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Report Addresses Depression Management in Pregnancy

Last Updated: August 24, 2009.

In the management of depression during pregnancy, psychotherapy alone may be appropriate for some women. However, other women may prefer pharmacotherapy or require pharmacological treatment, according to a report published in the September issue of Obstetrics & Gynecology.

MONDAY, Aug. 24 (HealthDay News) -- In the management of depression during pregnancy, psychotherapy alone may be appropriate for some women. However, other women may prefer pharmacotherapy or require pharmacological treatment, according to a report published in the September issue of Obstetrics & Gynecology.

Kimberly A. Yonkers, M.D., of the Yale School of Medicine in New Haven, Conn., and colleagues from the American Psychiatric Association and the American College of Obstetricians and Gynecologists reviewed recent research on fetal and neonatal outcomes associated with depression and antidepressant treatment, and offered strategies for the management of women with depression who are either pregnant or planning a pregnancy.

The researchers found that maternal depression and antidepressant exposure are associated with fetal growth changes, shorter gestations, short-term neonatal irritability and neurobehavioral changes, but cautioned that most studies that assessed antidepressant risks were unable to control for the possible effects of a depressive disorder. They also cited research showing an association between first trimester antidepressant exposure and a non-specific pattern of fetal defects, and an association between late gestational use of selective serotonin reuptake inhibitor antidepressants and transitory neonatal signs and a low risk for persistent pulmonary hypertension in the newborn.

"Antidepressant use in pregnancy is well studied, but available research has not yet adequately controlled for other factors that may influence birth outcomes, including maternal illness or problematic health behaviors that can adversely affect pregnancy," the authors conclude.

Several authors reported financial relationships with the pharmaceutical industry.

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