Depression accompanying pregnancy is a topic that receives less discussion than the well-documented postpartum depression.

Depression is not uncommon in pregnant women. Between 14 and 23 percent of pregnant women will experience a depressive episode while pregnant.

In 2003, approximately 13 percent of pregnant women took an antidepressant at some point during their pregnancy. According to background information in an article in the journal General Hospital Psychiatry, this rate has doubled since 1999. Many women go untreated due to concerns regarding the safety of treating pregnant women.

A variety of medical specialists collaborated on the report, “The management of depression during pregnancy: A report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists.”

These authors reviewed the world’s English-language literature and reported results describing the association of depressive symptoms and antidepressant treatment on fetal and neonatal outcomes.

Both depressive symptoms and antidepressant exposure were found to be associated with fetal growth changes and shorter gestations. Short-term neonatal irritability and neurobehavioral changes were also linked with both maternal depression and antidepressant treatment.

Some, but not all, studies reported low rates of fetal malformations with first trimester exposure, but there was no specific pattern of defects for individual medications or class of agents.

“This timely article by Yonkers and colleagues reviews the data on the potential effects of both anti-depressant medications and depressive symptoms on birth and fetal outcomes,” said Wayne J. Katon, MD, editor in chief of General Hospital Psychiatry.

Source: Elsevier