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New Recommendations for Treating Depression During Pregnancy

Depression is common during pregnancy-between 14 percent and 23 percent of pregnant women will experience depressive symptoms while pregnant. In 2003, approximately 13 percent of women took an antidepressant at some time during their pregnancy.

A new report from the American College of Obstetricians and Gynecologists (ACOG) and the American Psychiatric Association (APA), based on an extensive review of existing research, offer recommendations for the treatment of women with depression during pregnancy.

During Pregnancy

Both depression symptoms and the use of antidepressant medications during pregnancy have been associated with negative consequences for the newborn.

Infants born to women with depression have increased risk for irritability, less activity and attentiveness, and fewer facial expressions compared with those born to mothers without depression. Depression and its symptoms are also associated with fetal growth change and shorter gestation periods. And while available research still leaves some questions unanswered, some studies have linked fetal malformations, cardiac defects, pulmonary hypertension, and reduced birth weight to antidepressant use during pregnancy.

Identifying depression in pregnant women can be difficult because its symptoms mimic those associated with pregnancy, such as changes in mood, energy level, appetite, and cognition.

According to the report, some patients with mild-to-moderate depression can be treated with psychotherapy (alone or in combination with medication. In addition, the report discusses the need for ongoing consultation between a patient’s ob-gyn and psychiatrist during pregnancy and presents algorithms for treating patients in common scenarios:

Women Thinking About Getting Pregnant

Pregnant Women Currently on Medication for Depression

Pregnant and not currently on Medication for Depression

For All Pregnant Women

SOURCE: American College of Obstetricians and Gynecologists and the American Psychiatric Association.

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