Depression in pregnancy

Martinez-Paredes, Jhon F.; Jácome-Pérez, Nathalia

doi:10.1016/j.rcpeng.2017.07.002

Cited by 28 publications

(26 citation statements)

References 43 publications

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“…Depression is the most common psychiatric morbidity in pregnancy, affecting more than 13% of pregnant women (5). Antenatal depressive symptoms are especially prevalent among adolescents, innercity women, and women with past histories of major depression, less common in comparison to postpartum depression, yet none the less important (6).…”

Section: Prenatal Depressionmentioning

confidence: 99%

Neuroendocrine Aspects of Pregnancy and Postpartum Depression

2019

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Introduction. Ties between the endocrine system and mental health are undeniably a consistent point of interest in modern day medicine. Furthermore, mental disturbances due to hormonal changes following childbirth have been mentioned in medical literature since Hippocrates. Considering the dramatic endocrine, paracrine and autocrine changes that occur during gestation, labour and postnatal phase, hormonal theories are not to be ignored in the treatment of postpartum disorders. Results. Reproductive hormones are known to modulate behavioural, emotional and cognitive response, therefore rapid changes in estradiol and progesterone plasma concentrations during pregnancy and labour create a vulnerable terrain leading towards postpartum disorders. New research shows that women suffering from postpartum disorders have abnormal neural responses, suggesting a neuroendocrine explanation for postpartum syndromes. Conclusion. To facilitate further research in this area, we present new information on several hormonal interactions and the psychiatric response involved in pregnancy and labour, offering an interdisciplinary outlook on pregnancy and postpartum disorders. There is enough evidence to suggest that estradiol, progesterone, oxytocin, cortisol and thyroid hormones are some of many hormones involved in postpartum syndromes and tackling their perinatal imbalance with pharmacological substituents or antagonists could be useful as an adjuvant form of treatment in future patients.

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Section: Prenatal Depressionmentioning

confidence: 99%

Neuroendocrine Aspects of Pregnancy and Postpartum Depression

2019

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“…Mental healthcare for perinatal women has emerged as an important area of research. Depression is one of the most common complications during the perinatal period 1,2 ; panic disorder and anxiety are also common 3,4 . Anxiety and stress during pregnancy may have various adverse effects, including morphological abnormalities of the baby, impaired fetal development, complications of labor, and altered mental development of the newborn [5][6][7][8][9][10] .…”

Section: 【Introduction】mentioning

confidence: 99%

Benzodiazepine Concentrations in the Breast Milk and Plasma of Nursing Mothers: Estimation of Relative Infant Dose

Nishimura

Furugen

Umazume

et al. 2021

Breastfeeding Medicine

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Benzodiazepines are common therapies for mental illness and insomnia and are used during pregnancy and lactation. Although benzodiazepines have been shown to be transferred into breast milk, the amount transferred is small and compatible with breastfeeding. However, information is not available for all drugs. Therefore, we aimed to determine the milk to plasma (M/P) ratio and relative infant dose (RID), which are used as indicators of drug transfer to breast milk, to determine the safety of such drugs for lactating women and breastfeeding infants. The study comprised 11 pregnant women who visited the obstetrics department of Hokkaido University Hospital and Tenshi Hospital for childbirth. The samples were analyzed using liquid chromatography-tandem mass spectrometry, and the M/P ratio and RID were calculated. The condition of the mother and baby at 1 month after delivery was determined from the clinical information. The target benzodiazepines were alprazolam, brotizolam, clonazepam, clotiazepam, etizolam, ethyl loflazepate, flunitrazepam, and lorazepam. For all drugs, the M/P ratios were <1 and remained constant over time. For drugs other than ethyl loflazepate, the RID values were less than 10%, which are considered safe; however, even with ethyl loflazepate, it was only slightly over 10%. No abnormalities were found in breastfeeding infants whose mothers were receiving these medications. The RID results of this study suggest that drug exposure through breast milk is small; thus, maternal drug treatment and breastfeeding are compatible. Good Good Clonazepam Flunitrazepam 1 No change Breast milk & formula milk Breast milk Good Good Etizolam 1 1.5 Breast milk Breast milk Good Worsening Lorazepam 0.5 No change Breast milk & formula milk Breast milk & formula milk Good Worsening Lorazepam Ethyl loflazepate 0.5 No change Breast milk Breast milk & formula milk Good Good Flunitrazepam 1 No change Breast milk Breast milk Good Good 10 Lorazepam 0.5 No change Breast milk & formula milk Breast milk & formula milk Good Good 11 Brotizolam 0.25 0.125 Breast milk & formula milk Formula milk (main) Good Good

