The world looks dramatically different than it did a week ago, and we are all struggling to find our equilibrium.  These are very challenging times, and it is easy to feel helpless and confused. To help our readers navigate and make sense of the current situation, we will provide information on COVID-19 relevant to our patient population:

COVID-19 Outbreak: Information for Pregnant Women

COVID-19 Outbreak: Flattening the (Anxiety) Curve

And the Center for Women’s Mental Health will continue to do what we do, albeit remotely.  We will continue to follow the literature and provide up-to-date information to our readers.  Access to providers with expertise in women’s mental health has always been limited, and the current restrictions with regard to mobility and on-site medical care may make it even more difficult for women to get the care they need and deserve.   We hope to fill in some of those gaps.

The website will continue to move forward, but as this crisis unfolds, we will likely explore other avenues for supporting patients and providers, who may be feeling more anxious and isolated than ever before.  Please do not hesitate to contact me at nonacs.ruta@mgh.harvard.edu if there is anything we can do to make this site more helpful.  

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

 

PMS AND PMDD

No articles this week

 

INFERTILITY AND MENTAL HEALTH

Fertility trends of women with serious mental illness in the United Kingdom 1992-2017: A primary care cohort study using the Clinical Practice Research Datalink.  

Hope H, et al.  J Affect Disord, March 2020.

Between 1992 and 2017 women with severe mental illness had 50% fewer live-births than women without (RR 0.50). Women are most likely to become pregnant after discontinuing either a second-generation or first-generation antipsychotic (RR 1.74).

 

PSYCHIATRIC ILLNESS DURING PREGNANCY

Managing bipolar disorder during pregnancy and the postpartum period: a critical review of current practice.

Sharma V, Sharma P, Sharma S.  Expert Rev Neurother. 2020 Mar 19:1-11. 


Suicide ideation among pregnant women: The role of different experiences of childhood abuse.

Zhang X, et al.   J Affect Disorder, April 2020.

Pregnant women with only physical abuse experience had high risk of suicide ideation (OR = 3.63, 95%CI: 1.32–10.03). Pregnant women with both childhood abuse and depression had increased risk of suicide ideation compared to those with neither risk factor (OR = 17.78, 95%CI 7.20–43.92).


Adding Perinatal Anxiety Screening to Depression Screening: Is It Worth It?

Lieb K, et al.  Am J Obstet Gynecol MFM, March 2020.

Screening for perinatal anxiety may increase referral rates to mental health professionals, who can then diagnose and treat patients who suffer from mood and anxiety disorders.


Female infants are more susceptible to the effects of maternal antenatal depression; findings from the Pelotas (Brazil) Birth Cohort Study.

Netsi E, et al.  J Affect Disord, March 2020.

Severe (but not moderate) antenatal depression was associated with an increased risk for lower weight, being SGA and being in the lower 10th centile for length — but only in female newborns.

 

MEDICATIONS AND PREGNANCY

Pregnancy exposure to venlafaxine—Therapeutic drug monitoring in maternal blood, amniotic fluid and umbilical cord blood and obstetrical outcomes.

Concentrations of venlafaxine (VEN) and O-desmethylvenlafaxine (ODV) were measured in nine mother-infant pairs at time of delivery.  Median daily dosage of venlafaxine was 75 mg (range 37.5–225 mg). There were no significant correlations between daily dose, maternal serum, umbilical cord blood and amniotic fluid concentrations. Median penetration ratio into amniotic fluid was 2.5 (range 0.56–4.48), indicating that VEN concentrations in amniotic fluid were higher than in maternal serum.  High penetration into amniotic fluid indicates accumulation or decreased elimination.

 

POSTPARTUM PSYCHIATRIC ILLNESS

Cost-Effectiveness of Brexanolone Versus Selective Serotonin Reuptake Inhibitors for the Treatment of Postpartum Depression in the United States.

Eldar-Lissai A, Cohen JT, Meltzer-Brody S, Gerbasi ME, Chertavian E, Hodgkins P, Bond JC, Johnson SJ.  J Manag Care Spec Pharm. 2020 Mar 19:1-13.  Free Article

In a study funded by Sage Therapeutics, researchers compared the cost-effectiveness of brexanolone versus treatment with an SSRI for postpartum depression.


A randomized controlled pilot study of the effectiveness of magnolia tea on alleviating depression in postnatal women.

Xue L, Zhang J, Shen H, Ai L, Wu R.  Food Sci Nutr. 2020 Feb 10;8(3):1554-1561. Free Article

Magnolia tea has been used in traditional oriental medicine for multiple purposes including as a sleep aid.  This small randomized controlled trial suggested that drinking single-ingredient magnolia tea daily for a 3-week period has positive effects on postpartum women with regard to sleep quality and mood.  This study did not specifically recruit women with PPD and did not provide any information on breastfeeding.  


Neurocognitive correlates of working memory and emotional processing in postpartum psychosis: an fMRI study.

Kowalczyk OS, Pauls AM, Fusté M, Williams SCR, Hazelgrove K, Vecchio C, Seneviratne G, Pariante CM, Dazzan P, Mehta MA.  Psychol Med. 2020 Mar 16:1-9.

Using fMRI, this study observed functional brain abnormalities in postpartum psychosis which differed from the pattern typically observed in psychoses unrelated to the postpartum period.


Health practitioners’ recognition and management of postpartum obsessive-compulsive thoughts of infant harm.

Mulcahy M, Rees C, Galbally M, Anderson R.  Arch Womens Ment Health. 2020 Mar 16. 

Almost 70% of participants did not accurately identify obsessive-compulsive symptoms. Furthermore, the majority of practitioners endorsed at least one contraindicated clinical management strategy likely to aggravate postpartum OC symptoms. 

 

MEDICATIONS AND BREASTFEEDING

No articles this week

 

PERINATAL SUBSTANCE USE

No articles this week

 

MATERNAL MENTAL HEALTH AND CHILD OUTCOMES

Trajectories of maternal symptoms of posttraumatic stress disorder predict long-term mental health of children following the Wenchuan earthquake in China: A 10-year follow-up study.

Chen X-Y, et al.  J Affect Disord, April 2020.

Chronic posttraumatic stress disorder in mothers was longitudinally associated with children poorer mental health (in particularly, PTSD and anxiety symptoms).


Maternal depression in Latinas and child socioemotional development: A systematic review.

Harris RA, et al.  PLOS One, March 2020.

Children of U.S.-born Latina mothers had poorer developmental outcomes than children of foreign-born Latina mothers across socioemotional domains and throughout early developmental windows.

MENOPAUSE AND MENTAL HEALTH

No articles this week

 

OTHER TOPICS IN WOMEN’S MENTAL HEALTH

No articles this week