Depression during pregnancy

Depression during pregnancy

The authors of this article present a case relating to a 34 year old woman who was admitted as a psychiatric inpatient for the treatment of depression following the birth of her second child. The woman had a history of depression and had tried to commit suicide 2 months after the birth of her baby. The authors go on to highlight the main issues involved in managing pregnant women with depression under the following headings:

• How common is depression during pregnancy?
• Who is at risk?
• How does pregnancy affect depression?
• How does depression affect the outcome of pregnancy?
• How is depression treated in pregnancy?
• What advice should be given about family planning?
• As pregnancy progresses

The main summary points (taken directly from the article) are provided below:

• Rates of depression are higher during pregnancy than at any other point during a woman's life
• About half of "postnatal" depression starts during pregnancy
• Two thirds of women with a history of recurrent depression will relapse during pregnancy if they discontinue their medications after conception
• Depression during pregnancy is associated with poorer obstetric outcomes, particularly preterm delivery
• Women who are depressed during pregnancy are more likely to smoke and drink alcohol and less likely to attend for antenatal obstetric care than women who are not depressed
• The treatment of depression during pregnancy must be considered individually for each woman, with the possibility of relapse and poorer obstetric outcomes balanced against the possible risks associated with taking antidepressant medication

Br Med J 2007; 334: 1003-5 (link to extract).