Treating depression in pregnancy

A new report from the American Psychiatric Association (APA) and the American College of Obstetricians and Gynecologists, which is published by Elsevier in the September-October 2009 issue of General Hospital Psychiatry, explores the management of pregnancy and depression.

Depression is not uncommon in pregnant women. Between 14 and 23% of pregnant women will experience a depressive disorder while pregnant. In 2003, approximately 13% of pregnant women took an anti-depressant at some point during their pregnancy. This rate has doubled since 1999. Many women go untreated due to concerns regarding the safety of treating pregnant women.

"The management of depression during pregnancy: a report from the American Psychiatric Association and the American College of Obstetricians and Gynecologists" describes results from an unusual collaboration of authors from the American Psychiatric Association and American College of Obstetricians and Gynecologists, as well as a consulting developmental pediatrician. These authors reviewed the world's English-language literature and reported results describing the association of depressive symptoms and anti-depressant treatment on fetal and neonatal outcomes.

Both depressive symptoms and anti-depressant 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 anti-depressant 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.

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This article is also published in the September 2009 issue of Obstetrics & Gynecology.

Notes to Editors:

Full text of the article mentioned above is available upon request. Contact Gretchyn Bailey at (215) 239-3719 or g.bailey@elsevier.com to obtain a copy or to schedule an interview. The article appears in General Hospital Psychiatry, September-October 2009, published by Elsevier.

About General Hospital Psychiatry

General Hospital Psychiatry is an international, peer-reviewed publication featuring original contributions which explore the many linkages among psychiatry, medicine, and primary care. In emphasizing a biopsychosocial approach to illness and health, the Journal provides a forum for professionals with clinical, academic, and research interests in psychiatry's role in the mainstream of medicine. In response to the unpredictable nature of contemporary life, the Journal explores the role of emergency psychiatry in addressing personal, social, political, and forensic responses to stress and trauma. Published six times per year, the Journal expands on traditional models of consultation-liaison, inpatient and outpatient services in the general hospital to address all aspects of ambulatory, inpatient, emergency, and community care. Its Editor-in-Chief is Wayne J. Katon, MD. General Hospital Psychiatry is available online at http://journals.elsevierhealth.com/periodicals/ghp/home.