOMEN’S MENTAL HEALTH

 

Neural correlates of depression in women across the reproductiv elifespan – An fMRI review.

Stickel S, Wagels L, Wudarczyk O, Jaffee S, Habel U, Schneider F, Chechko N.  J Affect Disord. 2019 Mar 1;246:556-570.

 

Epigenetic variation at the SLC6A4 gene promoter in mother-child pairs with major depressive disorder.

Mendonça MS, Mangiavacchi PM, De Sousa PF, Crippa JAS, Mendes AV, Loureiro SR, Martín-Santos R, Quirino CR, Kanashiro MM, Rios AFL.  J Affect Disord. 2019 Feb 15;245:716-723. 

 

Association of oral contraceptive use with suicidal behavior among representative Korean population: Results from Korea National Health and Nutrition Examination Survey (2007-2016).

Jung SJ, Cho SMJ, Kim HC.  J Affect Disord. 2019 Jan 15;243:8-15. 

Oral contraceptive use was associated with an increased prevalence of suicidality (OR?=?1.13, 95% CI 1.00-1.24) after adjustment for age, demographic factors, age of menarche, and lifestyle behaviors.