Depressed women should seek treatment - Pregnancy - research into effects of depression during pregancy on mother and child

USA Today (Society for the Advancement of Education), Feb, 2004

One in five pregnant women may be experiencing symptoms of depression, but few are getting help for them, a University of Michigan, Ann Arbor, study finds. Moreover, those with a history of depression any time before their pregnancy--about one in four--are almost twice as likely to show signs of depression while expecting.

The study reveals troubling under-diagnosis and -treatment of depression in pregnancy. Twenty percent of the women scored high on a standard survey of depression symptoms, but of those, just 13.8% were receiving any mental health counseling, drugs, or other treatment. Only about 24% of those who experienced depression in the last six months were receiving treatment during pregnancy.

Growing scientific evidence suggests that hormone imbalances associated with depression can affect the fetus or put a woman at higher risk of postpartum depression. Population-based evidence also has shown that babies of depressed mothers do worse at birth, and beyond, than other infants. Medications and psychotherapy can regulate the stress hormones and other brain chemistry involved in depression, helping alleviate women's symptoms, improve quality of life, and reduce chances of debilitating postpartum depression, self-harming acts, and suicide.

This moderating effect also may spare the fetus lasting repercussions. Studies have shown that babies born to depressed mothers have lower birth weights, higher risk of premature birth and birth complications, delayed cognitive and language development, and more behavioral problems. Scientists are beginning to speculate that these effects may be due in part to the unbalanced sea of hormones and reduced blood flow that these fetuses are exposed to in the womb. Even minor depression may affect the unborn child.

"A woman's childbearing years are also her highest-risk time for depression. Doctors used to think of pregnancy as a 'honeymoon' away from depression risk, but this is turning out to be a myth," says Sheila Marcus, clinical assistant professor of psychiatry. "We now know that the hormones and brain chemistry involved in depression are known to be affected by changes in other hormones related to pregnancy. And we know this may affect the fetus."

Research demonstrates that some standard depression treatments--including various antidepressant drugs--do not appear to increase the risk of birth defects. A few longer-term studies suggest that infants exposed to a number of antidepressants in pregnancy look very similar to their siblings who are not exposed, both in terms of IQ and learning difficulties.

Marcus and her colleagues hope their findings will help raise awareness among pregnant women, and their doctors and midwives, about the pressing need to recognize depression symptoms and seek treatment. "We need to educate women about the signs of depression, and encourage them to be open about how they're feeling during pregnancy and after delivery, rather than feeling guilty and embarrassed," she concludes.