Depression and Anxiety in Pregnancy
The Risk of Depression During Pregnancy
Managing anxiety and depression is never an easy task, but it can be particularly difficult during pregnancy. Given the higher rates of depression in women and the risk being so high during childbearing years, special precautions should be taken by women who might become pregnant, according to a new article by the Staff Psychiatrist for the Reproductive Life Stages Program at Women’s College Hospital in Canada.
The Dangers of Psychotropic Medications
Those facing depression are often given a variety of medications to help manage it. SSRIs are fairly common as are SNRIs and tricyclic antidepressants. Some are also given atypical antipsychotic agents. Previous studies have suggested that all of these medications can increase the risk of spontaneous abortion, congenital malformations, and cardiovascular malformations, as well as preterm births. Fishell’s work, though, suggested these previous studies had real underlying problems, and if the mother was concerned about the risk to the baby, she should have tests scheduled to keep an eye on development.
One actual risk to the baby that Fishell did cite was poor neonatal adaption syndrome, or PNAS. It occurs somewhere between four and thirty percent of babies, and research suggests it combines serotonin toxicity and discontinuation syndrome. Newborns display characteristics of it within a matter of hours after delivery. From hypertonia to tremors and difficulty eating, there are many symptoms; most babies, though, don’t need admission to a neonatal unit, as symptoms can disappear on their own. Fishell suggested, instead, that a three-day monitoring period before discharge was a must.
Fishell’s bigger conclusions were that women who planned to become pregnant should discuss the option of controlling depression and anxiety with a doctor before the pregnancy occurs. In some cases, psychotherapy would be better than medications, but in severe cases, medication should be carefully monitored.