Depression During Pregnancy and Postpartum

Overview

Journal Curr Psychiatry Rep

Publisher Current Science

Specialty Psychiatry

Date 2016 Feb 17

PMID 26879925

Citations 95

Authors

Madeleine Becker

Tal Weinberger

Ann Chandy

Sarah Schmukler

Affiliations

Soon will be listed here.

Abstract

Depression is a common complication of pregnancy and the postpartum period. There are multiple risk factors for peripartum mood disorders, most important of which is a prior history of depression. Both depression and antidepressant medications confer risk upon the infant. Maternal depression has been associated with preterm birth, low birth weight, fetal growth restriction, and postnatal cognitive and emotional complications. Antidepressant exposure has been associated with preterm birth, reductions in birth weight, persistent pulmonary hypertension, and postnatal adaptation syndrome (PNAS) as well as a possible connection with autism spectrum disorder. Paroxetine has been associated with cardiac malformations. Most antidepressant medications are excreted in low levels in breast milk and are generally compatible with breastfeeding. The use of antidepressants during pregnancy and postpartum must be weighed against the risk of untreated depression in the mother.

Citing Articles

Association between cardiorenal syndrome and depressive symptoms among the US population: a mediation analysis via lipid indices.

Yu G, Liu L, Ma Q, He H Lipids Health Dis. 2024; 23(1):365.

PMID: 39516797 PMC: 11545254. DOI: 10.1186/s12944-024-02356-x.

Prolonged transcranial magnetic stimulation in a pregnant patient with treatment-resistant depression: a case report.

Jawish R, Smid M, Gordon A, Shangraw K, Mickey B J Med Case Rep. 2024; 18(1):512.

PMID: 39438948 PMC: 11498958. DOI: 10.1186/s13256-024-04855-y.

Mind-Body Medicine in the Treatment of Depression: A Narrative Review of Efficacy, Safety and Mechanisms.

Kucukosmanoglu H, Cramer H, Tavakoly R, Moosburner A, Bilc M Curr Psychiatry Rep. 2024; 26(12):729-740.

PMID: 39424743 PMC: 11706891. DOI: 10.1007/s11920-024-01548-7.

The Antidepressant Drug Amitriptyline Affects Human SH-SY5Y Neuroblastoma Cell Proliferation and Modulates Autophagy.

Adornetto A, Lagana M, Satriano A, Licastro E, Corasaniti M, Bagetta G Int J Mol Sci. 2024; 25(19).

PMID: 39408742 PMC: 11476963. DOI: 10.3390/ijms251910415.

The impact of the early COVID-19 pandemic on maternal mental health during pregnancy and postpartum.

Bartmann C, Kimmel T, Davidova P, Kalok M, Essel C, Ben Ahmed F PLoS One. 2024; 19(9):e0310902.

PMID: 39302940 PMC: 11414898. DOI: 10.1371/journal.pone.0310902.

References

Andrade S, McPhillips H, Loren D, Raebel M, Lane K, Livingston J . Antidepressant medication use and risk of persistent pulmonary hypertension of the newborn. Pharmacoepidemiol Drug Saf. 2009; 18(3):246-52. DOI: 10.1002/pds.1710. View

Furu K, Kieler H, Haglund B, Engeland A, Selmer R, Stephansson O . Selective serotonin reuptake inhibitors and venlafaxine in early pregnancy and risk of birth defects: population based cohort study and sibling design. BMJ. 2015; 350:h1798. PMC: 4410618. DOI: 10.1136/bmj.h1798. View

Chad L, Pupco A, Bozzo P, Koren G . Update on antidepressant use during breastfeeding. Can Fam Physician. 2013; 59(6):633-4. PMC: 3681447. View

Dias C, Figueiredo B . Breastfeeding and depression: a systematic review of the literature. J Affect Disord. 2014; 171:142-54. DOI: 10.1016/j.jad.2014.09.022. View

Davanzo R, Copertino M, De Cunto A, Minen F, Amaddeo A . Antidepressant drugs and breastfeeding: a review of the literature. Breastfeed Med. 2010; 6(2):89-98. DOI: 10.1089/bfm.2010.0019. View

