The first three articles on this week’s list address the long-term effects of exposure to maternal depression and anxiety on the child.  While many women feel significant pressure to avoid taking psychotropic medications during pregnancy, these studies clearly find that untreated illness may also carry risks for the child.  Also this week, we have a study from Wisner and colleagues which suggests that in a group of women with bipolar disorder, women who took medications for the treatment of bipolar disorder had similar pregnancy outcomes to women with no history of mood disorder, and perhaps better outcomes than women with BD who were untreated.  


Ruta Nonacs, MD PhD

Intergenerational transmission of depression: clinical observations and molecular mechanisms.

Sawyer KM, Zunszain PA, Dazzan P, Pariante CM.  Mol Psychiatry. 2018 Oct 3.

This review summarises clinical evidence showing the effects of perinatal depression on offspring physical and behavioural development, and on the transmission of psychopathology between generations and may increase the child’s vulnerability to neuropsychiatric illness later on in life.  We also have a study from Wisner and colleagues

Fetal programming of neuropsychiatric disorders by maternal pregnancy depression: a systematic mini review.

Robinson R, Lahti-Pulkkinen M, Heinonen K, Reynolds RM, Räikkönen K.Pediatr Res. 2018 Sep 18.

Maternal prenatal depression is associated with neuropsychiatric adversities in children.

Maternal Anxiety During Pregnancy and the Association With Adverse Perinatal Outcomes: Systematic Review and Meta-Analysis.

Grigoriadis S, Graves L, Peer M, Mamisashvili L, Tomlinson G, Vigod SN, Dennis CL, Steiner M, Brown C, Cheung A, Dawson H, Rector NA, Guenette M, Richter M.  J Clin Psychiatry. 2018 Sep 4;79(5).

Antenatal anxiety is associated with multiple adverse perinatal outcomes, including preterm birth, lower birth weight, small for gestational age, and smaller head circumference.

Bipolar disorder and psychotropic medication: Impact on pregnancy and neonatal outcomes.

Wisner KL, Sit D, O’Shea K, Bogen DL, Clark CT, Pinheiro E, Yang A, Ciolino JD.  J Affect Disord. 2019 Jan 15;243:220-225.

Overall pregnancy outcomes for women with bipolar disorder (BD) were similar to those in a comparison group of women with no mood disorder.  Reduced head circumference was observed in women with untreated BD but appeared to be due to factors related to disadvantaged sociodemographic status, a higher proportion of female births, and/or a protective effect of medication in the treated bipolar group.

Long-term neurodevelopmental consequences of intrauterine exposure to lithium and antipsychotics: a systematic review and meta-analysis.

Poels EMP, Schrijver L, Kamperman AM, Hillegers MHJ, Hoogendijk WJG, Kushner SA, Roza SJ.  Eur Child Adolesc Psychiatry. 2018 Sep;27(9):1209-1230. Free Article

The lack of high-quality clinical studies make interpretation of these findings difficult, since most studies have compared exposed children with their peers from the unaffected population, which does not allow correction for potential confounding variables, including genetic predisposition or parental psychiatric illness.

Beta-Blocker Use in First Trimester Seems Safe

Kelly Young, PFW and Anna Wald, MD, MPH reviewing Bateman BT et al. Ann Intern Med 2018 Oct 16.

However, only 2350 of 18,000 participants used first-trimester beta-blockers, limiting the statistical precision of the study.

Impact of prenatal exercise on both prenatal and postnatal anxiety and depressive symptoms: a systematic review and meta-analysis.

Davenport MH, McCurdy AP, Mottola MF, Skow RJ, Meah VL, Poitras VJ, Jaramillo Garcia A, Gray CE, Barrowman N, Riske L, Sobierajski F, James M, Nagpal T, Marchand AA, Nuspl M, Slater LG, Barakat R, Adamo KB, Davies GA, Ruchat SM.

Br J Sports Med. 2018 Nov;52(21):1376-1385.

Prenatal exercise reduced the odds and severity of prenatal depression.

Obsessive-compulsive personality disorder symptoms as a risk factor for postpartum depressive symptoms.

van Broekhoven KEM, Karreman A, Hartman EE, Lodder P, Endendijk JJ, Bergink V, Pop VJM.  Arch Womens Ment Health. 2018 Aug 31. doi:

Trajectories of maternal depression: a 27-year population-based prospective study.

Najman JM, Plotnikova M, Williams GM, Alati R, Mamun AA, Scott J, Wray N, Clavarino AM.  Epidemiol Psychiatr Sci. 2017 Feb;26(1):79-88.

Three trajectory groups, each with different life-course patterns of depression were identified. The low/no symptoms of depression trajectory group comprised 48.4% of women. The mid-depression group (41.7%) had a consistent pattern of occasional symptoms of depression. The high/escalating trajectory group comprised 9.9% of the women in the study.  The high/escalating trajectory group had an earlier age of first onset, more frequent episodes, longer duration of each episode of depression and experienced higher levels of impairment for their episodes of depression. For the high symptoms trajectory group, clinically significant depression is estimated to be experienced by women almost one in every 6 days of their life.

Acupuncture for symptoms in menopause transition: a randomized controlled trial.

Liu Z, Ai Y, Wang W, Zhou K, He L, Dong G, Fang J, Fu W, Su T, Wang J, Wang R, Yang J, Yue Z, Zang Z, Zhang W, Zhou Z, Xu H, Wang Y, Liu Y, Zhou J, Yang L, Yan S, Wu J, Liu J, Liu B.

Am J Obstet Gynecol. 2018 Oct;219(4):373.e1-373.e10.

Negative study:  Among women during menopause transition, 8 weeks’ electroacupuncture treatment did not seem to relieve menopausal symptoms, even though it appeared to improve their quality of life.


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