title: Perinatal risks of untreated depression during pregnancy.
abstract: OBJECTIVE
  To review the literature on the perinatal risks involved in untreated depression during pregnancy.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: The Hospital for Sick Children and the Department of of Pharmacology, University of Toronto, Toronto, Ontario.
authors.forename: Lori
authors.initials: L
authors.lastname: Bonari
authors.forename: Natasha
authors.initials: N
authors.lastname: Pinto
authors.forename: Eric
authors.initials: E
authors.lastname: Ahn
authors.forename: Adrienne
authors.initials: A
authors.lastname: Einarson
authors.forename: Meir
authors.initials: M
authors.lastname: Steiner
authors.forename: Gideon
authors.initials: G
authors.lastname: Koren
mesh_terms: D000022:Abortion, Spontaneous; D001921:Brain / Q000378:metabolism / Q000503:physiopathology*; D003346:Corticotropin-Releasing Hormone / Q000378:metabolism; D003863:Depression / Q000378:metabolism / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D005316:Fetal Distress; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000378:metabolism / Q000503:physiopathology; D007231:Infant, Newborn; D007234:Infant, Premature; D010500:Perinatology; D010913:Pituitary-Adrenal System / Q000378:metabolism / Q000503:physiopathology; D011225:Pre-Eclampsia; D011247:Pregnancy / Q000523:psychology*; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012307:Risk Factors
chemical_list: D003346:Corticotropin-Releasing Hormone