In California, the recreational use of marijuana was legalized in 2017, but even before then, the use of marijuana has been increasing. A recent report (Young-Wolff et al, 2017) notes that in 2016, 7% of pregnant women tested positive for marijuana.
Ruta Nonacs, MD PhD
Young-Wolff KC, Tucker LY, Alexeeff S, Armstrong MA, Conway A, Weisner C, Goler N. JAMA. 2017 Dec 26;318(24):2490-2491.
From 2009 to 2016, the percentage of women with positive urine tests for marijuana at roughly 8 weeks into pregnancy rose from 4 percent to 7 percent. Marijuana use was particularly prevalent among those younger than 18 (22 percent), and women between ages 18 and 24 (19 percent).
Park M, Brain U, Grunau RE, Diamond A, Oberlander TF. Arch Womens Ment Health. 2018 Jan 16.
Three distinct patterns of maternal depressive symptom trajectories were identified: low (n?=?105), increasing (n?=?27), and decreasing (n?=?15). Children of mothers whose depressive symptoms increased reported more problem behaviors at 3 years and poorer executive functioning at 6 years, but no significant differences in mental health symptomatology at 6 years, compared to children whose mothers had consistently low depressive symptoms. If mothers’ depressive symptoms improve over the first 3 years postpartum, their children’s outlook may be comparable to those whose mothers had consistently low depressive symptoms.
Treatment of Postpartum Depression: Recommendations for the Clinician.
O’Hara MW, Engeldinger J. Clin Obstet Gynecol. 2018 Jan 18.
Between a rock-a-bye and a hard place: mood disorders during the peripartum period.
Thomson M, Sharma V. CNS Spectr. 2017 Dec;22(S1):49-64.
Barkmann C, Helle N, Bindt C. J Affect Disord. 2017 Dec 13;229:415-420.
Very low birth weight (VLBW) was a significant predictor for the course of parental depression – even after controlling for preexisting psychiatric disorders and other confounders.
Maternal early pregnancy obesity and depressive symptoms during and after pregnancy.
Kumpulainen SM, Girchenko P, Lahti-Pulkkinen M, Reynolds RM, Tuovinen S, Pesonen AK, Heinonen K, Kajantie E, Villa PM, Hämäläinen E, Laivuori H, Räikkönen K. Psychol Med. 2018 Jan 17:1-11.
In comparison to normal weight women, overweight, and obese women reported higher levels of depressive symptoms and had higher odds of clinically significant depressive symptoms during (23% and 43%, respectively) and after pregnancy (22% and 36%, respectively). Underweight women had 68% higher odds of clinically significant depressive symptoms after pregnancy.
Cuomo A, Goracci A, Fagiolini A. J Affect Disorder, 2018.
This article summarizes the literature on the use of aripiprazole during pregnancy and lactation. The data are limited but reassuring, indicating a low risk of adverse outcomes.
Ford E, Shakespeare J, Elias F, Ayers S. Fam Pract. 2017 Feb;34(1):11-19.
In this review, the observed that the reported awareness and ability to diagnose perinatal depression among general practitioners (GPs) was high. GPs knew about and used screening tools in the UK but less so in US settings. Counseling by GPs and referrals to specialists were common in the postpartum period, less so in pregnancy.
Active ghrelin and the postpartum.
Baker JH, Pedersen C, Leserman J, Brownley KA. Arch Womens Ment Health. 2016 Jun;19(3):515-20.
The appetite hormone ghrelin, which fluctuates during pregnancy, is associated with depression in nonpregnant samples. Results do not suggest an association between PPD and ghrelin levels after adjusting for creatinine.
El Tanbouly N, El Sayed AM, Ali ZY, Abdel Wahab S, El Gayed SH, Ezzat SM, El Senousy AS, Choucry MA, Abdel-Sattar E. Evid Based Complement Alternat Med. 2017.
In rat model of PPD, flaxseed oil of Egyptian cultivars G9 and G10 exhibited significant antidepressant-like effect without affecting locomotor activity. At the treatment doses, the antidepressant-like activity of Giza 9 oil is comparable to fluoxetine.
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