It’s been a while since we posted a weekly roundup.  Now that the new website is up, we are back on track.  In one of the few studies assessing the physical and cognitive development of infants exposed to psychotropic medications in breast milk, Kronenfeld and colleagues observed normal growth and development in exposed infants.  In a study from Park et al, use of certain atypical antipsychotic agents (quetiapine and olanzapine) during pregnancy was associated with a small increase in risk for gestational diabetes.


Ruta Nonacs, MD PhD



Chronic use of psychotropic medications in breastfeeding women: Is it safe?

Kronenfeld N, Ziv Baran T, Berlin M, Karra N, Dinavitser N, Cohen R, Wiener Y, Schwartzberg E, Bercovitch M.  PLoS One. 2018 May 21;13(5):e0197196.Free Article

Chronic use of psychotropic monotherapy during lactation is associated with normal growth and gross motor development as assessed by milestone achievements reported by parents.

Improvement of postpartum depression and psychosis after electroconvulsive therapy: A population-based study with a matched comparison group.

Rundgren S, Brus O, Båve U, Landén M, Lundberg J, Nordanskog P, Nordenskjöld A.

J Affect Disord. 2018 Apr 9;235:258-264.  Free Article

The response rate of those with postpartum depression and/or psychosis to ECT was high. The response rate of patients with psychosis or depression was higher during the postpartum period than outside it.

Continuation of Atypical Antipsychotic Medication During Early Pregnancy and the Risk of Gestational Diabetes.

Park Y, Hernandez-Diaz S, Bateman BT, Cohen JM, Desai RJ, Patorno E, Glynn RJ, Cohen LS, Mogun H, Huybrechts KF.  Am J Psychiatry. 2018 May 7

Gestational diabetes was more common in women taking quetiapine and olanzapine.  

Emerging literature in the Microbiota-Brain Axis and Perinatal Mood and Anxiety Disorders.

Rackers HS, Thomas S, Williamson K, Posey R, Kimmel MC.Psychoneuroendocrinology. 2018 May 17;95:86-96.

The pregnancy-related anxiety scale: A validity examination using Rasch analysis.

Brunton RJ, Dryer R, Krägeloh C, Saliba A, Kohlhoff J, Medvedev O.  J Affect Disord. 2018 Apr 27;236:127-135.

The Rasch results, together with previous validation evidence, point to the PrAS as a comprehensive and psychometrically sound screening scale for pregnancy-related anxiety. The PrAS offers clinicians the ability to screen for pregnancy-related anxiety.

Temperamental factors in remitted depression: The role of effortful control and attentional mechanisms

Perinatal maternal depression, antidepressant use and infant sleep outcomes: exploring cross-lagged associations in a pregnancy cohort study.
Galbally M, et al.  J Affect Dirord, May 2018.

Maternal antepartum depression and antidepressant use were not significant predictors of infant sleep problems. Likewise, infant sleep problems were not significant predictors of postpartum maternal depression.

Physical activity in pregnancy and postpartum depressive symptoms in a multiethnic cohort.

Shakeel N, Richardsen KR, Martinsen EW, Eberhard-Gran M, Slinning K, Jenum AK.  J Affect Disord. 2018 Apr 23;236:93-100.

Women who accumulated ?150 moderate-to-vigorous intensity physical activity (MVPA) minutes/week had significantly lower risk (OR?=?0.2, 95% CI: 0.06-0.90), for PPDS compared to those who did not accumulate any minutes/week of MVPA. The results for MVPA persisted in the sub-sample of ethnic minority women.

Perinatal depression prevention through home visitation: a cluster randomized trial of mothers and babies 1-on-1.

Tandon SD, Ward EA, Hamil JL, Jimenez C, Carter M.  J Behav Med. 2018 May 15.

Although larger studies should be conducted, MB 1-on-1 appears promising in using home visitors to deliver a cognitive behavioral intervention to women at risk for postpartum depression.

Maternal depression and cortisol in pregnancy predict offspring emotional reactivity in the preschool period.

Swales DA, Winiarski DA, Smith AK, Stowe ZN, Newport DJ, Brennan PA.  Dev Psychobiol. 2018 May 25.

