Every week we review the most recent publications in women’s mental health, covering topics related to premenstrual symptoms, perinatal mood and anxiety disorders, use of medications in pregnant and breastfeeding women, perinatal substance use, and menopausal mental health. 

For more detailed descriptions of many of these topics, you can sign up to receive our weekly CWMH NEWSLETTER which comes out every Thursday.  

And don’t forget to visit ESSENTIAL READS – a curated selection of up-to-date and clinically relevant articles in women’s mental health.

Ruta Nonacs, MD PhD


No articles this week


No articles this week


Trajectories of Depressive and Anxiety Symptoms Across Pregnancy and Postpartum in Selective Serotonin Reuptake Inhibitor-Treated Women.

Mesches GA, Ciolino JD, Stika CS, Sit DK, Zumpf K, Fisher S, Clark CT, George AL, Avram MJ, Rasmussen-Torvik LJ, Erickson DL, Caritis S, Fischer D, Venkataramanan R, Costantine M, West H, Welch E, Clark S, Wisner KL, Gollan JK. Psychiatr Res Clin Pract. 2022 Mar 4;4(2):32-41.

Three relatively stable depression trajectories emerged, described as Minimal, Mild, and Subthreshold, in each group across pregnancy. Two of the four anxiety trajectories were stable, including Asymptomatic and Minimal, while the third, termed Breakthrough, was ascending with increasing symptoms and the fourth trajectory, described as Mild, had descending symptoms.

Prospective Cohort Study of Depression During Pregnancy and the Postpartum Period in Women With Epilepsy vs Control Groups.

Meador KJ, Stowe ZN, Brown C, Robalino CP, Matthews AG, Kalayjian LA, Voinescu PE, Gerard EE, Penovich P, Gedzelman ER, Cavitt J, Pennell PB; MONEAD Investigator Group. Neurology. 2022 Oct 11;99(15):e1573-e1583.

This prospective study confirms higher rates of psychiatric symptoms in patients with epilepsy during pregnancy and postpartum, provides new data on associated factors, and underscores the importance of anxiety in risk for depression and thoughts of death/dying or suicide.

The synergistic effects of short inter-pregnancy interval and micronutrients deficiency on third-trimester depression.

Lin J, Zhou Y, Gu W. Front Nutr. 2022 Sep 28;9:949481.

There is a synergistic effect between shorter interpregnancy interval (IPI) and micronutrient deficiency (vitamin D, folic acid) in early pregnancy, which can increase risk for depression in late pregnancy.

Maternal Anxiety, Depression and Stress Affects Offspring Gut Microbiome Diversity and Bifidobacterial Abundances.

Galley JD, Mashburn-Warren L, Blalock LC, Lauber CL, Carroll JE, Ross KM, Hobel C, Coussons-Read M, Dunkel Schetter C, Gur TL.

Brain Behav Immun. 2022 Oct 11:S0889-1591(22)00410-X.

Results revealed that infants of mothers who reported higher anxiety and perceived stress had reduced alpha diversity. Additionally, the relative taxonomic quantitative abundances of Bifidobacterium dentium and other species that have been associated with either modulation of the gut-brain axis, or other beneficial health outcomes, were reduced in the offspring of mothers with higher anxiety, perceived stress, and depression. We also found associations between bifidobacteria and prenatal maternal pro-inflammatory cytokines IL-6, IL-8, and IL-10. In summary, specific microbial taxa involved in maintaining proper brain and immune function are lower in offspring born to mothers with anxiety, depression, or stress, providing strong evidence for a mechanism by which maternal factors may affect offspring health through microbiota dysregulation.

Cognitive Function Decline in the Third Trimester of Pregnancy Is Associated with Sleep Fragmentation.

Wo?y?czyk-Gmaj D, Majewska A, Bramorska A, Ró?a?ska-Wal?dziak A, Ziemka S, Brzezicka A, Gmaj B, Czajkowski K, Wojnar M. J Clin Med. 2022 Sep 23;11(19):5607.

This study demonstrates a relationship between lower sleep quality in pregnancy and worse cognitive functioning.

The Association of Antenatal Depression and Cesarean Delivery Among First Time Parturients: A population based study.

Ayala NKK, Schlichting L, Lewkowitz AK, Kole-White MB, Gjelsvik A, Monteiro K, Amanullah S. Am J Perinatol. 2022 Oct 13. doi: 10.1055/a-1960-2919.

In a large, population-weighted, nationally representative sample of first time parturients, there was no association between depression during pregnancy and Cesarean delivery.

Racial-Ethnic Differences in Treatment Initiation for New Diagnoses of Perinatal Depression.

Avalos LA, Nance N, Iturralde E, Badon SE, Quesenberry CP, Sterling S, Li DK, Flanagan T. Psychiatr Serv. 2022 Oct 13:appips20220173.

