Perinatal depression

Abstract

Purpose of reviewPerinatal depression is a common and debilitating complication of pregnancy and childbirth. Recent studies have elucidated relationships between acute birth events on depression risk, and novel treatments for postpartum depression have been discovered and approved. This article reviews current understandings about birth events on depression, new screening standards, and novel treatments for postpartum depression. Recent findingsPain, analgesia, and depression are complex traits that are inter-related during and after pregnancy. Certain individuals may benefit more than others from addressing pain and suffering around childbirth. Exposures to general anesthesia or postdural puncture headache are associated with postpartum depression symptoms, although a causal relationship is unlikely. Brexanolone, ketamine and its related compounds, and nonpharmacologic options offer new or alternative therapies for depression, although safety information for some of these treatments in pregnancy and lactation are needed. Maternal health bundles call for close attention to perinatal mental health screening with validated instruments, and for timely treatment referrals in the 'fourth trimester'. SummaryClinical monitoring and timely treatment of depression in the perinatal and postpartum periods is critical for maternal postpartum health and recovery. Perinatal specialists and researchers should continue to focus on tailored treatments specific to this special population.

Association between gestational depression and weight management behaviors during pregnancy: A cross-sectional study in Eastern China

“…They were also less likely to follow doctor's recommendations for physical activity ( 31 , 32 ). Possible reasons are depressive symptoms damage a patient's mental health and physical performance, making them less willingness and uninterested in external activities ( 33 ). As a result of their negative emotions, these pregnant women may be hesitant to engage in various physical activities.…”

Initiation of an Enhanced Recovery After Cesarean Delivery Protocol in a University Hospital in Serbia: A randomized comparison with existing management

“…Finally, poor pain control after cesarean delivery has been suggested as a possible factor in the development of post-partum depression in the mother's future life 27,28 ; the relationship remains unclear but many recent studies consider this possible cause.…”

Childbirth Pain, Labor Epidural Analgesia, and Postpartum Depression: Recent Evidence and Future Directions

“…The findings of these studies may have clinical significance since they will address knowledge gaps around individualized pain management and childbirth experience and may lead to new methods or discoveries for PPD risk assessment and treatment. 72 …”

“…The findings of these studies may have clinical significance since they will address knowledge gaps around individualized pain management and childbirth experience and may lead to new methods or discoveries for PPD risk assessment and treatment. 72 Third, although universal screening is now recommended by numerous professional organizations, screening rates are low, and screening is often not performed using a validated instrument. For example, postpartum EPDS scores were only recorded in 55% of women who underwent a vaginal delivery in the study by Lim et al 37 Finally, since pain relief may have favorable consequences for the postpartum emotional state of the mother, these observations indicate the need to direct more of our focus to better management of labor pain in order to prevent longer-term morbidity and improve outcomes, including the duration of labor, intrapartum support, mode of pain relief, and quality of analgesia.…”