Weekly Roundup for NOVEMBER 2, 2018: Recent Publications in Women’s Mental Health

By | November 5, 2018

Uguz and colleagues present data that indicate, in a group of women with panic disorder, neonatal outcomes were worse in the women who did not get treatment.  This week’s roundup also features a lot of articles on postpartum depression, addressing an array of factors which increase women’s vulnerability to postpartum psychiatric illness, including adverse life events, BMI, asthma, gestational diabetes, and prolonged nausea during pregnancy.  Still the impact of these factors is smaller than having a history of psychiatric illness prior to pregnancy.

Ruta Nonacs, MD PhD

Neonatal outcomes in pregnant women with untreated and treated panic disorder.

Uguz F, Yuksel G, Onur OS, Karsidag C, Gezginc K, Arpaci N.  Compr Psychiatry. 2018 Oct 9;87:107-111.

The highest proportions of preterm birth (28.8%), low birth weight (34.6%) and requirement of neonatal care (25.0%) were observed in infants of untreated patients. Pharmacotherapy group and control subjects had similar neonatal outcomes.

Risk of postpartum depression among women with asthma.

Blais L, Salah Ahmed SI, Beauchesne MF, Forget A, Kettani FZ, Lavoie K.  J Allergy Clin Immunol Pract. 2018 Oct 4

Women with asthma were twice as likely to have postpartum depression.  

The association between gestational diabetes mellitus and postpartum depressive symptomatology: A prospective cohort study.

Ruohomäki A, Toffol E, Upadhyaya S, Keski-Nisula L, Pekkanen J, Lampi J, Voutilainen S, Tuomainen TP, Heinonen S, Kumpulainen K, Pasanen M, Lehto SM.  J Affect Disord. 2018 Dec 1;241:263-268.

Gestational diabetes (GDM) was associated with an increased risk of experiencing postpartum depressive symptoms (OR 2.23, 95% CI 1.23-4.05; adjusted for maternal age at delivery, BMI in the first trimester, smoking before pregnancy, relationship status, nulliparity, delivery by caesarean section, gestational age at delivery, neonatal intensive care unit admission and third-trimester EPDS scores).

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The association between body mass index and postpartum depression: A population-based study.

Silverman ME, Smith L, Lichtenstein P, Reichenberg A, Sandin S.  J Affect Disord. 2018 Nov;240:193-198.

Low BMI (<?18.5) and high BMI (>?35) were associated with increased risk of postpartum depression (adjusted RR?=?1.52 and 1.23, respectively).

A systematic review of cultural orientation and perinatal depression in Latina women: are acculturation, Marianismo, and religiosity risks or protective factors?

Lara-Cinisomo S, Wood J, Fujimoto EM. Arch Womens Ment Health. 2018 Oct 25.

Marianismo, the traditional female role of virtue, passivity, and priority of others over oneself, was inconsistently correlated with risk for depression in pregnancy, but significantly and indirectly associated with postpartum depression. Two of three studies found religiosity to be protective during the postpartum period.

Women with prolonged nausea in pregnancy have increased risk for depressive symptoms postpartum.  Iliadis SI, Axfors C, Johansson S, Skalkidou A, Mulic-Lutvica A.  Sci Rep. 2018 Oct 25;8(1):15796. doi: 10.1038/s41598-018-33197-1. Free Article

Women with prolonged nausea have increased risk of depressive symptoms at six weeks postpartum, regardless of history of depression.

Severe maternal morbidity and postpartum mental health-related outcomes in Sweden: a population-based matched-cohort study.

Wall-Wieler E, Carmichael SL, Urquia ML, Liu C, Hjern A.  Arch Womens Ment Health. 2018 Oct 17.

Women who experienced severe medical morbidity during pregnancy or at the time of delivery had significantly greater odds of being treated for a psychiatric disorder (aOR 1.22; 95% CI 1.03-1.45) and being prescribed psychotropic medications (aOR 1.40; 95% CI 1.24-1.58) in the postpartum year.

Impact of psychiatric medication co-exposure on Neonatal Abstinence Syndrome severity.

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Wachman EM, Warden AH, Thomas Z, Thomas-Lewis JA, Shrestha H, Nikita FNU, Shaw D, Saia K, Schiff DM.  Drug Alcohol Depend. 2018 Nov 1;192:45-50.

Among a group of opioid-exposed infants, psychiatric medication co-exposure is common, with 54% of the mothers on ?1 psychiatric medication and with 32% on ?2 or psychiatric medications (polypharmacy group). Polypharmacy exposure was associated with longer length of stay (??=?4.31 days, 95% CI 2.55-6.06) and opioid treatment days (??=?3.98 days, 95% CI 2.24-5.72) and more treatment with adjunctive medication for neonatal abstinence symptoms (aOR?=?2.49, 95% CI 1.57-3.95). Benzodiazepines were associated with the most prominent effects.  

Trauma-informed care with women diagnosed with postpartum depression: a conceptual framework.

Polmanteer RSR, Keefe RH, Brownstein-Evans C. Soc Work Health Care. 2018 Oct 22:1-16.

Trauma-informed care (TIC) is a best practice that recognizes the importance of, and takes steps to promote recovery from, trauma while preventing retraumatization. Despite its potential utility, there is limited research published on TIC, including how TIC is operationalized across practice settings.

Protocol for a randomised, double-blind, placebo-controlled trial to explore the effect of tramadol in the prevention of postpartum depression (ETPPD).

Duan G, Wu Z, Zhao P, Peng J, Chen Z, Zhang Q, Xu R, Li H.  BMJ Open. 2018 Oct 21;8(10):e022538. Free Article

Chinese researchers will explore whether postoperative intravenous analgesia using tramadol, an opioid analgesic, may decrease the incidence of postpartum depression in women receiving caesarean sections.

MGH Center for Women's Mental Health