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. 

At the beginning of the month, the new journals come out and the list of interesting articles is long.  One thing that I have noticed is that the number of articles documenting the impact of maternal mental health on child well-being continues to grow.  We are looking at how maternal depression and anxiety affect attachment and behavior, but we are taking a more granular look now, using various imaging techniques to measure the impact of maternal mental health on the structure and organization of the child’s brain (reviewed by Rotem-Kohavi and colleagues in Seminars in Perinatology).  

And a novel treatment for menopausal vasomotor symptoms, NK-814, a neurokinin-3 receptor antagonist.  

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


Eighteen-year trajectories of depressive symptoms in mothers with a lifetime eating disorder: findings from the ALSPAC cohort.

Chua YW, Lewis G, Easter A, Lewis G, Solmi F.  Br J Psychiatry. 2019 May 14:1-7

Women with lifetime eating disorders had greater depressive symptoms scores than women with no eating disorders, before and after adjustment for confounders (anorexia nervosa: 2.10, 95% CI 1.36-2.83; bulimia nervosa: 2.28, 95% CI: 1.61-2.94, both anorexia and bulimia nervosa: 2.86, 95% CI 1.81-3.90). 

Cognitive Behavioral Therapy for Antenatal Depression in a Pilot Randomized Controlled Trial and Effects on Neurobiological, Behavioral and Cognitive Outcomes in Offspring 3-7 Years Postpartum: A Perspective Article on Study Findings, Limitations and Future Aims.

Bleker LS, Milgrom J, Sexton-Oates A, Parker D, Roseboom TJ, Gemmill AW, Holt CJ, Saffery R, Connelly A, Burger H, de Rooij SR.  Front Psychiatry. 2020 Feb 13;11:34. Free Article

Treatment of antenatal depression with CBT decreases overall child DNA-methylation, increases cortical thickness, and decreases white matter fiber-bundle cross-section in regions involved in cognitive function and the stress response. Nevertheless, larger studies are warranted to confirm these preliminary findings  that CBT in pregnancy alters neurobiological outcomes in children. Clinical relevance remains unclear as this study found no effects of antenatal CBT on child behavior or cognition.

Neighbourhood socioeconomic status modifies the association between anxiety and depression during pregnancy and preterm birth: a Community-based Canadian cohort study.

Adhikari K, Patten SB, Williamson T, Patel AB, Premji S, Tough S, Letourneau N, Giesbrecht G, Metcalfe A.  BMJ Open. 2020 Feb 10.  Free Article

The presence of both anxiety and depression, but neither of these conditions alone, was significantly associated with preterm birth (PTB, OR 1.6, 95% CI 1.1 to 2.3) and had significant interaction with neighbourhood deprivation (p=0.004). The predicted probability of PTB for women with both anxiety and depression was 10.0%, which increased to 15.7% if they lived in the most deprived neighbourhoods and decreased to 1.4% if they lived in the least deprived neighbourhoods.

Microbiota of newborn meconium is associated with maternal anxiety experienced during pregnancy.

Hu J, Ly J, Zhang W, Huang Y, Glover V, Peter I, Hurd YL, Nomura Y.  Dev Psychobiol. 2019 Jul;61(5):640-649

The meconium contained diversified microbiota, and greater pregnancy-related anxiety was significantly associated with a less diverse meconium microbiota community. At the specific taxa level, greater pregnancy-related anxiety was correlated with a lower level of the Enterococcaceae family.  

The role of personality dimensions and trait anxiety in increasing the likelihood of suicide ideation in women during the perinatal period.

En?tescu I, Craina M, Gluhovschi A, Giurgi-Oncu C, Hogea L, Nussbaum LA, Bernad E, Simu M, Cosman D, Iacob D, Marinescu I, En?tescu VR.

J Psychosom Obstet Gynaecol. 2020 Mar 2:1-11.

Trait anxiety was predictive for the appearance of suicide ideation within the entire perinatal period assessed. Agreeableness and conscientiousness predicted antenatal suicide ideation.


