Perinatal Risks of Untreated Depression during Pregnancy

Author:

Bonari Lori1,Pinto Natasha1,Ahn Eric1,Einarson Adrienne2,Steiner Meir3,Koren Gideon4

Affiliation:

1. Graduate student, Motherisk Program, The Hospital for Sick Children and the Department of Pharmacology, University of Toronto, Toronto, Ontario

2. Associate Director, Motherisk Program, The Hospital for Sick Children, Toronto, Ontario

3. Professor of Psychiatry, McMaster University, Hamiton, Ontario

4. Director, Motherisk Program, The Hospital for Sick Children, Toronto, Ontario; Professor, the Department of Pharmacology, University of Toronto. Toronto, Ontario; Ivey Chair in Molecular Toxicology, University of Western Ontario, London, Ontario

Abstract

Objective: To review the literature on the perinatal risks involved in untreated depression during pregnancy. Method: We searched Medline and medical texts for all studies pertaining to this area up to the end of April 2003. Key phrases entered were depression and pregnancy, depression and pregnancy outcome, and depression and untreated pregnancy. We did not include bipolar depression. Results: While there is wide variability in reported effects, untreated depression during pregnancy appears to carry substantial perinatal risks. These may be direct risks to the fetus and infant or risks secondary to unhealthy maternal behaviours arising from the depression. Recent human data suggest that untreated postpartum depression, not treatment with antidepressants in pregnancy, results in adverse perinatal outcome. Conclusion: The biological dysregulation caused by gestational depression has not received appropriate attention: most studies focus on the potential but unproven risks of psychotropic medication. No in-depth discussion of the role of psychotherapy is available. Because they are not aware of the potentially catastrophic outcome of untreated maternal depression, this imbalance may lead women suffering from depression to fear teratogenic effects and refuse treatment.

Publisher

SAGE Publications

Subject

Psychiatry and Mental health

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