title: Depression during Pregnancy.
abstract: A proportion of women enter pregnancy with active psychiatric symptoms or disorders, with or without concomitant psychotropic medication. Studies report that exposure to untreated depression and stress during pregnancy may have negative consequences for birth outcome and child development. Studies also report that antenatal exposure to antidepressant medications may have adverse consequences for birth outcome and child development. Antidepressant medication use during pregnancy leads to a small increased risk of miscarriage, a possible small increased risk of congenital cardiac malformations, a small increased risk of preterm birth, a small increased risk of persistent pulmonary hypertension of the newborn (PPHN), and transient neonatal symptoms in up to one-third of neonates. In addition, there is a possible increased risk of delayed motor development in children. Several recent systematic reviews and meta-analyses of the existent literature emphasize that there are minimal definitive conclusions to guide treatment recommendations. This review describes best practices for the management of depression in pregnancy, and it provides suggestions for future research.
authors.affiliation: Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Women's Behavioral Medicine, Women's Medicine Collaborative, 146 West River Street, Providence, RI 02904, USA. Electronic address: Teri_Pearlstein@brown.edu.
authors.forename: Teri
authors.initials: T
authors.lastname: Pearlstein
mesh_terms: D000928:Antidepressive Agents / Q000009:adverse effects / Q000145:classification / Q000627:therapeutic use*; D001007:Anxiety / Q000523:psychology; D002657:Child Development; D000013:Congenital Abnormalities / Q000453:epidemiology; D003863:Depression / Q000188:drug therapy* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D010547:Persistent Fetal Circulation Syndrome / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology*; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000453:epidemiology; D011297:Prenatal Exposure Delayed Effects; D013315:Stress, Psychological / Q000523:psychology
chemical_list: D000928:Antidepressive Agents
keywords: antidepressant; congenital malformation; depression; miscarriage; persistent pulmonary hypertension of the newborn; pregnancy