This week’s offering includes an article published in Pediatrics indicating that cannabis metabolites are found in the breast milk up to 6 days after the last use.  A small prospective study from Wisner and colleagues looks at pregnancy outcomes in women with bipolar disorder.


Ruta Nonacs, Md PhD

Marijuana Use by Breastfeeding Mothers and Cannabinoid Concentrations in Breast Milk.

Bertrand KA, Hanan NJ, Honerkamp-Smith G, Best BM, Chambers CD.  Pediatrics. 2018 Sep;142(3). PMID:  Free Article

50 breastfeeding women who reported marijuana use provided 54 breast milk samples.  ?-9-tetrahydrocannabinol (?9-THC) was detectable in 34 (63%) of the 54 samples up to ?6 days after last reported use.

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. 2018 Sep 18;243:220-225.

Looking at three groups of women – bipolar disorder without medication treatment, bipolar disorder with treatment, and a comparison group without bipolar disorder — no significant differences in outcomes occurred for APGAR scores?<?8, NICU admissions, sex or infant length. Infants of mothers with bipolar disorder and no treatment had significantly smaller head circumferences (HC) than the other groups, adjustment for confounding variables mitigated this association.

Course of major depressive disorder after pregnancy and the postpartum period.

Freeman MP, Claypoole LD, Burt VK, Sosinsky AZ, Moustafa D, Noe OB, Cheng LJ, Cohen LS.  Depress Anxiety. 2018 Sep 7.

Approximately one third reported sustained remission from MDD after pregnancy; however, the remaining two thirds of women reported subsequent depressive episodes. Allmost one fifth (?12% of the total sample) endorsed depression more than 50% of the time following their index pregnancy. A total of 6.3% of the women with previously validated diagnoses of MDD reported new diagnoses of bipolar disorder.

Prenatal and postnatal maternal depression and infant hospitalization and mortality in the first year of life: A systematic review and meta-analysis.  Jacques N.

J Affect Disord. 2018 Sep 17;243:201-208.

Six studies were included in this review. Children born to mothers with antenatal and postnatal depression symptoms had a 1.44-fold (CI95% 1.10 – 1.89) greater risk of hospitalization, and children of mothers with postnatal depressive symptoms had a 1.93-fold (CI95% 1.02-3.64) greater risk of death before one year of age than those whose mothers did not have the disorder.

Screening for Postpartum Depression by Hospital-Based Perinatal Nurses.

Logsdon MC, Vogt K, Davis DW, Myers J, Hogan F, Eckert D, Masterson K.  MCN Am J Matern Child Nurs. 2018 Sep 14.

The majority of new mothers found it acceptable to be screened for depression and educated about community resources by hospital-based perinatal nurses. Many new mothers were not asked about depressive symptoms by community providers.

History of postpartum depression as a contributor to the severity of NAS.

Nellhaus EM, Nieuwenhuizen L, Egleton R, Hansen Z, Chaffin D, Loudin S, Davies TH.  Addict Behav. 2018 Sep 12;89:78-84.

Among the 110 neonates born to mothers with substance use disorder, a maternal history of Postpartum Depression (PPD) was found to be correlated with increased severity of withdrawal symptoms in the newborns.

Seasonality of depressive symptoms during pregnancy.

Bais B, de Groot N, Grootendorst-van Mil NH, Harmsen van der Vliet-Torij HW, Bijma HH, Dieleman GC, Hoogendijk WJG, Lambregtse-van den Berg MP, Kamperman AM.

Psychiatry Res. 2018 Oct;268:257-262.

In women untreated for psychiatric complaints, researchers observed the lowest level of depressive symptomatology in September and the highest in March. In women treated for psychiatric complaints, they found the lowest levels of depressive symptomatology in December and the highest in June. Thus, the effects of seasonality are apparent, but opposite in treated and untreated women.

Shortening day length: a potential risk factor for perinatal depression.

Goyal D, Gay C, Torres R, Lee K.  J Behav Med. 2018 Sep 27.

When days were shortening (August to first 4 days of November) in late third trimester, depressive symptom scores were highest (35%) and continued to be higher at each postpartum assessment compared to other day length categories. Implications for clinical practice include increased vigilance for depressive symptoms, particularly if late pregnancy and birth occurs during the 3 months around the Autumn equinox when day length is shortening. Strategies that increase light exposure in late pregnancy and postpartum should also be considered.

Maternal pre- and postnatal anxiety symptoms and infant attention disengagement from emotional faces.

Kataja EL, Karlsson L, Parsons CE, Pelto J, Pesonen H, Häikiö T, Hyönä J, Nolvi S, Korja R, Karlsson H.  J Affect Disord. 2018 Sep 17;243:280-289.

Maternal prenatal anxiety symptoms associate with infant’s heightened attention bias for threat. Maternal postnatal anxiety symptoms, in turn, associate with infant’s overall disengagement probability differently for boys and girls. Boys may show enhanced vigilance for distractors, except when viewing fearful faces, and girls enhanced vigilance for all socio-emotional stimuli.

The HPA axis during the Perinatal Period: implications for Perinatal Depression.

Dickens MJ, Pawluski JL.  Endocrinology. 2018 Sep 25. Review.


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