Mass General Hospital

Harvard Medical School

Weekly Roundup for January 12, 2018: Recent Publications in Women’s Mental Health

The two most important articles of late present the results of two studies (Levine et al 2018, Bjork et al 2018) demonstrating that periconceptual use of folic acid reduces the risk of having a child with autism or autistic traits.  The first study assessed risk in all women; the second focused on the risk in women taking antiepileptic drugs.  Also interesting is the study from Gordon and colleagues which observed that treatment with transdermal estrogen and micronized progesterone reduces the risk of depression in peri- and post-menopausal women.

Ruta Nonacs, MD PhD


Association of Maternal Use of Folic Acid and Multivitamin Supplements in the Periods Before and During Pregnancy With the Risk of Autism Spectrum Disorder in Offspring.

Levine SZ, Kodesh A, Viktorin A, Smith L, Uher R, Reichenberg A, Sandin S.

JAMA Psychiatry. 2018 Jan 3.

Maternal exposure to folic acid and multivitamin supplements before and during pregnancy is associated with a 40%-70% reduced risk of ASD in the offspring compared with the offspring of mothers who did not use multivitamins and folic acid.


Association of Folic Acid Supplementation During Pregnancy With the Risk of Autistic Traits in Children Exposed to Antiepileptic Drugs In Utero.

Bjørk M, Riedel B, Spigset O, Veiby G, Kolstad E, Daltveit AK, Gilhus NE.  JAMA Neurol. 2017 Dec 26.

Risk of autistic traits in children exposed to antiepileptic drugs in utero may be reduced by periconceptional folic acid supplementation.


Maternal suicide – Register based study of all suicides occurring after delivery in Sweden 1974-2009.

Lysell H, Dahlin M, Viktorin A, Ljungberg E, D’Onofrio BM, Dickman P, Runeson B.  PLoS One. 2018 Jan 5;13(1):e0190133.

The first postpartum year was associated with a lower risk of suicide, compared to later (RR 0.80, 95%CI 0.66-0.96), which was unaltered after adjustment for socio-economic status and history of self-harm.  Suicide victims more often had affective disorders (aRR 133.94, 95%CI 45.93-390.61), psychotic disorders (aRR 83.69, 95%CI 36.99-189.31) and history of self-harm (aRR 47.56, 95%CI 18.24-124.02). Stillbirth was also associated with a higher risk of suicide (aRR 2.66, 95%CI 0.63-11.30).


Efficacy of Transdermal Estradiol and Micronized Progesterone in the Prevention of Depressive Symptoms in the Menopause Transition: A Randomized Clinical Trial.

Gordon JL, Rubinow DR, Eisenlohr-Moul TA, Xia K, Schmidt PJ, Girdler SS.  JAMA Psychiatry. 2018 Jan 10.

Twelve months of transdermal estrogen and micronized progesterone were more effective than placebo in preventing the development of clinically significant depressive symptoms among initially euthymic perimenopausal and early postmenopausal women.  The mood benefits of this hormonal intervention were more evident among women in the early menopause transition versus women in later phases of the transition and in postmenopausal women.


Effect of singing interventions on symptoms of postnatal depression:three-arm randomised controlled trial.

Fancourt D, Perkins R.  Br J Psych, 2018.

Group singing workshops, compared to usual care, led to improvements in depressive symptoms.  The effect was most robust in women with moderate to severe depression.


Yoga for menopausal symptoms—A systematic review and meta-analysis.  

Cramer H, Peng w, Lauche R. Maturitas, March 2018.

Yoga improved a variety of menopausal symptoms, including vasomotor and psychological symptoms.


Depressive symptoms and weight in midlife women: the role of stress eating and menopause status.

Schreiber DR, Dautovich ND.  Menopause. 2017 Oct;24(10):1190-1199.

Both stress eating and menopause status significantly contributed to the depressive symptom—weight association. Psychosocial factors play an important role in the association between depressive symptoms and weight.


Iron Deficiency and Risk of Maternal Depression in Pregnancy: An Observational Study.

Journal of Obstetrics and Gynaecology Canada, January 2018.

In this retrospective study, iron deficient pregnant women scored significantly higher on the EPDS (10.14?±?5.69 vs. 7.87?±?5.75; P?=?0.03) and were more likely to develop antenatal depression (45% vs. 25%; P?=?0.02) compared with women who were not. Women with iron deficiency were 2.5 times as likely to develop depression during pregnancy (adjusted OR 2.51; 95% CI 1.14–5.52).


Accuracy of the Whooley questions and the Edinburgh Postnatal Depression Scale inidentifying depression and other mental disorders in early pregnancy.

Br J Psych, January 2018.


The molecular basis for sex differences in depression susceptibility.

Issler O, Nestler EJ.  Current Opinion in Behavioral Sciences, 2018.


The effect of sleep pattern changes on postpartum depressive symptoms.

Lewis BA, Gjerdingen D, Schuver K, Avery M, Marcus BH.  BMC Womens Health. 2018 Jan 9;18(1):12. Free Article

Postpartum women who are at high risk for PPD are at increased risk for depressive symptoms later in the postpartum phase if sleep problems worsen or show only minimal improvement after childbirth.


Developing a Postpartum Depression Screening and Referral Procedure in Pediatric Primary Care.

Waldrop J, Ledford A, Perry LC, Beeber LS.  J Pediatr Health Care. 2018 Jan 2.

 

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