Effects Of Depression On Pregnancy

The Potential Impact Of Other Mental Health Conditions

While depression is perhaps the most common condition affecting women during and immediately after pregnancy, it is not the only mental health disorder that can negatively affect a pregnancy. According to researchers writing for the medical journal Obstetrics, Gynaecology & Reproductive Medicine, other mental health conditions, such as schizophrenia, bipolar disorder, anxiety disorders, and post-traumatic stress disorder can increase the risk of complications including miscarriage, poor fetal growth, preterm birth, and low birthweight.

There are actually physiological reasons behind the link between mental health conditions during pregnancy and negative effects on child development. For example, there are some substances in the body that contribute to both the function of the central nervous system and the development of the growing baby. If a mental health condition alters the functioning of the nervous system, there can also be effects on the placenta, and therefore, the baby.

What all of this means is that it is critical for mothers who have mental health conditions to discuss their mental health status with a physician and ensure that they are receiving quality care. By addressing mental health symptoms, you can reduce the potential negative impact on your growing baby.

Can You Prevent Pregnancy Depression

The U.S. Preventive Services Task Force recommends that moms-to-be seek out therapy or counseling to address pregnancy depression preemptively if they have one or more of the following risk factors:

• Youre currently experiencing signs or symptoms of depression.
• You have a history of depression or other mental health conditions.
• Youre partnerless or are a teenager.
• Youre dealing with major stressors like low income or unemployment.
• Youre a victim of domestic abuse.

That said, pregnancy depression can affect any woman not just those deemed high-risk. Your provider may opt to screen you for depression during your pregnancy. The American College of Obstetricians and Gynecologists recommends screening women at least once for depression and anxiety either shortly before or after birth, so some providers might not screen during pregnancy.

That means that you should still let your provider know if you start to notice signs of possible depression whether they ask about your mood or not.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect When You’re Expecting. What to Expect follows strict reporting guidelines and uses only credible sources, such as peer-reviewed studies, academic research institutions and highly respected health organizations. Learn how we keep our content accurate and up-to-date by reading our medical review and editorial policy.

Can Depression During Pregnancy Cause Harm To My Baby

Depression that is not treated can have potential dangerous risks to the mother and baby. Untreated depression can lead to poor nutrition, drinking, smoking, and suicidal behavior, which can then cause premature birth, low birth weight, and developmental problems. A woman who is depressed often does not have the strength or desire to adequately care for herself or her developing baby.Babies born to mothers who are depressed may be less active, show less attention and be more agitated than babies born to moms who are not depressed. This is why getting the right help is important for both mom and baby.

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What Is The Long Term Prognosis

An estimated 50% of people with one episode of depression have another, and 80% of those will have chronic or recurrent episodes.94 The highest risk for relapse is likely to be in those women with greater severity of illness and especially if symptoms are not treated to remission. When antidepressants are effective during the initial phase of treatment, maintenance treatment may reduce the risk of relapse by about 50%, and this may be improved further with continued combination psychological and drug treatments in women with severe illness.95 The current recommendation for people with a first episode of depression is maintenance treatment for at least six months to one year, and longer for those with multiple or severe episodes.95 Some evidence suggests that women who have episodes of depression in pregnancy or post partum may have recurrent depression at other times of hormonal change, such as during the perimenopause.96 Long term follow-up for women with depression in pregnancy is therefore required, with specific attention to subsequent pregnancies and other reproductive life events, such as perimenopause.

Questions for future research

• What is the effectiveness of psychological interventions for mother and infant?

Treatment options being explored currently include facilitated self help and online psychological treatments for women with mild and moderate depression4197

• What is the effectiveness of non-invasive somatic interventions for mother and infant?

Characteristics Of Study Sample

Of the 749 women with valid EPDS data, 444 were ethnic minorities. Baseline socio-demographic characteristics according to ethnic group are presented in Table . The ethnic minority women were younger, had less education, and higher parity and unemployment compared to Western European women. Heterogeneity was found across ethnic minority subgroups. No significant baseline differences were found between participants and the 74 excluded women on the following variables: ethnicity, age, GW at inclusion, parity, single parenthood, employment status and education.

Table 1 Baseline characteristics for Western and ethnic minority women

To investigate our secondary aim, we replaced ethnicity by the PCA variable for overall level of integration , due to the strong correlation between markers of social integration and ethnicity. In the alternative modelling strategy, the variable reflecting social integration was significant ), including history of depression, recent adverse life events and poor subjective health three months before conception, although the total explained variance in this model was slightly reduced .

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The Fetal Programming The Intrauterine Environment And The Effects On Neonatal Outcomes: Role Of Stress And Depression

Growing lines of evidence support an important role for the intrauterine environment in shaping the fetal development and the subsequent childs health or disease risk. Indeed, the developing fetal brain is particularly plastic and sensitive to several in utero environmental adversities that can lead to long-term implications . This phenomenon, known as early life programming, has been extensively studied in relation to individual exposure to maternal depression and/or obesity during pregnancy, but there is a lack of data about the effects of their comorbidity on the fetal development. In particular, a major knowledge gap concerns the biological pathways that are altered by comorbid depression and obesity in pregnancy, and that shape the fetal vulnerability of developing altered mood and/or metabolic dysfunctions later in life.

