ABSTRACT
OBJECTIVE: This study systematically examines risk for postpartum depressive symptoms based on COVID-19 positivity status during pregnancy. METHODS: This is a retrospective matched cohort study of pregnant patients admitted to labor and delivery units from March through December 2020. Patients were administered three depression screening questions followed by the Edinburgh Postnatal Depression Scale (EPDS). RESULTS: 129 patients with positive COVID-19 tests (most with mild symptoms) were matched with 516 COVID-19 negative controls. We found no significant differences in rates of positive responses to screening questions (14/129, 10.9% vs. 72/516, 14.0%; p = .35) or EPDS scores >9 (6/97, 6.2% vs. 42/410, 10.2%; p = .22). Prior history of psychiatric illness was the only significant predictor of an EPDS score > 9 (adjOR 2.57, p = .002) or a positive brief screen for postpartum depressive symptoms (adjOR 2.93, p < .001). CONCLUSIONS: No significant differences in the rates for postpartum depressive symptoms were observed among pregnant women with and without a positive COVID-19 test during pregnancy, suggesting that testing positive for COVID-19 during pregnancy was not associated with an increased risk for the development of depressive symptoms during the acute postpartum period. Overall rates of postpartum depression symptoms were low, perhaps owing to the higher socioeconomic status of the sample.
Subject(s)
COVID-19 , Depression, Postpartum , Pregnancy , Humans , Female , Pregnant Women , Depression/diagnosis , Depression/epidemiology , Cohort Studies , Retrospective Studies , Tertiary Healthcare , COVID-19/epidemiology , Depression, Postpartum/diagnosis , Depression, Postpartum/epidemiology , Postpartum Period , Psychiatric Status Rating ScalesSubject(s)
Psychiatry/history , History, 20th Century , History, 21st Century , Humans , United StatesABSTRACT
Women of childbearing age with depression present with a unique set of risks. This article will discuss the following topics: these specific risks, current literature on treating depression in the peripartum, and roles of physician and patient in peripartum treatment.
Subject(s)
Antipsychotic Agents/adverse effects , Antipsychotic Agents/therapeutic use , Depressive Disorder/drug therapy , Pregnancy Complications/drug therapy , Abnormalities, Drug-Induced/epidemiology , Abnormalities, Drug-Induced/etiology , Depression, Postpartum/prevention & control , Female , Humans , Infant, Newborn , Maternal-Fetal Exchange , Neonatal Abstinence Syndrome/epidemiology , Neonatal Abstinence Syndrome/etiology , Pregnancy , Prenatal Exposure Delayed Effects/chemically induced , Prenatal Exposure Delayed Effects/epidemiology , RecurrenceABSTRACT
Failure to treat depression during pregnancy can lead to problems for the mother and the baby. However, given the lack of convincing evidence of the safety of antidepressant drugs to the fetus during pregnancy and lactation, any antidepressive treatment plan must be embarked on with caution. The authors offer practical guidelines for managing depression during pregnancy and lactation.
Subject(s)
Antidepressive Agents/therapeutic use , Depression/drug therapy , Pregnancy Complications , Pregnancy Outcome , Abnormalities, Drug-Induced , Antidepressive Agents/adverse effects , Breast Feeding , Depression/therapy , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy Trimesters/drug effects , SafetyABSTRACT
Premenstrual dysphoric disorder (PMDD), a severe form of premenstrual syndrome (PMS), is characterized by physical and behavioral symptoms that cause marked social impairment during the last half of the menstrual cycle. Symptoms are believed to result from the interaction of central neurotransmitters and normal menstrual hormonal changes. Treatment usually begins with lifestyle changes, over-the-counter medications, and if needed, selective serotonin reuptake inhibitors. Physicians should be aware of the risks of many of the alternative therapies commonly touted in the popular press.
