Galbally M, Watson SJ, van IJzendoorn M, Saffery R, Ryan J, de Kloet ER, Oberlander TF, Lappas M, Lewis AJ. Psychoneuroendocrinology. 2020 Feb 8;115:104611.
Two genes involved in stress response regulation, the glucocorticoid and mineralocorticoid receptors (NR3C1 and NR3C2) have been a focus in understanding stressful exposures and mental health outcomes. These findings show a relationship between antenatal depression, NR3C2 DNA methylation and infant cortisol response providing support for a specific fetal programming pathway.
Utilization of Health Care Among Perinatal Women in the United States: The Role of Depression.
Masters GA, Li N, Lapane KL, Liu SH, Person SD, Byatt N. J Womens Health (Larchmt). 2020 Feb 20
Among perinatal U.S. women, 7.3% had depressive symptoms. Relative to those without these symptoms, women experiencing depressive symptoms were younger, more impoverished, and uninsured (p?<?0.05). Women with depressive symptoms, compared with those without them, had twice the odds of being without routine medical care (21.6% vs. 12.5%, adjusted odds ratio [aOR]: 2.1, 95% confidence interval [CI]: 1.1 to 4.1) and of using urgent care more frequently (26.5% vs. 15.1%, aOR: 1.9, 95% CI: 1.0 to 3.9). Depressive symptoms combined with lack of insurance generally increased the odds of not having routine care (RERI: 8.4, 95% CI: -0.5 to 17.3) and more frequent use of urgent care (RERI: 7.1, 95% CI: -2.7 to 17.0).
Vigod SN, Murphy KE, Dennis CL, Oberlander TF, Ray JG, Daskalakis ZJ, Blumberger DM. Brain Stimul. 2019 Nov – Dec;12(6):1475-1483.
At 4 weeks postpartum, 75.0% of tDCS women were remitted versus 12.5% of women receiving sham-control (p?=?0.04).
Disordered sleep is related to delusional ideation and depression during the perinatal period.
Solomonova E, MacKinnon AL, Gold I, Robins S, Wunderlich S, Feeley N, Hayton B, Libman E, Zelkowitz P. Sleep Health. 2020 Feb 6.
Sleep disturbances in early pregnancy directly predicted symptoms of depression in late pregnancy and had an indirect effect on postpartum depression through DI in late pregnancy.
Osnes RS, Eberhard-Gran M, Follestad T, Kallestad H, Morken G, Roaldset JO. J Affect Disord. 2020 Jan 27;266:319-326. Free Article
Mid-pregnancy insomnia was significantly associated with both concurrent and postpartum anxiety. Women with mid-pregnancy insomnia had significantly higher levels of perinatal anxiety and postpartum OCD symptoms than participants with normal mid-pregnancy sleep. OCD symptoms affected more women after delivery than before (6.4% vs. 3.8% p = 0.034).
Huybrechts KF, Bateman BT, Pawar A, Bessette LG, Mogun H, Levin R, Li H, Motsko S, Scantamburlo Fernandes MF, Upadhyaya HP, Hernandez-Diaz S. BMJ. 2020 Feb 19. Free Article
On the basis of the evidence available to date, duloxetine is unlikely to be a major teratogen but may be associated with an increased risk of postpartum hemorrhage and a small increased risk of cardiac malformations.
Barker LC, Dennis CL, Hussain-Shamsy N, Stewart DE, Grigoriadis S, Metcalfe K, Oberlander TF, Schram C, Taylor VH, Vigod SN. BMC Psychiatry. 2020 Feb 7;20(1):54. Free Article
Quan C, Wang S, Duan K, Ma J, Yu H, Yang M, Hu N, Long G, Zeng G, Huang Z. Brain Behav. 2020 Feb 26.
Kynurenic aminotransferase (KAT) is an important kynurenine pathway enzyme, catalyzing kynurenine (KYN) into kynurenic acid (KYNA). These data support a role for alterations in the kynurenine pathway in the pathogenesis of postpartum depressive symptoms.
Guglielminotti J, Li G. Anesth Analg. 2020 Jan 29.
Of the 428,204 cesarean delivery cases included, 34,356 had general anesthesia (8.0%). Relative to neuraxial anesthesia, general anesthesia in cesarean delivery was associated with a 54% increased odds of PPD (aOR, 1.54; 95% CI, 1.21-1.95) and a 91% increased odds of suicidal ideation or self-inflicted injury (aOR, 1.91; 95% CI, 1.12-3.25).
Dennis CL, Grigoriadis S, Zupancic J, Kiss A, Ravitz P. Br J Psychiatry. 2020 Feb 7:1-8.
At 12 weeks, 10.6% of women in the IPT group (11/104) and 35% in the control group (35/100) remained depressed (OR = 0.22, 95% CI 0.10-0.46), with the IPT group 4.5 times less likely to be clinically depressed (SCID); 21.2% in the IPT group and 51% in the control group had an Edinburgh Postnatal Depression Scale (EPDS) score >12 (OR = 0.26, 95% CI 0.14-0.48) at 12 weeks.
A closer look at the nosological status of the highs (hypomanic symptoms) in the postpartum period.
Sharma V, Singh P, Baczynski C, Khan M. Arch Womens Ment Health. 2020 Feb 7.
Studies from several countries have reported occurrence of hypomanic symptoms immediately after childbirth; this review discussed the relationship of these hypomanic symptoms with mood disorders.
Assessing Mothers’ Postpartum Depression From Their Infants’ Cry Vocalizations.
Gabrieli G, Bornstein MH, Manian N, Esposito G. Behav Sci (Basel). 2020 Feb 6;10(2). Free Article
Previous studies have highlighted the presence of significant differences in the acoustical properties of the vocalizations of infants of depressed and healthy mothers, suggesting that the mothers’ behavior can induce changes in infants’ vocalizations. Acoustical features of the baby’s crying can be successfully used to distinguished postpartum depressed from non-depressed mothers with high accuracy (89.5%).