In a new study published today at ScienceDirect, researchers concluded that Prenatal Depression restricts fetal growth. They also state that up to 18% of all pregnant women experience depression but when focusing specifically on lower socio-economic status and minority moms, the risk more than doubles to 40%. Babies born to depressed moms are more likely to have a smaller head circumference, low birthweight, arrive prematurely, and experience a certain level of growth retardation within their first year of life.
Many mothers, doctors, and family members will buy into the myth that all pregnant mothers are happy. Obviously the numbers beg to differ as do the mothers who experience depression during pregnancy. Moreso than mothers with Postnatal Mood Disorders, pregnant mothers struggling with depression or other mental illness face quite the quandary in seeking treatment. Many find themselves dismissed by their doctors or faced with taking anti-depressants which will affect their fetus as all medications do cross the placenta.
As with any decision, we must always remember to make an educated decision with the support of your physician and other professional advice. There are also risks v. benefits to consider. Yes, there are risks associated with taking medicine during pregnancy but most studies out there do not put this risk at a much higher rate than mothers who do not take anti-depressants.
There are resources for mothers and professionals alike to refer to when faced with this situation:
Mother Risk: A project of the Toronto Hospital for Sick Children, they are staffed and well informed regarding medications, herbs, etc, in pregnancy and the postpartum breastfeeding period.
University of Illinois @ Chicago Women’s Mental Health Program is designed to meet the unique needs of women with psychiatric disorders and life problems including during pregnancy and postpartum.
The Emory Women’s Mental Health Program, established in 1991, primarily focuses on the evaluation and treatment of emotional disorders during pregnancy and the postpartum period. The clinical program is complemented by both clinical and laboratory research into the causes of these conditions and their treatment.
I also want to take this opportunity to promote an upcoming teleclass over at Pampered Pregger and Beyond with Tiffani Lawton and Shoshana Bennett. The class starts tomorrow at 11am EST and will be taking an in depth look at her new book, Pregnant on Prozac. I would highly recommend participating if this topic is near and dear to your heart. Registration at the site is not required but the call is a long distance one. Callers will be muted during discussion and unmuted for Q&A so if you have little ones running around, don’t worry – they won’t be interrupting the flow. For more information, click here.
I am SO GLAD you do present articles like these. (By the way, you’ve been very active lately and I love it!)
From the first comment I had been wondering if you saw this type of research as an opportunity to encourage treatment-resistant mothers to go ahead and seek care. It seems this may be the case.
It is a great thing to be well-armed with knowledge and keep up the good work! We all become impassioned at times; this is the perfect fuel for our work.
I re-read my comments to be sure I did NOT make a statement regarding medications. I have never, in any format, said that women should not use psych meds and I will never do so. In fact, I recently visited a well-known psychiatrist who uses absolutely no medications in her practice and I was taken aback. Indeed, women need access to a range of treatments. It takes all different kinds of treatments to treat all different kinds of women.
The point I brought was that correlation does not imply causation. The author’s stated conclusion was a jump from ‘associated with prematurity’ to ’causes prematurity’.
Sneezing is associated with having a cold. Sneezing does not cause a cold, however. There have been several papers written lately that imply the authors have found THE cause of PMD. Stating a causal relationship is much different that implying a causal relationship might exist.
It used to be that most journal articles ended with a call for more research. Now, it seems most end with a declaration of having found a definitive answer. Research should never take it’s cues from popular culture, where fantastic claims are made without raising an eyebrow. Breakthroughs are wonderful, but the truth is that most research does not result in a breakthrough no matter how badly researchers want to be distinguished.
The discovery of correlation should be stated as such. That was my whole point and I said nothing about the use of psychiatric medications.
I apologize if my response came across that way (and I see that it did now that I am re-reading it). Please forgive me for this.
That being said, we both know to take research with a grain of salt and are very adept at finding both sides of the story. I do agree that research is neverending and exists in a very fluid environment. All I was attempting to do by presenting this research here was to allow for just that – the addition of knowledge of what these researchers found in their study. I have also experienced a depression during pregnancy that went untreated. I delivered early, my daughter was born with a birth defectand even today we struggle with her weight and diet, so yes, I may be a bit biased towards this particular study. I wish I had been aware of depression during pregnancy and can’t help but wonder sometimes if things would be different had I gone in for treatment during my pregnancy with her. But that’s in the past and I can only move forward, and in doing so, I want to make sure that women have access to information they need to have access to even if that means that not everyone will agree with the end result.
We must remember that correlation does not necessarily imply causation. The conclusion of the article stated the essence of this research:
Prenatal depression was associated with adverse perinatal outcomes, including premature delivery and slower fetal growth rates. Prenatal maternal cortisol levels appear to play a role in mediating these outcomes.
Prenatal depression WAS ASSOCIATED WITH, it may not CAUSE adverse outcomes. It may be untrue that PMDs are a cause of prematurity. What if it were something else causing both? What messages are women getting with the idea that their mood states can cause harm for babies? Is there something else underlying both disorders?
Many nutrtional factors are associated with both PMDs and premature birth. One example is Omega-3 fatty acids. These fats have been shown to prevent premature delivery.
Many other nutrients are linked to both mood and low birth weight.
PMDs and prematurity are probably correlated, just as epilepsy and PMDs probably are:
But we have to be careful not to ‘blame the mother’ in relaying this type of research. The authors could have crafted their title with sensitivity to mother’s needs, or at least to their moral responsibilities to the sharing of data- every researcher knows the rules against implying causation. The last thing a depressed new mother needs is the idea that her mood state caused her baby’s prematurity.
I agree that it may be possible that their depression during pregnancy may be due to an underlying cause such as nutritional deficiency; however; I disagree with the view regarding the presentation of the research. Yes, we do need to be sensitive to mother’s needs and emotional viewpoints, but to what extent should we go to protect them from facts they need to be aware of when deciding on treatment for depression? Yes, most pregnant women would much rather approach treatment in a natural manner to decrease the risk of AD or other psychiatric medicine affecting their babies but truth be told, some mothers DO need the medicine in order to correct what is going on with them. This research shows that depression does, as Shoshana stated earlier today in a teleclass at Pampered Pregger and Beyond, cross the placenta and affects the fetus. Her new book, Pregnant on Prozac, is proving to be a wonderful resource regarding the confusing labryinth women with mood disorders, mental illness or a history of mental illness too often find themselves pregnant or trying to get pregnant.
Pregnant women deserve to hear both sides of the story and enabled to make a powerful educated decision with (hopefully) her co-operative caretakers. We also must keep in mind that this research when reaching most pregnant women will hopefully be presented in a more compassionate manner, something which I’ve attempted to do here by giving additional resources for mothers and caregivers to go to with their answers about medication during pregnancy.
I love your passion and your heart for the natural approach and am always conscious of embracing all approaches towards Perinatal Mood Disorder Treatment. Thank you for sparking this conversation!