Consensus Bundle on Maternal Mental Health

Abstract

Perinatal mood and anxiety disorders are among the most common mental health conditions encountered by women of reproductive age. When left untreated, perinatal mood and anxiety disorders can have profound adverse effects on women and their children, ranging from increased risk of poor adherence to medical care, exacerbation of medical conditions, loss of interpersonal and financial resources, smoking and substance use, suicide, and infanticide. Perinatal mood and anxiety disorders are associated with increased risks of maternal and infant mortality and morbidity and are recognized as a significant patient safety issue. In 2015, the Council on Patient Safety in Women’s Health Care convened an interdisciplinary workgroup to develop an evidence-based patient safety bundle to address maternal mental health. The focus of this bundle is perinatal mood and anxiety disorders. The bundle is modeled after other bundles released by the Council on Patient Safety in Women’s Health Care and provides broad direction for incorporating perinatal mood and anxiety disorder screening, intervention, referral, and follow-up into maternity care practice across health care settings. This commentary provides information to assist with bundle implementation.

Good Practices in Perinatal Mental Health during the COVID-19 Pandemic: A Report from Task-Force RISEUP-PPD COVID-19

“…Assessing the broad definition of psychological distress. Research on perinatal mental health should address the full realm of psychological distress, with a focus on depression and anxiety, which are the most prevalent psychological disorders in the perinatal period (Kendig et al, 2017).…”

Use of antidepressants and anxiolytics in early pregnancy and the risk of preeclampsia and gestational hypertension: a prospective study

“…The prevalence of perinatal depression and anxiety disorders is estimated to vary widely from 5% to more than 25% of pregnant women and new mothers [5–9]. Depression is one of the most common complications of the prenatal and postpartum periods [7, 10]. During pregnancy, antidepressants are among the most frequently prescribed medications [11, 12].…”

Are Antidepressant Medications Safe for Pregnant Women With Epilepsy? The Signs Point to Yes

“…5 Furthermore, failure to adequately treat significant depression during pregnancy can lead to significant harm to the mother including suicide, substance abuse, lower adherence with appropriate prenatal care, and harm to the child including maternal neglect and abuse. 6 Absent definitive evidence, guidance from the American College of Obstetrics and Gynecology has been to utilize counseling when depression and anxiety in the perinatal period are mild and to prescribe antidepressant medications when moderate to severe. 6 For women with both depression and epilepsy, evidence is limited on the potential risks associated with concurrent use of an AED and antidepressant drug (ADD) for the developing fetus or the mother.…”