At this top of the list, we have a study which looked at prenatal exposure to a wide array of psychotropic medications and risk for autism spectrum disorders in the offspring.  They found no association between exposure to SSRIs and risk for autism.

Ruta Nonacs, MD PhD

Association of Autism Spectrum Disorder With Prenatal Exposure to Medication Affecting Neurotransmitter Systems.

Janecka M, Kodesh A, Levine SZ, Lusskin SI, Viktorin A, Rahman R, Buxbaum JD, Schlessinger A, Sandin S, Reichenberg A.  JAMA Psychiatry. 2018 Oct 31.

Most of the medications affecting neurotransmitter systems (including SSRIs) in this sample had no association with the estimates of ASD risk.


Adverse life events increase risk for postpartum psychiatric episodes: A population-based epidemiologic study.

Meltzer-Brody S, Larsen JT, Petersen L, Guintivano J, Florio AD, Miller WC, Sullivan PF, Munk-Olsen T.  Depress Anxiety. 2018 Feb;35(2):160-167.

Using Danish registers, researchers examined the link between adverse childhood experiences (ACE) in girls and risk of later postpartum psychiatric episodes.  Approximately 52% of the sample experienced ACE. Highest risk for postpartum psychiatric illness was observed among women who experienced out-of-home placement, hazard ratio (HR) 2.57 (95% CI: 1.90-3.48). Women experiencing two adverse life events had higher risks of postpartum psychiatric diagnosis HR: 1.88 (95% CI: 1.51-2.36), compared to those with one ACE, HR: 1.24 (95% CI: 1.03-49) and no ACE, HR: 1.00 (reference group).


Maternal antenatal mood and child development: an exploratory study of treatment effects on child outcomes up to 5 years.

Milgrom J, Holt CJ, Bleker LS, Holt C, Ross J, Ericksen J, Glover V, O’Donnell KJ, de Rooij SR, Gemmill AW  J Dev Orig Health Dis. 2018 Oct 10:1-11.

In women with depression or anxiety during pregnancy, treatment during pregnancy showed significant benefits for children’s development at age 2, but not at age 5.  Irrespective of treatment, higher depression or anxiety during pregnancy was associated with worse neurodevelopmental outcomes at 5 years.


Antiepileptic drug clearances during pregnancy and clinical implications for women with epilepsy.

Voinescu PE, Park S, Chen LQ, Stowe ZN, Newport DJ, Ritchie JC, Pennell PB.  Neurology. 2018 Sep 25;91(13):e1228-e1236.

Clearance of antiepileptic drugs significantly changes by the first trimester for levetiracetam and by the second trimester for oxcarbazepine and topiramate. Lower levels were associated with seizure worsening.   This study did not follow women taking lamotrigine


The effectiveness of telemedicine interventions to address maternal depression: A systematic review and meta-analysis.

Nair U, Armfield NR, Chatfield MD, Edirippulige S.  J Telemed Telecare. 2018 Dec;24(10):639-650.

Ten studies were identified.  Therapeutic strategies involved cognitive behavioral therapy (CBT), behavioral activation and other psychoeducation. Eight trials reported significant improvement in depression scores post-intervention; four studies that conducted post-intervention follow-up found that these improvements continued. However, high attrition rates and lack of blinding were common problems.


Hypothalamic-pituitary-adrenal axis and autonomic nervous system reactivity in children prenatally exposed to maternal depression: A systematic review of prospective studies.

Bleker LS, van Dammen L, Leeflang MMG, Limpens J, Roseboom TJ, de Rooij SR.  Neurosci Biobehav Rev. 2018 Oct 23.

A total of 13 studies comprising 2271 mother-infant dyads were included. None of the studies were suitable for meta-analysis. Only three studies described an independent association between exposure to high maternal prenatal depressive symptoms and altered stress reactivity in children.


Paternal characteristics associated with maternal periconceptional use of folic acid supplementation.

Mortensen JHS, Øyen N, Nilsen RM, Fomina T, Tretli S, Bjørge T. BMC Pregnancy Childbirth. 2018 May 30;18(1):188. Free Article

In this study from Norway, maternal folic acid use before and during pregnancy was found in 16% of the births. Adequate folic acid use in the periconceptional period was lower when fathers were younger or older than 30-34 years, had shorter education, had manual or self-employed occupations, or originated from low/middle-income countries.


Seasonal and gestational variation in perinatal depression in a prospective cohort in New Zealand.

Chan JE, Samaranayaka A, Paterson H.  Aust N Z J Obstet Gynaecol. 2018 Oct 29.

Prevalence of depression was significantly higher in winter and spring antenatally (odds ratio (OR) 3.15, 95% CI 1.01-9.82 and OR 3.16, CI 1.05-9.55), and in spring postnatally (OR 8.40, 95% CI 1.01-69.52) compared to autumn. Antenatal depression was associated with poor sleep quality (OR 4.27, 95% CI 1.22-14.93), while postnatal depression was associated with cesarean delivery (OR 5.03, 95% CI 1.29-19.64).


The impact of postpartum psychosis on partners.

Holford N, Channon S, Heron J, Jones I.  BMC Pregnancy Childbirth. 2018 Oct 23;18(1):414. doi: 10.1186/s12884-018-2055-z.  Free Article

Seven themes emerged from the interview data: loss; powerlessness; united vs. individual coping; hypothesizing and hindsight; barriers to accessing care and unmet needs; managing multiple roles; and positive changes from Postpartum Psychosis.


Do Defective Immune System-Mediated Myelination Processes Increase Postpartum Psychosis Risk?

Dazzan P, Fusté M, Davies W.  Trends Mol Med. 2018 Oct 19.

Emerging evidence suggests that immune system (dys)function plays an important role in disorder onset. On the basis of new findings from clinical and animal model studies, we hypothesize that the abundance and/or activity of regulatory T cells, and the efficacy of consequent (re)myelination processes in the brain mediated by CCN proteins, is perturbed in PP; this pathway may be modulated by risk and protective/treatment factors for the disorder, and identifying abnormalities within it could signpost novel predictive biomarkers and therapeutic targets.



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