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“…Depression during pregnancy is a risk factor for preterm delivery and SGA ( 46 ). Moreover, we observed that lack of interest in daily activities, another symptom of depression ( 45 ), was associated with increased odds of a larger AFI. Thus, the possibility of underlying depression, suspected in women who had more hours of sleep and lack of interest in daily activities, is plausible and warrants further investigation.…”

Section: Discussionmentioning

confidence: 70%

“…We also observed that more self-reported hours of sleep were associated with lower fetal weights. Prolonged nocturnal sleep is known to be associated with mood disorders including depression in the general population ( 43 ) and also during pregnancy ( 44 , 45 ). Depression during pregnancy is a risk factor for preterm delivery and SGA ( 46 ).…”

Section: Discussionmentioning

confidence: 99%

Associations of History of Displacement, Food Insecurity, and Stress With Maternal-Fetal Health in a Conflict Zone: A Case Study

Gonzalez‐Fernandez

Sahajpal

Chagüendo

et al. 2020

Front. Public Health

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Background: In populations with a history of conflict, early identification of pregnant women who are at risk of adverse pregnancy outcomes is challenging, especially if sonography is not available. We evaluated the performance of symphysis-fundal height (SFH) for identification of high-risk pregnancies and investigated if food security and diet quality, clinical biomarkers, and stress were associated with SFH and two known indicators of maternal-fetal well-being, sonography-estimated fetal weight and amniotic fluid index (AFI). Methods: For this cross-sectional study, 61 women with high-risk pregnancies were recruited after referral to the obstetrics and gynecology unit at San José Hospital in Popayán, Colombia. Multiple stepwise linear and ordered logistic regressions were used to identify associations of SFH, sonography-estimated fetal weight and AFI classification with history of displacement, food insecurity, post-traumatic stress symptoms as well as biopsychosocial risk evaluated through the Colombian risk scale. Results: History of displacement was associated with lower SFH Z-scores, but higher hemoglobin, taking iron supplements and a higher diastolic blood pressure were associated with higher SFH Z-scores. SFH was also associated with AFI but not with sonography-estimated fetal weight. Stress indicators were associated with a higher AFI. In contrast family support, an element of the Colombian biopsychosocial risk assessment, was associated with a higher sonography-estimated fetal weight, whereas more hours of sleep/day were associated with lower sonography-estimated fetal weight. Conclusion: SFH was not only associated with biological factors known to affect maternal/fetal health but also with history of displacement, thus validating its use in conflict areas for pregnancy assessment. Associations of biopsychosocial stressors with maternal-fetal outcomes highlight the need for a systematic assessment of stress in pregnant women from conflict zones.

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Depression in pregnancy

Cited by 28 publications

References 43 publications

Neuroendocrine Aspects of Pregnancy and Postpartum Depression

Neuroendocrine Aspects of Pregnancy and Postpartum Depression

Benzodiazepine Concentrations in the Breast Milk and Plasma of Nursing Mothers: Estimation of Relative Infant Dose

Associations of History of Displacement, Food Insecurity, and Stress With Maternal-Fetal Health in a Conflict Zone: A Case Study

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