The article that received the most attention this week is one examining the risks associated with the use of stimulants to treat ADHD during pregnancy (Cohen JM et al, 2017).  There were no real surprises here, but the study suffers from many of the same shortcomings as other studies investigating the effects of other psychotropic medications.  We will cover this article in greater detail next week.  

Have a happy and healthy Thanksgiving!

Ruta Nonacs, MD PhD


Placental Complications Associated With Psychostimulant Use in Pregnancy.

Cohen JM, Hernández-Díaz S, Bateman BT, Park Y, Desai RJ, Gray KJ, Patorno E, Mogun H, Huybrechts KF.  Obstet Gynecol. 2017 Nov 3.

Compared with discontinuation, the adjusted risk ratio for continuation of stimulant use in the latter half of pregnancy was 1.26 for preeclampsia (0.94-1.67), 1.08 for placental abruption (0.67-1.74), 1.37 for small for gestational age (0.97-1.93), and 1.30 for preterm birth (1.10-1.55). Atomoxetine was not associated with the outcomes studied.

The birth of a psychiatric orphan disorder: postpartum psychosis.

Florio AD, Munk-Olsen T, Bergink V. Lancet Psychiatry. 2016 Jun;3(6):502.

Management of New Onset Psychosis in the Postpartum Period.

Tinkelman A, Hill EA, Deligiannidis KM.  J Clin Psychiatry. 2017 Nov 7. Free Article

Postpartum psychosis is a psychiatric emergency. Immediate treatment with a combination of lithium, antipsychotics, and benzodiazepines has been demonstrated to be effective, and ECT may be required.

Maternal mental health: Handle with care

BMJ, November 2017 (Full Text).

A mother describes how opportunities were missed to identify her postpartum psychosis.

Premenstrual Dysphoric Disorder: A Review of Neural and Cognitive Changes in Women with PMDD

Liselotte Wiklund. Bachelor Degree Project in Cognitive Neuroscience, University of Skovde. 2017.

This is not an article published in a peer-reviewed journal but rather a Bachelor’s Degree Project in Cognitive Neuroscience.  It is one of the most thorough reviews of the neurobiological underpinnings of PMDD I have ever seen.  (And the entire text is available online.)

Timing of Maternal Depression and Sex-Specific Child Growth, the UpstateKIDS Study.

Park H, Sundaram R, Gilman SE, Bell G, Louis GMB, Yeung EH.  Obesity (Silver Spring). 2017 Nov 1.

Antenatal depression was associated with lower weight and smaller height only for boys, whereas postnatal depressive symptoms were associated with higher weight for height only for girls.

Lucky gene 5-HTTLPR and postpartum depression: A systematic review.

[no author listed]. Neuro Endocrinol Lett. 2017 Oct 6;38(5):316-320. [Epub ahead of print]

There was a strong association between 5-HTTLPR polymorphism and the pathogenesis of PPD, with established evidence showing that L allele (Long allele) in 5-HTTLPR was associated with reduced susceptibility to PPD.

Elevated maternal anxiety in the NICU predicts worse fine motor outcomein VLBW infants.

Greene MM, Rossman B, Meier P, Patra K.  Early Hum Dev. 2017 Nov 8;116:33-39.

This was a prospective study of 69 mothers and their VLBW infants, elevated maternal anxiety in the NICU predicted lower fine motor scores at 20 months.

Trajectories of maternal ante- and postpartum depressive symptoms and their association with child- and mother-related characteristics in a West African birth cohort study.

Barthel D, Kriston L, Fordjour D, Mohammed Y, Kra-Yao ED, Bony Kotchi CE, Koffi Armel EJ, Eberhardt KA, Feldt T, Hinz R, Mathurin K, Schoppen S, Bindt C, Ehrhardt S; International CDS Study Group.  PLoS One. 2017 Nov 6;12(11):e0187267.

In the Child Development Study, a prospective birth cohort study in Côte d’Ivoire and Ghana, three distinct classes of depressive symptoms that were characterized by an asymptomatic trajectory (91.5%), by recurrent risk (4.3%) and by postnatal risk (4.3%). Higher levels of anxiety, new pregnancy within years of previous birth, economic stress, and family stress were associated with the risk of depressive illness.

Postpartum outcomes of a pilot prenatal care-based psychosocial intervention for PTSD during pregnancy.

Weinreb L, Wenz-Gross M, Upshur C.  Arch Womens Ment Health. 2017 Nov 7.

Among women with current PTSD, women receiving the Seeking Safety intervention, compared to controls, significantly decreased PTSD symptoms, and showed a non-significant trend for improved social support. However, depression, coping, and birth outcomes did not differ between the two groups.

Perinatal weight and risk of prenatal and postpartum depressive symptoms.

Ertel KA, Huang T, Rifas-Shiman SL, Kleinman K, Rich-Edwards J, Oken E, James-Todd T.  Ann Epidemiol. 2017 Oct 16.

Pre-pregnancy obesity is associated with elevated depressive symptoms in the postpartum period.

Related Posts