In this context, maternal stress represents a key factor that has received most of the attention, as it is known to influence the fetal development determining also long-term consequences . Interestingly, psychosocial stress exposure in pregnancy has been suggested influencing the infant temperament .

Fig. 1: Effects in the transmission of vulnerability from comorbid depressed and obese mothers to their offspring.

Stress And Preterm Birth

More than 80 scientific investigations on stress and PTB were recently reviewed by Dunkel Schetter and Glynn , of which a majority had prospective designs, large samples, and validated measures, and were fairly well controlled for confounds such as medical risks, smoking, education, income, and parity. These studies can be grouped by the type of stress examined. Of the more than a dozen published studies assessing `major life events in pregnancy’, a majority found significant effects women who experienced major life events such as the death of a family member were at 1.4 to 1.8 times greater risk of PTB, with strongest effects when events occurred early in pregnancy. The majority of a second, smaller group of studies on catastrophic, community-wide disasters also showed significant effects on gestational age at birth or PTB. A third small set of studies on chronic stressors, such as household strain or homelessness, all reported significant effects on PTB. Finally, a majority of past investigations on neighborhood stressors such as poverty and crime indicated significant effects on gestational age or PTB. In comparison, studies on daily hassles and perceived stress did not consistently predict PTB. Thus, of the many distinguishable forms of stress, many contribute to the risk of PTB.

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What Are The Signs Of Depression

Depression can come on slowly. The symptoms are different for everyone. They can be mild, moderate or severe. Some of the more common signs are:

• changes in appetite, like eating too much or having little interest in food,
• changes in sleep, such as trouble sleeping or sleeping too much,
• lack of energy,
• feeling sad, hopeless or worthless,
• crying for no reason, and
• loss of interest or pleasure in activities you normally enjoy.

New moms with depression may have trouble caring for their baby. They might not want to spend time with their baby, which can lead to a baby who cries a lot.

Symptoms Of Postpartum Depression

The symptoms of postpartum depression are similar to symptoms of depression, but may also include:

• Crying more often than usual.
• Feelings of anger.
• Feeling distant from your baby.
• Worrying or feeling overly anxious.
• Thinking about hurting yourself or your baby.
• Doubting your ability to care for your baby.

If the situation is potentially life-threatening, call 911.

Call or text 988, or chat at 988lifeline.org.

988 is confidential, free, and available 24/7/365, connecting those experiencing a mental health, substance use, or suicidal crisis with trained crisis counselors.

24/7, Free, Confidential Hotline for Pregnant and New Moms in English and SpanishCall or text 1-833-9-HELP4MOMS .

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If I Take Antidepressants During My Pregnancy Will They Hurt My Baby

You may think you should stop taking medication for depression when you are pregnant. Remember that, if left untreated, depression can have serious effects for both you and your baby. If you are taking antidepressants and are thinking about getting pregnant , talk to your doctor first, before stopping any medication. You can also consult the following trusted resources: www.mothertobaby.org, www.medicinesinpregnancy.org.

Some newborn babies may have symptoms such as irritability, fast breathing, tremors and poor feeding if their mothers took antidepressants during pregnancy. These symptoms are usually mild and pass quickly, usually within 2 weeks. These babies typically respond well to a quiet environment, swaddling, skin-to-skin contact, and frequent small feeds. Serious problems such as heart defects or more severe breathing issues are very rare.After your baby is born, they will be watched closely to make sure they are healthy. Your doctors and nurses will make sure that you are both well before letting you go home. You may need to stay an extra day or two in the hospital so that they can be sure.

Difference Between Depression And Postpartum Depression

Before jumping into the effects of depression during pregnancy, it is helpful to understand the difference between general depression and postpartum depression. Both depression during pregnancy and postpartum depression can negatively affect child development. As the Office on Womens Health explains, postpartum depression refers to an incident of depression that occurs during the period after childbirth. Its not unusual for women to experience baby blues, which are feelings of sadness that occur in the first few days after giving birth. If sadness persists for more than two weeks and is accompanied by other symptoms, such as excessive crying, feelings of being worthless or being a bad mother, and withdrawal from friends and loved ones, a mother may be suffering from postpartum depression. Unfortunately, experts report that postpartum depression can interfere with the attachment between mother and baby and lead to harsher parenting, which can negatively affect a babys developing social and cognitive skills.

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What Do You Need To Know About St Johns Wort To Treat Depression

St. John’s wort is an herb that some people use to treat depression. We dont know for sure how well it works in pregnant women or if it can cause problems during pregnancy. Herbal products arent regulated by the Food and Drug Administration , so there isnt much information about how safe it is for pregnant women or rules about how much you can take.