Depression and maternal cortisol measured in the first and second trimesters was more strongly associated with child emotional reactivity. Sex was found to moderate associations between maternal prepartum depression/cortisol and child emotional reactivity, with the general pattern reflecting positive associations in girls, and negative associations in boys.

Polyunsaturated Fatty Acids in Perinatal Depression: A Systematic Review and Meta-analysis.

Lin PY, Chang CH, Chong MF, Chen H, Su KP.  Biol Psychiatry. 2017 Oct 15;82(8):560-569.

There were significantly lower levels of total n-3 PUFAs and docosahexaenoic acid and significantly increased n-6/n-3 ratios in women with PPD. In the subgroup analyses, there were significantly lower levels of n-3 PUFAs, eicosapentaenoic acid, and docosahexaenoic acid in women with prenatal depression. The n-6/n-3 ratio was significantly increased in both prenatal and postnatal depression subgroups.

Cortical and subcortical changes in patients with premenstrual syndrome.

Liu P, Wei Y, Fan Y, Liao H, Wang G, Li R, Duan G, Deng D, Qin W.  J Affect Disord. 2018 Apr 7;235:191-197.

Compared to healthy controls, PMS patients exhibited reduced cortical thickness in the medial prefrontal cortex (MPFC), orbitofrontal cortex (OFC) and insula, and increased subcortical volumes of the amygdala, thalamus and pallidum.

Vitamin D deficiency and depressive symptoms in the perinatal period.

Lamb AR, Lutenbacher M, Wallston KA, Pepkowitz SH, Holmquist B, Hobel CJ.  Arch Womens Ment Health. 2018 May 29.

At a large medical center in southern California, pregnant women (N?=?126) were assessed for depressive symptoms and vitamin D status (25OHD) at three time points in the perinatal period: early pregnancy, third trimester, and postpartum.  An inverse relationship between vitamin D status and depressive symptoms was observed between 25OHD and EPDS scores at all time points.

The effect of perinatal depression treatment for mothers on parenting and child development: A systematic review.

Letourneau NL, Dennis CL, Cosic N, Linder J.  Depress Anxiety. 2017 Oct;34(10):928-966.

Self-help cognitive behavior therapy for working women with problematic hot flushes and night sweats (MENOS@Work): a multicenter randomized controlled trial.

Hardy C, Griffiths A, Norton S, Hunter MS.  Menopause. 2018 May;25(5):508-519.

A brief, unguided SH-CBT booklet is a potentially effective management option for working women experiencing problematic hot flashes and night sweats.

Adverse obstetric and neonatal outcomes complicated by psychosis among pregnant women in the United States.

Zhong QY, Gelaye B, Fricchione GL, Avillach P, Karlson EW, Williams MA.  BMC Pregnancy Childbirth. 2018 May 2;18(1):120.

Pregnant women with psychosis have elevated risk of several adverse obstetric and neonatal outcomes, including cesarean delivery (aOR = 1.26; 95% CI: 1.23 – 1.29) , antepartum hemorrhage (aOR = 1.22; 95% CI: 1.14 – 1.31), placental abruption (aOR = 1.22; 95% CI: 1.13 – 1.32), postpartum hemorrhage (aOR = 1.18; 95% CI: 1.10 – 1.27), premature delivery (aOR = 1.40; 95% CI: 1.36 – 1.46), stillbirth (aOR = 1.37; 95% CI: 1.23 – 1.53), premature rupture of membranes (aOR = 1.22; 95% CI: 1.15 – 1.29), fetal abnormalities (aOR = 1.49; 95% CI: 1.38 – 1.61), poor fetal growth (aOR = 1.26; 95% CI: 1.19 – 1.34), and fetal distress (aOR = 1.14; 95% CI: 1.10 – 1.18).

Prevalence of and risk factors associated with sexual health issues in primiparous women at 6 and 12 months postpartum; a longitudinal prospective cohort study (the MAMMI study).

O’Malley D, Higgins A, Begley C, Daly D, Smith V.  BMC Pregnancy Childbirth. 2018 May 31;18(1):196. doi: 10.1186/s12884-018-1838-6.  Free Article


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