Perinatal Depression

Abstract

In this issue of JAMA, the US Preventive Services Task Force (USPSTF) recommends "that clinicians provide or refer pregnant and postpartum persons who are at increased risk of perinatal depression to counseling interventions" (B recommendation; net benefit is moderate). 1 This recommendation is supported by the accompanying evidence review that evaluated the benefits and harms of primary care-relevant interventions to prevent perinatal depression. 2 Perinatal depression, defined as a major or minor depressive episode that occurs during pregnancy or within the postpartum year, affects approximately 11.5% of new mothers annually in the United States, 3 representing a substantial burden for women and families. In addition to risks to the mother, there are important risks for the infant associated with antenatal depression, including preterm birth, low birth weight, and longer-term temperament and behavioral problems. 4,5 Postpartum depression also is associated with short-and longer-term risk factors for the infant, including effects on bonding and attachment, success of breastfeeding, cognitive and social development, and the risk of future psychopathology. 6 Therefore, the targeted prevention of perinatal depression is important, and if done successfully will improve a broad range of outcomes for women and their children.The USPSTF previously recommended broad screening for acute depression among adults, including pregnant and postpartum women. 7 The current recommendation advances the previous more broad recommendation by focusing on prevention rather than screening for acute illness, and the recommendation calls for a specific treatment intervention. 1 The recommendation to refer women at risk for perinatal depression to counseling is based on evidence from clinical trials. The task force completed a rigorous review of clinical studies to prevent perinatal depression, including psychotherapies, antidepressants, and complementary and alternative medicines. Fifty studies (49 randomized clinical trials, 1 nonrandomized controlled intervention study) met inclusion criteria. Counseling or psychotherapeutic interventions were the most widely studied and were demonstrated to be associated with a lower likelihood of onset of perinatal depression. Other treatment modalities were not supported

A Mobile Health Mindfulness Intervention for Women With Moderate to Moderately Severe Postpartum Depressive Symptoms: Feasibility Study

“…Highlighting the need for such studies is the recent recommendation by the United States Preventive Services Task Force to refer all women at increased risk of perinatal depression to counseling services. Implementing this recommendation will place a tremendous burden on the health care system, which already has a shortage of mental health care providers [69][70][71][72][73][74]. Thus, the findings from this study support the need for pragmatic trials, which will provide evidence on the effectiveness of implementing low-cost, technology-based programs for women with moderate to moderately severe PPD symptoms, which are necessary for improving the health of families.…”

Trajectories of perinatal depressive symptoms in the context of the COVID‐19 pandemic

“…Notably, these rates are two to three times those reported by Gavin et al, (2005) in their systematic review of the prevalence of perinatal depression, which highlights the significant burden of perinatal depression during the pandemic. This is of particular concern given that prior to the COVID-19 pandemic, the high prevalence of psychopathology among perinatal women (Ko et al, 2017) lead to recommendations by the US Preventive Services Task Force to screen all perinatal individuals for depression risk and refer for services as indicated (Curry et al, 2019;Freeman, 2019). The 11% discrepancy between our point-prevalence estimates and the period-prevalence estimates highlights the need for repeated assessment of depression during the perinatal period in order to accurately identify and treat women at risk.…”

Hippocampal miRNA-144 Modulates Depressive-Like Behaviors in Rats by Targeting PTP1B

“…Depression is a type of mental disorder mainly characterized by low mood, which seriously affects the quality-of-life of patients. 33 Long-term external stress was found to be a major contributor to depression. 34 The hippocampus is the central brain region that receives long-term external stress and plays an important role in the development of depression.…”