If youre thinking about taking St. Johns wort or any other herbal product during pregnancy, talk to your provider first. Theres very little information on how herbal products may affect your pregnancy.

Seeking Help For Depression During Pregnancy

Researchers say their findings have important implications for the nature and timing of interventions to prevent depression in children of depressed mothers.

In particular, the findings suggest that treating depression in pregnancy, irrespective of background, may be most effective, the study concludes.

Treatments like cognitive behavioral therapya kind of talk therapyhave been shown to help women with depression without the risk of side effects that comes with some psychoactive medications.

Health professionals should be aware and ready to support women, Pearson said. Depression during pregnancy is important in its own right and not just because it may continue after birth.

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Problems For The Pregnant Women

The negative effects of prenatal depression on pregnant women include sleep disturbances and continuing depression into the postpartum period. In one study, sleep quality during pregnancy was not only associated with prenatal depression symptoms but also with postnatal depression . Unfortunately, as in many other studies, this research relied on self-report measures including depression scores on the EPDS and sleep ratings on the Pittsburgh Sleep Quality Index. In a much larger sample study from Australia, 3,144 women of a total sample of 35,374 women had a score greater than 12 on the EPDS . Prenatal depression along with a history of depression and low partner support were the strongest predictors of postpartum depression. Again this study was totally reliant on self-report measures, as would be expected with a sample that large. In a smaller sample from Korea, 26% had EPDS scores > 10 and prenatal and postpartum depression scores were significantly correlated . Surprisingly, no data on pre-pregnancy depression are included in these studies. Prenatal depression that continues as postpartum depression may relate to a hormonal imbalance, an unwanted pregnancy or equally as likely a manifestation of chronic depression.

Depression During And After Pregnancy Is Common And Treatable

Recent CDC research shows that about 1 in 8 women experience symptoms of postpartum depression. Additionally, a recent analysis by CDC found the rate of depression diagnoses at delivery is increasing and it was seven times higher in 2015 than in 2000.

Having a baby is challenging and every woman deserves support. If you are experiencing emotional changes or think that you may be depressed, make an appointment to talk to your health care provider as soon as possible. Most people get better with treatment and getting help is the best thing you can do for you and your baby.

Effective depression treatment can include a combination of medication therapy, counseling, and referrals. is talking to your health care provider. After your visit, make sure to follow-up on all referrals and treatment that he or she suggests. When discussing medications with your provider, let her or him know if you are pregnant, thinking about becoming pregnant, or breastfeeding. You and your provider can decide if taking medicine while pregnant or breastfeeding is right for you. Read Medicine and Pregnancy for more information.

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Association Between Social Support Marital Discord Domestic Violence Prenatal Anxiety Consanguinity And Catastrophic Events With Prenatal Depression

Association with low social support and presence of marital discord was significant on bivariate analysis but not in multivariate logistic regression. Presence of domestic violence was found to impose a five times higher and highly significant risk of developing prenatal depression among the respondents . Pregnancy related anxiety was also found to be a positive predictor of prenatal depression . The blood relationship with the husband did not show any significant association with prenatal depression on bivariate analysis and multivariable analysis. Presence of catastrophic events over the past 1 year imposed a two times higher and significant risk of developing prenatal depression among the respondents . History of mental illness was not included in the analysis because only one respondent had history of this kind and was undergoing treatment with medications.

Table 4. Association of maternal depression with social support, marital discord, and domestic violence among the pregnant mothers .

How Prenatal Depression Effects The Child After Birth

Depression experienced during the prenatal period can go on to effect that exposed fetus well after they are born, into childhood. Prenatal depression can impair future socio-emotional development of the child. This term describes a young person’s ability to be socially competent and emotionally intelligent. These are the building blocks of what we associate with psychological stability and good behavior in an academic setting.

For mothers experiencing depression during pregnancy, the odds of having children with behavioral difficulties were 1.5 to almost 2 times greater than for mothers not experiencing prenatal depression.

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Women Not Taking Antidepressants Before Pregnancy

Antidepressants should be offered for severe and moderate depression when psychological therapy is not, or has not been, effective or where such therapy is not available.23 Antidepressants should be used along with psychological therapies whenever possible because combination therapy may lead to higher remission rates and lower relapse rates compared with either therapy alone.2452 People with moderate and severe depression benefit most, and symptoms can begin to improve, within two weeks of starting drugs.5354 For women with no previous antidepressant use, any SSRI is a reasonable first choice, with the possible exception of paroxetine owing to its higher risk of neonatal adaptation syndrome and withdrawal symptoms in the mother.5657 For former antidepressant users, previous efficacy and tolerability must be considered when selecting antidepressants during pregnancy.

Box 4: Neonatal adaptation syndrome

Symptoms of neonatal adaptation syndrome tend to begin within 48 hours of birth, are usually short lived , and last no longer than four weeks from birth.55 Symptoms can include:

• Tachypnoea, respiratory distress, nasal congestion, or cyanosis