Occurs in greater than 12% of patients during pregnancy.
A metaanalysis estimated depression in pregnancy affects 9.2% of pregnant women in high income countries.
Prenatal depression is associated with negative outcomes, including increased risk of postpartum depression and chronic mental illness, preterm birth, other perinatal complications, childhood developmental, social and behavioral problems.
The treatment of depression in pregnancy is a priority for affected women, and their families.
Strongest risk factor during pregnancy is a history of depression.
Associated with poorer pregnancy outcomes, including increased risk of preterm delivery, and may cause increased neonatal morbidity and mortality.
Risk factors of depression during pregnancy include: a family history of depression or bipolar disorder, childhood mistreatment, single mothers, a pregnant women with three or more children, smoking history, low socioeconomic status, age younger than 20 years, history of domestic violence and insufficient social support system.
Consequences of depression in pregnancy include impaired prenatal care, diet, and use of harmful substances including alcohol, tobacco, drugs and risk of self harm and suicide (Deave T et al).
Increases the risk of postpartum depression and may lead to difficulties in mother child bonding and infant care, as well as to impaired relationships with the woman’s relationships.
Can lead to alterations in fetal growth and childhood behavior.
Psychotherapies may be effective to treat depression of pregnancy in mild and moderate severe cases, however anti-depressants may be required for more severe depression or when therapy does not lead to remission.
A Danish population study of school-aged children and association between maternal anti-depressant prescriptions, found no statistically significant association for language scores, but a statistically small difference was found for standardized mathematics scores.
Selective serotonin reuptake inhibitors (SSRIs) are the most common agents for depression during pregnancy.
SSRI agents during pregnancy may be associated with poor outcomes including congenital abnormalities, spontaneous abortions, neonatal withdrawal syndrome, and persistent pulmonary hypertension of the newborn.
Discontinuing antidepressant therapy during pregnancy is associated with increased risks of a relapse of major depression.
Maternal mental illness is associated with the risks of infant mortality and sudden infant death syndrome.
In a population-based study from all Nordic countries from 1996-2007 of women with single births and utilizing SSRIs it was no significant association between the use of such drugs during pregnancy and the risk of stillbirth, neonatal mortality, postneonatal mortality (Stephansson O et al).
In the above study there were more than 1.6 million births, with 1.79% of mothers utilizing SSRIs.