Postpartum Depression

Perinatal depression, also called postpartum depression, affects about 1 in 7 perinatal individuals. More than 75% of these individuals receive no treatment for perinatal depression. Onset of perinatal depression may occur prepregnancy or may develop over the course of pregnancy and the postpartum period. Untreated perinatal depression is associated with an increased risk of suicide and has additional negative effects on the perinatal individual, the fetus (preterm birth, low birth weight), and the child (impaired attachment, which may affect neurodevelopment) and may negatively affect relationships with partners and other family members.

Author/s:

Rebecca Voelker

Perinatal Depression: A Guide to Detection and Management in Primary Care

Linda Fowler — Fri, 19 Jan 2024 17:34:34 +0000

Date Added:

January 19, 2024

Journal/Publication:

Journal of the American Board of Family Medicine

Publication Date:

January 5, 2024

Issue:

Volume:

Pages:

1071-1086

URL:

Perinatal Depression: A Guide to Detection and Management in Primary Care

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.3122/jabfm.2023.230061R1

Keywords

breast feeding

Interpersonal Psychotherapy

Lactation

Postpartum

Postpartum Depression

Pregnancy

Psychiatry

Psychosocial Intervention

selective serotonin reuptake inhibitors

Surveys and Questionnaires

PMID (1):

37704392

MeSH

Depression / drug therapy

Sertraline / therapeutic use

Depressive Disorder, Major*

An evidence-based summary of the recognition and treatment of patients with peripartum depression. James W. Mold, MD, MPH

Free full text

View

Introduction: Existing guidelines for primary care clinicians (PCCs) on the detection and management of perinatal depression (PD) contain important gaps. This review aims to provide PCCs with a summary of clinically relevant evidence in the field.

Methods: A narrative literature review was conducted by searching PubMed and PsycINFO for articles published between 2010 to 2023. Guidelines, systematic reviews, clinical trials, and/or observational studies were all examined.

Results: Screening with the Edinburgh Postnatal Depression Scale or Patient Health Questionnaire-9 followed by a diagnostic evaluation for major depressive disorder in probable cases can enhance PD detection. At-risk individuals and mild to moderate PD should be referred for cognitive behavioral therapy or interpersonal psychotherapy when available. Selective serotonin reuptake inhibitors should be used for moderate to severe PD, with sertraline, escitalopram, or citalopram being preferred first. Using paroxetine or clomipramine in pregnancy, and fluoxetine or doxepin during lactation is generally not preferred. Gestational antidepressant use is associated with a small increase in risk of reduced gestational age at birth, low birth weight, and lower APGAR scores, though whether these links are causal is unclear. Sertraline and paroxetine have the lowest rate of adverse events during lactation. Consequences of untreated PD can include maternal and offspring mortality, perinatal complications, poor maternal-infant attachment, child morbidity and maltreatment, less breastfeeding, and offspring developmental problems.

Conclusions: These clinically relevant data can support the delivery of high-quality care by PCCs. Risks and benefits of PD treatments and the consequences of untreated PD should be discussed with patients to support informed decision making.

Author/s:

Manish H Dama, Ryan J Van Lieshout

Postpartum Depression-New Screening Recommendations and Treatments

Erin Blanchette — Tue, 05 Dec 2023 20:35:41 +0000

Date Added:

December 5, 2023

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

November 27, 2023

URL:

Postpartum Depression-New Screening Recommendations and Treatments

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2023.21311

Keywords

Depressive Disorders

Pregnancy

Obstetrics and Gynecology

Women's Health

Postpartum Depression

PMID (1):

38010647

MeSH

A summary of current recommendations regarding detection and treatment of postpartum depression. James W. Mold, MD, MPH

Free full text

View

Perinatal mental health conditions are those that occur during pregnancy and the year following childbirth, whether onset of the condition(s) predates pregnancy or occurs in the perinatal period. Perinatal mental health conditions are the leading cause of overall and preventable maternal mortality and include a wide array of mental health conditions including anxiety, depression, and substance use disorders. Perinatal depression specifically affects 1 in 7 perinatal individuals. While commonly referred to as postpartum depression, it is more accurately called perinatal depression because its onset corresponds with prepregnancy (27%), pregnancy (33%), and postpartum (40%) time frames.

Author/s:

Tiffany A Moore Simas, Anna Whelan, Nancy Byatt