Of the pregnant women with depression, 31.4% initiated treatment during pregnancy. Of the postpartum women, 73.1% initiated treatment. Latina and Asian women were less likely than White women to initiate treatment postpartum. During pregnancy and postpartum, non-White women were more likely to initiate psychotherapy. White women were more likely to initiate antidepressant medication during pregnancy and postpartum or a combination of antidepressant medication and psychotherapy during the postpartum period.

The immune phenotype of perinatal anxiety.

Sherer ML, Voegtline KM, Park HS, Miller KN, Shuffrey LC, Klein SL, Osborne LM. Brain Behav Immun. 2022 Nov;106:280-288.

Compared to women without anxiety during pregnancy, women with anxiety had lower levels of cytokine expression during pregnancy and an increase in levels into the postpartum, whereas women with no anxiety experienced a time-dependent decline in cytokines. This study suggests an immune phenotype of perinatal anxiety.


Prescribing Guideline for Valproic Acid and Women of Reproductive Potential: Forget It Exists.

Freeman MP. J Clin Psychiatry. 2022 Oct 12;83(6):22ed14609.

Based on current data, this opinion piece recommends to avoid the use of valrpoic acid in women of reproductive age.

Lithium Pharmacokinetics in the Perinatal Patient With Bipolar Disorder.

Clark CT, Newmark RL, Wisner KL, Stika C, Avram MJ. J Clin Pharmacol. 2022 Nov;62(11):1385-1392.

Small study including 3 patients. Compared to the nonpregnant state, lithium elimination clearance increased an average of 63.5% by the third trimester. Lithium elimination clearance was inversely related to changes in serum lithium concentration. Mood symptoms worsened with declines in serum lithium concentration. Lithium elimination clearance returned to baseline at 4 to 9 weeks postpartum.


No articles this week


Breastfeeding while on treatment with antiseizure medications: a systematic review from the ILAE Women Task Force.

Tomson T, Battino D, Bromley R, Kochen S, Meador KJ, Pennell PB, Thomas SV.

Epileptic Disord. 2022 Dec 1;24(6):1-13.

Very low concentrations (in the order of 10% or less of maternal serum concentrations) were reported for carbamazepine, gabapentin, levetiracetam, oxcarbazepine, valproate, and clonazepam. Slightly higher levels (up to approximately 30% of maternal serum concentrations) have been observed with lamotrigine and topiramate.


Patterns of Substance Use During Early Pregnancy and Associations With Behavioral Health Characteristics.

Sujan AC, Alexeeff SE, Slama N, Avalos LA, Adams SR, Conway A, Ansley D, Young-Wolff KC. J Addict Med. 2022 Oct 18.

4 latent groups with different patterns of substance use: (a) predominantly alcohol and no other substances (9.30%), (b) predominantly cannabis and no other substances (4.88%), (c) predominantly nicotine and some pharmaceutical opioids (1.09%), and (d) high-polysubstance (alcohol, cannabis, nicotine, and stimulants; 0.36%).

Association of cannabis use during pregnancy with severe acute respiratory syndrome coronavirus 2 infection: a retrospective cohort study.

Young-Wolff KC, Ray GT, Alexeeff SE, Benowitz N, Adams SR, Does MB, Goler N, Ansley D, Conway A, Avalos LA.

Addiction. 2022 Oct 3.

Current cannabis use appears to be associated with a reduced risk of SARS-CoV-2 infection among pregnant individuals.

In-utero cannabis exposure and long-term psychiatric and neurodevelopmental outcomes: The limitations of existing literature and recommendations for future research.

Sujan AC, Young-Wolff KC, Avalos LA. Birth Defects Res. 2022 Aug 1;114(13):689-713. Review.


Maternal caregiving ameliorates the consequences of prenatal maternal psychological distress on child development.

Grande LA, Swales DA, Sandman CA, Glynn LM, Davis EP. Dev Psychopathol. 2022 Oct;34(4):1376-1385.

Elevated prenatal distress was associated with poorer child cognitive function and elevated negative emotionality. Children exposed to elevated prenatal maternal distress did not, however, display these outcomes if they received high-quality caregiving.


Menopause hormone therapy and complementary alternative medicine, quality of life, and racial/ethnic differences: the Study of Women’s Health Across the Nation (SWAN).

Christmas M, Janssen I, Joffe H, Upchurch D, Santoro N, Kravitz HM. Menopause. 2022 Oct 18.

Overall, neither HT nor CAM was associated with changes in QoL. However, the treatment-by-race/ethnicity interaction was significant for self-reported QoL. Among White women, self-reported QoL was higher in HT-only users than in those who used neither. In contrast, Black women using HT only had lower self-reported QoL compared with Black women using neither.


No articles this week

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