This roundup has some really interesting and clinically relevant articles. The first one, from Palomo and colleagues, evaluates risk for cardiovascular malformations in children prenatally exposed to lithium. Yang and colleagues look at neonatal discontinuation symptoms in children exposed to SNRIs and SSRIs and conclude that they are more related to prematurity than to exposure to antidepressants. Analyzing data from Danish Medical Register, researchers note that first onset of depression or anxiety during the postpartum period may be a marker for bipolarity (Liu, et al).
Ruta Nonacs, MD PhD
Patorno E, Huybrechts KF, Bateman BT, Cohen JM, Desai RJ, Mogun H, Cohen LS, Hernandez-Diaz S. N Engl J Med. 2017 Jun 8;376(23):2245-2254.
Cardiac malformations were present in 16 of the 663 infants exposed to lithium (2.41%), 15,251 of the 1,322,955 nonexposed infants (1.15%), and 27 of the 1945 infants exposed to lamotrigine (1.39%). The risk ratio was 1.11 for a daily dose of 600 mg or less, 1.60 for 601 to 900 mg, and 3.22 for more than 900 mg.
Yang A, Ciolino JD, Pinheiro E, Rasmussen-Torvik LJ, Sit DKY, Wisner KL. J Clin Psychiatry. 2017 May;78(5):605-611.
The presence of neonatal signs at 2-4 weeks was more closely associated with prematurity than with prenatal exposure to SRI or mood disorder exposure.
Liu X, Agerbo E, Li J, Meltzer-Brody S, Bergink V, Munk-Olsen T. J Clin Psychiatry. 2017 May;78(5):e469-e476. Free Article
First-onset nonpsychotic postpartum affective disorder can be a marker of underlying bipolarity. Women who fill an antidepressant prescription following childbirth should be asked about hypomanic or manic symptoms and monitored long term. Clinically, when antidepressant monotherapy is ineffective or the individual woman experiences persistent and concerning symptoms, health professionals should consider a possible bipolar spectrum disorder.
Kataja EL, Karlsson L, Huizink AC, Tolvanen M, Parsons C, Nolvi S, Karlsson H.
J Affect Disord. 2017 Aug 15;218:66-74.
Maternal depressive symptoms and pregnancy-related anxiety symptoms were both associated with decrements in visuospatial working memory/executive functioning.
Flouri E, Ioakeimidi S, Midouhas E, Ploubidis GB. J Affect Disord. 2017 Aug 15;218:35-40.Free Article
Young daughters of chronically distressed mothers tend to be particularly reckless decision-makers.
Simpson W, Frey BN, Steiner M. J Womens Health (Larchmt). 2016 Jun;25(6):594-8.
Strong correlation between daily rhythm disruptions and prenatal depressive symptoms during the third trimester.
Dinwiddie KJ, Schillerstrom TL, Schillerstrom JE. J Psychosom Obstet Gynaecol. 2017 Jun 2:1-8.
Galland BC, Sayers RM, Cameron SL, Gray AR, Heath AM, Lawrence JA, Newlands A, Taylor BJ, Taylor RW. BMJ Open. 2017 Jun 2;7(5):e014908. PMID: Free Article
A strategy delivering infant sleep education antenatally and at 3?weeks postpartum was not effective in preventing the development of parent-reported infant sleep problems.
Heller HM, Ravelli ACJ, Bruning AHL, de Groot CJM, Scheele F, van Pampus MG, Honig A.
BMC Pregnancy Childbirth. 2017 Jun 2;17(1):166. Free Article
pregnant women using serotonergic medication have an increased risk of postpartum haemorrhage, but this high risk is also seen in pregnant women using other psychopharmacological medications.
Shankar R, Badker R, Brain U, Oberlander TF, Misri S. Can J Psychiatry. 2017 May;62(5):318-326.
Factors that predicted full recovery from depression included the absence of maternal health concerns, low total parental stress, and few child behavioural issues, whereas low levels of spousal stress were a significant factor in achieving full recovery from anxiety.
Casilla-Lennon MM, Meltzer-Brody S, Steiner AZ. Am J Obstet Gynecol. 2016 Sep;215(3):314.e1-5.
These data suggest that antidepressants may reduce the probability of a woman with a history of depression to conceive naturally. Future studies are needed to differentiate the extent to which this association is due to the antidepressant itself versus the underlying depression.
Postpartum Depression, Risk Factors, and Child’s Home Environment Among Mothers in a Home Visiting Program
Sampson M, Duron JF, Mauldin RL, et al. J Child Fam Stud (2017).
In a population of families at high risk for child maltreatment, elevated PPD symptoms at 3?months postpartum were predicted by elevated depressive symptoms during pregnancy (OR?=?4.34) and being unemployed (OR?=?1.37).
Gerstein ED, Woodman AC, Burnson C, Cheng ER, Poehlmann-Tynan J. J Pediatr. 2017 May 19.
Children born prematurely followed 1 of 3 distinct developmental trajectories for both internalizing and externalizing behavior problems. The most severe behavior problems started early in development and were associated with increased child dysregulation, maternal depression, and lower socioeconomic status.