Association of Antidepressant Use With Adverse Health Outcomes: A Systematic Umbrella Review.

Dragioti E, Solmi M, Favaro A, Fusar-Poli P, Dazzan P, Thompson T, Stubbs B, Firth J, Fornaro M, Tsartsalis D, Carvalho AF, Vieta E, McGuire P, Young AH, Shin JI, Correll CU, Evangelou E.  JAMA Psychiatry. 2019 Oct 2.

In analyses, antidepressant exposure was associated with autism spectrum disorders (exposure both before and during pregnancy), preterm birth, and low Apgar scores. HOWEVER, none of these associations remained supported by convincing evidence after sensitivity analysis, which adjusted for confounding by indication.

Dose-effect of maternal serotonin reuptake inhibitor use during pregnancy on birth outcomes: A prospective cohort study.

Molenaar NM, Houtman D, Bijma HH, Brouwer ME, Burger H, Hoogendijk WJG, Bockting CLH, Kamperman AM, Lambregtse-van den Berg MP.  J Affect Disord. 2020 Feb 3;267:57-62.

Higher maternal SRI dose at 36 weeks of gestation was associated with lower birth weight. No significant associations between maternal SRI dose and gestational age or being small for gestational age were observed.

Advanced neuroimaging: A window into the neural correlates of fetal programming related to prenatal exposure to maternal depression and SSRIs.

Rotem-Kohavi N, Williams LJ, Oberlander TF.  Semin Perinatol. 2020 Jan 26:151223. 

Advances in neuroimaging, using MR and EEG, offer novel insights into central processes that might reveal the neural correlates of fetal programming. This review focuses on emerging findings from neuroimaging studies reflecting early brain functional and structural development associated with prenatal exposure to maternal depression and SSRI antidepressants. 

Relation of in-utero exposure to antiepileptic drugs to pregnancy duration and size at birth.

Margulis AV, Hernandez-Diaz S, McElrath T, Rothman KJ, Plana E, Almqvist C, D’Onofrio BM, Oberg AS.  PLoS One. 2019 Aug 5;14(8):e0214180. Free Article

Relative to lamotrigine, valproic acid and carbamazepine were associated with smaller head circumference.

Prevalence of benzodiazepines and benzodiazepine-related drugs exposure before, during and after pregnancy: a systematic review and meta-analysis.

Bais B et al, J Affect Disord 2020.

The international prevalence of benzodiazepine use during pregnancy is 1.9%; however, there is considerable variability in the use of benzodiazepine use during pregnancy across countries.


Interventions for paternal perinatal depression: A systematic review.

Goldstein Z, Rosen B, Howlett A, Anderson M, Herman D.  J Affect Disord. 2020 Mar 15;265:505-510. 

There remains limited research on interventions assessing paternal depressive symptomatology, and none have targeted diagnosed PPD.

Postnatal trajectories of maternal depressive symptoms: Postpartum antecedents and differences in toddler adjustment.

Choe DE, McDonough SC, Sameroff AJ, Lawrence AC.  Infant Ment Health J. 2020 Feb 14. 

Both externalizing and internalizing children’s behaviors are associated with prolonged maternal depressive symptoms.


No articles this week


No articles this week


The role of prenatal stress as a pathway to personality disorder: longitudinal birth cohort study.

Brannigan R, Tanskanen A, Huttunen MO, Cannon M, Leacy FP, Clarke MC.  Br J Psychiatry. 2019 Sep 6:1-5.

Compared to children with no exposure to prenatal stress, children exposed to any maternal stress during gestation had three times the odds of developing a personality disorder (odds ratio 2.76, 95% CI 1.59–4.80). Those exposed to moderate stress had three times the odds (odds ratio 3.13, 95% CI 1.42–6.88), and those exposed to severe stress had seven times the odds (odds ratio 7.06, 95% CI 2.10–23.81) of developing a personality disorder. These associations remained after adjusting for parental psychiatric history, comorbid psychiatric diagnoses, prenatal smoking and antenatal depression.

