Adequate Treatment of Depression During Pregnancy Is Vital

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Treatment for Depression

Though options vary to decrease risk, depressive symptoms often remain untreated

Although depression during pregnancy confers substantial health risks, many women are reluctant to take antidepressants because of concerns about potential effects on the developing fetus. Finding treatment options that are acceptable to, and useful for, women during pregnancy is crucial, a University of Pittsburgh researcher reports in the August issue of the journal The Female Patient.

Studies show that up to 20 percent of pregnant women have significant symptoms of depression, yet only a fraction of them receive treatment, notes Katherine Wisner, M.D., professor of psychiatry and obstetrics and gynecology at the University of Pittsburgh School of Medicine and director of the Women's Behavioral HealthCARE program at Western Psychiatric Institute and Clinic.

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"Depression during childbearing is a major public health problem," said Dr. Wisner, senior author of the report. "Research must proceed aggressively to target ways to ensure that women who need it receive safe, appropriate treatment to allow them to be the best mothers possible."

Studies done over the past 10 years have pointed toward more evidence-based choices concerning management of depression during pregnancy so that risk-benefit analysis is clearer than ever before.

Some women decline to use antidepressants during pregnancy, while others are more concerned about the effects of depression on parenting skills. Others consider alternative treatments such as psychotherapy, bright light therapy, acupuncture, exercise or supplements of omega-3 fatty acids. Each therapy has potential benefits, Dr. Wisner writes.

"High maternal stress itself is significantly associated with lower birth weight and a greater risk of preterm birth. There is ample evidence that parenting while depressed carries its own risk of negative effects on children's cognitive and psychological development," she said. "Interventions should be considered in view of their capacity to maximize maternal wellness while minimizing toxicity to the developing fetus," said Dr. Wisner. "With physician input, each patient will make choices based on her own values and priorities."

Funding for this analysis was provided by the National Institute of Mental Health. For more information, visit http://www.womensbehavioralhealth.org

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