• Psychiatric illness was identified as the leading cause of indirect death in the fifth and sixth CEMACH reports; the decrease in the rate of suicide in the seventh report may indicate that previous recommendations are having a beneficial effect. • Half of the women identified in the earlier reports had a history of serious mental illness. • Depression during pregnancy is complex and difficult to treat. Learning objectives: • To learn about the background, diagnosis and management. Ethical issues: • How aggressive should any active approach be to reduce the risk of maternal death? • Can the use of pharmacological agents, which can cause fetal toxicity and neonatal withdrawal problems, be justified?
The aim of this study was to compare pregnant women with a previous history of postnatal depression, attending a Tertiary Obstetric Unit in Belfast and a District General Hospital in Newry. Women with a previous history of postnatal depression recorded at booking for their most current pregnancy were studied between January 2001 and May 2002. A total of 443 women (6.6%) in Belfast had a history of postnatal depression, compared with 113 women (6%) in Newry. The most common age range was 31 - 35 years in both centres. Some 69% of women in Belfast compared with 81% of women in Newry were given treatment. Fluoxetine was the commonly prescribed drug for each centre. During this subsequent pregnancy, 19 women (4.3%) in Belfast and five women (4.4%) in Newry remained on antidepressants. There was one woman in each centre who took an overdose during this pregnancy. More women in Newry were given treatment. During the subsequent pregnancy, the percentages of women from each unit requiring antidepressant therapy were similar.
More than half of all doctors who responded had changed their prescribing practices on HRT, yet some respondents still preferred more traditional prescribing.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.