Burt V, Suri R, Altshuler L, Stowe Z, Hendrick V, Muntean E . The use of psychotropic medications during breast-feeding. Am J Psychiatry. 2001; 158(7):1001-9. DOI: 10.1176/appi.ajp.158.7.1001. View

Biederman J, Faraone S, Hirshfeld-Becker D, Friedman D, Robin J, Rosenbaum J . Patterns of psychopathology and dysfunction in high-risk children of parents with panic disorder and major depression. Am J Psychiatry. 2001; 158(1):49-57. DOI: 10.1176/appi.ajp.158.1.49. View

Orsolini L, Bellantuono C . Serotonin reuptake inhibitors and breastfeeding: a systematic review. Hum Psychopharmacol. 2015; 30(1):4-20. DOI: 10.1002/hup.2451. View

Potts A, Young K, Carter B, Shenai J . Necrotizing enterocolitis associated with in utero and breast milk exposure to the selective serotonin reuptake inhibitor, escitalopram. J Perinatol. 2007; 27(2):120-2. DOI: 10.1038/sj.jp.7211640. View

10.

Louik C, Lin A, Werler M, Hernandez-Diaz S, Mitchell A . First-trimester use of selective serotonin-reuptake inhibitors and the risk of birth defects. N Engl J Med. 2007; 356(26):2675-83. DOI: 10.1056/NEJMoa067407. View

11.

Hatton D, Harrison-Hohner J, Coste S, Dorato V, Curet L, McCarron D . Symptoms of postpartum depression and breastfeeding. J Hum Lact. 2005; 21(4):444-9. DOI: 10.1177/0890334405280947. View

12.

Winterfeld U, Klinger G, Panchaud A, Stephens S, Arnon J, Malm H . Pregnancy outcome following maternal exposure to mirtazapine: a multicenter, prospective study. J Clin Psychopharmacol. 2015; 35(3):250-9. DOI: 10.1097/JCP.0000000000000309. View

13.

Chaudron L, Schoenecker C . Bupropion and breastfeeding: a case of a possible infant seizure. J Clin Psychiatry. 2004; 65(6):881-2. DOI: 10.4088/jcp.v65n0622f. View

14.

Yonkers K, Blackwell K, Glover J, Forray A . Antidepressant use in pregnant and postpartum women. Annu Rev Clin Psychol. 2013; 10:369-92. PMC: 4138492. DOI: 10.1146/annurev-clinpsy-032813-153626. View

15.

Ramoz L, Patel-Shori N . Recent changes in pregnancy and lactation labeling: retirement of risk categories. Pharmacotherapy. 2014; 34(4):389-95. DOI: 10.1002/phar.1385. View

16.

Byatt N, Deligiannidis K, Freeman M . Antidepressant use in pregnancy: a critical review focused on risks and controversies. Acta Psychiatr Scand. 2012; 127(2):94-114. PMC: 4006272. DOI: 10.1111/acps.12042. View

17.

. ACOG Practice Bulletin: Clinical management guidelines for obstetrician-gynecologists number 92, April 2008 (replaces practice bulletin number 87, November 2007). Use of psychiatric medications during pregnancy and lactation. Obstet Gynecol. 2008; 111(4):1001-20. DOI: 10.1097/AOG.0b013e31816fd910. View

18.

El Marroun H, White T, Verhulst F, Tiemeier H . Maternal use of antidepressant or anxiolytic medication during pregnancy and childhood neurodevelopmental outcomes: a systematic review. Eur Child Adolesc Psychiatry. 2014; 23(10):973-92. DOI: 10.1007/s00787-014-0558-3. View

19.

Greene M . Teratogenicity of SSRIs--serious concern or much ado about little?. N Engl J Med. 2007; 356(26):2732-3. DOI: 10.1056/NEJMe078079. View

20.

Iliadis S, Comasco E, Sylven S, Hellgren C, Poromaa I, Skalkidou A . Prenatal and Postpartum Evening Salivary Cortisol Levels in Association with Peripartum Depressive Symptoms. PLoS One. 2015; 10(8):e0135471. PMC: 4556108. DOI: 10.1371/journal.pone.0135471. View