Recognizing maternal mental health disorders: beyond postpartum depression

Abstract

Purpose of review Maternal mental health disorders, including anxiety and depression, are one of the most common obstetric complications, presenting in pregnancy and postpartum. Recent findings Maternal mental health disorders are associated with adverse maternal and neonatal outcomes. Screening women in pregnancy and postpartum for mental health disorders is key to early identification and treatment of anxiety and depression in the perinatal population. Although universal screening is now recommended by numerous professional organizations, rates of screening are low and often not performed with a validated screening instrument. Although clinical assessment is important, it is insufficient to identify maternal mental health disorders. As symptoms may change throughout pregnancy, screening for anxiety and depression should be done at multiple time points in pregnancy, including intake and postpartum. In addition, it is important to complete a mental health history on intake to identify women who are either at risk for, or experiencing, anxiety and depression. All screening programmes must be accompanied by a protocol to respond to a positive screen to ensure appropriate follow-up and treatment. Summary Identification and treatment of maternal mental health disorders has important implications for maternal and child health. Obstetric providers should screen all women using a validated screening instrument and have systems in place to ensure timely diagnosis and treatment.

Impact of the COVID-19 Pandemic on Maternal Anxiety in Brazil

“…This outbreak is leading to additional worldwide health problems, such as stress, anxiety, depressive symptoms, insomnia, denial, anger and fear [7][8][9][10][11]. The COVID-19 pandemic has also increased anxiety among the pregnant population [12].…”

Relationship between postpartum depression and lactation status at a Japanese perinatal center: A cross-sectional study

“…Exclusive breastfeeding for the first 6 months of life has been recommended because of important health, medical, social, and developmental benefits to both mothers and babies 1 . Postpartum depression has been recognized as the leading medical complication among new mothers 2,3 . To date, some risk factors for postpartum depression, such as personal and family factors, socioeconomic status, support from other family members and personal plans for furthering careers, have been examined 4-8 .…”

Perspectives on Early Screening and Prompt Intervention to Identify and Treat Maternal Perinatal Mental Health. Protocol for a Prospective Multicenter Study in Italy

“…Typically, this situation tends to resolve itself naturally, however, where there is a wide gap between expectations or resources and the reality of motherhood, psychological difficulties or mental health disorders can be consolidated or even worsen (Sipsma et al, 2016). Moreover, this situation has consequences on a larger scale because, during the perinatal period, the wellbeing and mental health of the mother, father and baby are closely interrelated (Yeaton-Massey and Herrero, 2019). Indeed, parental perinatal complications can interfere with the parentchild relationship, with the risk of significant consequences over the years (Cirulli et al, 2003;Milgrom et al, 2006;Meneghetti, 2007Meneghetti, , 2011Branchi et al, 2013;Stefana and Lavelli, 2017) for the child's cognitive, social and emotional development (Kim-Cohen et al, 2005).…”

“…The most common perinatal mental disorders in women during pregnancy and postpartum are depressive syndromes and anxiety syndromes: non-psychotic disorders characterized by the specific feelings and thoughts about the parental role (Robinson and Stewart, 2001). The global prevalence of clinically significant maternal perinatal depression ranges from 10 to 20% (Korja et al, 2018;Earls et al, 2019), while the prevalence of perinatal anxiety disorders ranges from 10 to 24% (Dennis et al, 2018;Yeaton-Massey and Herrero, 2019). Furthermore, the comorbidity of mood disorder and anxiety disorder in perinatal women is common (Falah-Hassani et al, 2016), reaching 40% in some studies (Reck et al, 2008;Austin et al, 2010), but often under-diagnosed (Misri and Swift, 2015).…”