More data on the reproductive safety of ADHD medications (Norby et al 2017), a study questioning the effectiveness of doxylamine-pyridoxine for nausea and vomiting during pregnancy (Persaud et al 2018), and a study documenting the strong association between adverse childhood events and risk for postpartum depression (Mahenge et al 2017).

Ruta Nonacs, MD PhD


Perinatal Outcomes After Treatment With ADHD Medication During Pregnancy.

Nörby U, Winbladh B, Källén K.  Pediatrics. 2017 Dec;140(6).

Infants exposed during pregnancy were more likely to have central nervous system-related disorders (aOR, 1.9; 95% CI, 1.1-3.1) and were more often moderately preterm (aOR, 1.3; 95% CI, 1.1-1.6) than nonexposed infants.

Are infectious agents involved in the pathogenesis of postpartum psychosis?

de Witte LD, Snijders G, Litjens M, Kamperman AM, Kushner SA, Kahn RS, Bergink V.  J Affect Disord. 2018 Jan 3;229:141-144.

Titers of immunoglobulin G (IgG) and M (IgM) to herpes simplex virus type 1 (HSV-1) and 2 (HSV-2), Epstein-Barr virus (EBV), cytomegalovirus (CMV) and Toxoplasma Gondii (TG) did not differ between a cohort of patients with postpartum psychosis (n = 81) and matched postpartum controls.

Doxylamine-pyridoxine for nausea and vomiting of pregnancy randomized placebo controlled trial: Prespecified analyses and reanalysis.

Persaud N, Meaney C, El-Emam K, Moineddin R, Thorpe K.  PLoS One. 2018 Jan 17;13(1):e0189978. Free Article

There is a trend towards efficacy for nausea and vomiting symptoms with doxylamine-pyridoxine (marketed as Diclegis) compared with placebo but the statistical significance of this difference depends on how the data is analuzed.  

Adverse childhood experiences and intimate partner violence during pregnancy and their association to postpartum depression.

Mahenge B, Stöckl H, Mizinduko M, Mazalale J, Jahn A.  J Affect Disord. 2017 Dec 27;229:159-163.

Four out of ten women reported to have experienced adverse childhood events (ACEs) and two out of ten women reported intimate partner violence (IPV) in the index pregnancy

Physical ACE (AOR 2.6, 95% CI: 1.50–4.57), sexual ACE (AOR 2.7, 95% CI: 1.35–5.41), physical IPV (AOR 5.8, 95% CI: 2.98–11.43) and Sexual IPV (AOR 5.5, 95%CI: 2.51, 12.09) were significantly associated with symptoms of postpartum depression.

Mood-Stabilizing Anticonvulsants, Spina Bifida, and Folate Supplementation: Commentary.

Patel N, Viguera AC, Baldessarini RJ.  J Clin Psychopharmacol. 2018 Feb;38(1):7-10.

Risks of neural tube defects (especially spina bifida) and other major malformations are especially great with valproate and can arise even before pregnancy is diagnosed. Standard supplementation of folic acid during pregnancy can reduce risk of spontaneous spina bifida, but not that associated with valproate or carbamazepine.

Maternal avoidance, anxiety cognitions and interactive behaviour predictsinfant development at 12 months in the context of anxiety disorders in the postpartum period.

Reck C, Van Den Bergh B, Tietz A, Müller M, Ropeter A, Zipser B, Pauen S.  Infant Behav Dev. 2017 Dec 19;50:116-131.

Maternal neutral engagement, which lacks positive affect and vocalisations, turned out as the strongest negative predictor of cognitive development. Maternal anxiety cognitions and joint activity in mother-infant interaction were the strongest predictors of infant language performance.

Prenatal maternal psychosocial stress and offspring’s asthma and allergic disease: a systematic review and meta-analysis.

Flanigan C, Sheikh A, DunnGalvin A, Brew BK, Almqvist C, Nwaru BI.  Clin Exp Allergy. 2018 Jan 13.

Maternal exposure to any type of stressors was associated with an increased risk of offspring atopic eczema/dermatitis (OR 1.34, 95%CI 1.22-1.47), allergic rhinitis (OR 1.30, 95%CI 1.04-1.62), wheeze (OR 1.34, 95%CI 1.16-1.54) and asthma (OR 1.15, 95%CI 1.04-1.27).

A Norwegian prospective study of preterm mother-infant interactions at 6 and 18?months and the impact of maternal mental health problems, pregnancy and birth complications.

Misund AR, Bråten S, Nerdrum P, Pripp AH, Diseth TH.  BMJ Open. 2016 May 4;6(5).Free Article

Mothers with symptoms of post-traumatic stress reactions, general psychological distress and anxiety at 2?weeks postpartum (PP) showed significantly better outcome than mothers without symptoms.

Nutrients and perinatal depression: a systematic review.

Sparling TM, Nesbitt RC, Henschke N, Gabrysch S.  J Nutr Sci. 2017 Dec 20;6:e61.   Free Article

In all, fourteen studies found associations of perinatal depression with lower levels of folate, vitamin D, Fe, Se, Zn, and fats and fatty acids, while two studies found associations between perinatal depression and higher nutrient levels, and eight studies found no evidence of an association. Only ten studies had low risk of bias.

Feasibility of a Mindfulness-Based Cognitive Therapy Group Intervention as an Adjunctive Treatment for Postpartum Depression and Anxiety.

Shulman B, Dueck R, Ryan D, Breau G, Sadowski I, Misri S. J Affect Disord. January 2018.

MBCT has potential as an adjunctive, non-pharmacological treatment for postpartum depression/anxiety that does not wholly remit with pharmacotherapy.

Extending Models of Sensitive Parenting of Infants to Women at Risk for Perinatal Depression.

Goodman SH, Bakeman R, McCallum M, Rouse MH, Thompson SF.  Parent Sci Pract. 2017;17(1):30-50.  Free Article


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