Depression in pregnancy: drug safety and nursing management.
Women who are already predisposed to depression are at increased risks during pregnancy because of endocrine changes; untreated depression in pregnant women might lead to adverse effects for both mothers and infants. This article examines outcomes associated with the use of antidepressants during pregnancy and identifies how nurses can help depressed pregnant women. It is recommended that pregnant women who have mild depression be treated with nonpharmacologic therapy, such as counseling, cognitive-behavioral therapy, or interpersonal psychotherapy. Current appropriate treatment for pregnant women with moderate and severe depression is antidepressant medication, although there is no consensus on the best antidepressants for use in pregnancy. Thus, the psychotropic drug must be chosen carefully to minimize negative effects on infants and mothers, for some studies have demonstrated deleterious effects on infants. Nurses in multiple settings who interact with pregnant women should be aware of the necessity of screening for depression. Nurses in antenatal care settings can refer appropriately screened women to mental health specialists; psychiatric nurse practitioners can identify suitable interventions based on potential risks and benefits to maternal and infant health.
Suppaseemanont
Wantana
W
School of Nursing, Saint Louis University, USA. suppasee@yahoo.com
D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003866:Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000451:nursing; D002658:Developmental Disabilities / Q000139:chemically induced / Q000517:prevention & control; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008403:Mass Screening; D016389:Maternal-Child Nursing / Q000379:methods*; D008431:Maternal-Fetal Exchange / Q000187:drug effects; D009357:Neonatal Abstinence Syndrome / Q000209:etiology / Q000517:prevention & control; D009722:Nurse Practitioners; D024802:Nurse's Role; D009730:Nursing Assessment; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000188:drug therapy / Q000451:nursing; D011256:Pregnancy Outcome; D011295:Prenatal Care / Q000379:methods*; D011568:Psychiatric Nursing; D011613:Psychotherapy; D012017:Referral and Consultation; D012307:Risk Factors; D017751:Safety Management; D012720:Severity of Illness Index
D000928:Antidepressive Agents