Depression During Pregnancy
Anne D. Walling
(Australia–Australian Family Physician, July 2000, p. 663.) For most women, pregnancy is a time of well-being. However, a few women develop clinical depression during pregnancy and up to 14 percent of mothers become depressed during the postpartum period. The principal risk factor for pregnancy-related depression is a previous depressive episode plus life stress, particularly conflict related to pregnancy or motherhood. Becoming pregnant during a depressive episode is also a significant risk factor for ongoing depression. In general, the use of medication is decreased during the first trimester, but there is little evidence of teratogenicity associated with the tricyclic antidepressants or fluoxetine. In the final trimester, fluoxetine has been shown to cause prematurity and neonatal irritability. Many medications are also found in breast milk, leading some investigators to recommend close monitoring of infants for side effects, particularly those related to the use of selective serotonin reuptake inhibitors. Cognitive therapy and supportive strategies are strongly encouraged to help reduce or replace medication in patients who experience depression during pregnancy and the puerperium.
COPYRIGHT 2001 American Academy of Family Physicians
COPYRIGHT 2001 Gale Group