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March 25, 2006

New York Times Examines Depression in Pregnant Women

A New York Times article, "The Dilemma of Depression for Mothers-to-Be," by Jane E. Brody (February 21, 2006) explores the issues in treating pregnant women for depression. Perhaps 10 to 20 per cent of pregnant women suffer from depression during pregnancy, which translates to about 80,000 women per year in the United States. Many are not treated, either because they are ashamed to reveal their symptoms, believing they should be happy when expecting a baby, or because the diagnosis is not made.

The general medical advice to women has been to avoid all medications during pregancy, but it has become gradually apparent that in the case of depression, an exception should be seriously considered. Each individual case needs to be assessed according to risks and benefits. Untreated depression has been linked to higher rates of miscarriage, stillbirths, premature deliveries, intrauterine growth restriction and low-birth-weight babies.

Depression can lead to damage to the woman's relationship to her spouse and other children. Those women already on medication who stop for the first trimester have an increased likelihood of a recurrence of depression, and prepartum depression is likely to continue after birth, leading to problems in establishing a healthy relationship with the baby.

But there are risks. A recent study of 60 newborns exposed in utero to S.S.R.I antidepressants showed that 18 had mild to severe signs of "neonatal absinence syndrome," including high pitched crying, disturbed sleep, feeding difficulties, tremor and muscular stiffness lasting a week or two. Another study showed an increased risk for a rare but serious lung disease. An earlier study showed that 1 per cent of babies exposed in the last trimester of prenancy to antidepressants developed serious respiratory problems.

The long term and immediate risks should be carefully evaluated in deciding about the use of antidepressants during pregnancy.

Posted by admin at March 25, 2006 08:50 AM