Article

Perinatal risks of untreated depression during pregnancy

The Hospital for Sick Children and the Department of of Pharmacology, University of Toronto, Toronto, Ontario.
Canadian journal of psychiatry. Revue canadienne de psychiatrie (Impact Factor: 2.41). 12/2004; 49(11):726-35.
Source: PubMed

ABSTRACT To review the literature on the perinatal risks involved in untreated depression during pregnancy.
We searched Medline and medical texts for all studies pertaining to this area up to the end of April 2003. Key phrases entered were depression and pregnancy, depression and pregnancy outcome, and depression and untreated pregnancy. We did not include bipolar depression.
While there is wide variability in reported effects, untreated depression during pregnancy appears to carry substantial perinatal risks. These may be direct risks to the fetus and infant or risks secondary to unhealthy maternal behaviours arising from the depression. Recent human data suggest that untreated postpartum depression, not treatment with antidepressants in pregnancy, results in adverse perinatal outcome.
The biological dysregulation caused by gestational depression has not received appropriate attention: most studies focus on the potential but unproven risks of psychotropic medication. No in-depth discussion of the role of psychotherapy is available. Because they are not aware of the potentially catastrophic outcome of untreated maternal depression, this imbalance may lead women suffering from depression to fear teratogenic effects and refuse treatment.

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    • "Results of antidepressant reproductive safety studies, however , have been inconclusive or conflicting (Einarson and Einarson 2005; Hemels et al. 2005; Koren and Nordeng 2012), and many adverse neonatal outcomes associated with fetal antidepressant exposure have also been linked with untreated gestational depression (Bonari et al. 2004; Wisner et al. 2009b), causing uncertainty about the risks versus benefits of antidepressant use in pregnancy (Kuehn 2009). "
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    • "Untreated perinatal depression and anxiety may have potentially adverse consequences for the mother and child. Women who are depressed engage in more high-risk behaviours and are less likely to receive adequate prenatal care (Bonari et al., 2004). Their pregnancies are more likely to end prematurely, result in operative deliveries, and have more obstetrical complications (Chung et al., 2001). "
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