Maternal postpartum depression is a risk factor for infant emotional variability at 4 months.

Vaever MS, Pedersen IE, Smith-Nielsen J, Tharner A.  Infant Ment Health J. 2020 Feb 14.

When infants of depressed mothers display high negative facial affect or gaze off, these expressions are more sustained, indicating lower infant ability to calm down and re-engage, interpreted as a disturbance in self-regulation. 

Maternal antenatal anxiety and electrophysiological functioning amongst a sub-set of preschoolers participating in the GUSTO cohort.

Tan HK, Goh SKY, Tsotsi S, Bruntraeger M, Chen HY, Broekman B, Tan KH, Chong YS, Meaney MJ, Qiu A, Rifkin-Graboi A.  BMC Psychiatry. 2020 Feb 12;20(1):62. Free Article

Antenatal anxiety and depression was associated with specific patterns of electrophysiological functioning in preschoolers and remained a significant predictor after controlling for postpartum mental health.

Maternal Antenatal Depression and Early Childhood Sleep: Potential Pathways Through Infant Temperament.

Kim Y, Bird A, Peterson E, Underwood L, Morton SMB, Grant CC.  J Pediatr Psychol. 2020 Mar 1;45(2):203-217

Antenatal depression is independently associated with more frequent nighttime awakenings in early childhood. 

The effects of paternal perinatal depression on socioemotional and behavioral development of children: A meta-analysis of prospective studies.

Cui C, Li M, Yang Y, Liu C, Cao P, Wang L. Psychiatry Res. 2020 Feb;284:112775

Paternal PPD may play a significant role in adversely impacting the emotional and behavioral development in children during early childhood.

The role of posttraumatic stress and depression symptoms in mother-infant bonding.  

Rados SN et al, J of Affect Disord 2020.

Both PTSD and depressive symptoms are related to impaired mother-infant bonding. Birth-related PTSD symptoms did not have an effect on bonding or depressive symptoms; however, pre-existing PTSD symptoms had an indirect effect on bonding via depressive symptoms.

Early infant temperament shapes the nature of mother-infant bonding in the first postpartum year

Takacs L et al. Infant Behav Develop, Feb 2020.  

Maternal bonding in the first week postpartum may temporarily affect child temperament, but infant’s temperament several weeks after birth – rather than several months postpartum – plays a pervasive role in shaping the long-lasting nature of the mother-child relationship. 

Maternal Perinatal Mental Health and Infant and Toddler Neurodevelopment – Evidence from Low and Middle-Income Countries. A Systematic Review.

Burger M et al.  J Affect Disord 2020.

Multiple risk factors in low and middle-income countries (LAMICs) may contribute to maternal mental health conditions; however, associations between perinatal mental health and child development in LAMICs are inconclusive due to a limited number of papers.


Impact of evening primrose oil consumption on psychological symptoms of postmenopausal women: a randomized double-blinded placebo-controlled clinical trial.

Sharif SN, Darsareh F.  Menopause. 2020 Feb;27(2):194-198.

In this randomized placebo-controlled trial,  women receiving treatment with evening primrose oil for 8 weeks experienced a greater reduction in severity of psychological symptoms compared to placebo, with a group mean difference of -3.44 (95% confidence interval of difference: -4.01 to -1.20) (P?<?0.01).

Effects of NT-814, a dual neurokinin 1 and 3 receptor antagonist, on vasomotor symptoms in postmenopausal women: a placebo-controlled, randomized trial.

Trower M, Anderson RA, Ballantyne E, Joffe H, Kerr M, Pawsey S.  Menopause. 2020 Feb 17.

Once-daily NT-814 (?150?mg/d) resulted in a rapid, marked improvement in hot flashes and waking due to night sweats. No safety concerns were identified. Doses up to 300?mg were well tolerated.


No articles this week

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