Implementing an inpatient postpartum depression screening, education, and referral program: a quality improvement initiative.

Background: Perinatal mood and anxiety disorders are common and may interfere with pregnancy, delivery, and the postpartum period. Best practice includes symptom screening, patient education, and appropriate referrals; however, many hospitals struggle to identify and support perinatal mood and anxiety disorders patients.

Objective: Therefore, the Cedars-Sinai Postpartum Depression Screening, Education and Referral Program was initiated and evaluated.

Vitamin D deficiency and depressive symptoms in pregnancy are associated with adverse perinatal outcomes.

Prenatal vitamin D deficiency and prenatal depression are both separately associated with adverse perinatal outcomes; however, to our knowledge no studies have investigated the effects of having both risk factors. Our objective was to determine to what extent vitamin D deficiency predicts adverse perinatal outcomes and whether elevated depressive symptoms in pregnancy places women at additional increased risk. This study was a secondary data analysis of prospective data collected from a cohort of pregnant women (N = 101) in an obstetric clinic of a large medical center.

Adverse Perinatal Outcomes and Postpartum Multi-Systemic Dysregulation: Adding Vitamin D Deficiency to the Allostatic Load Index.

Background Allostatic load (AL) is an index of multi-system physiological "wear-and-tear," operationalizing emergent chronic disease risk and predicting morbidity and mortality. AL has been proposed as an organizing framework for studying pregnancy outcomes and additional AL biomarkers for the study of maternal health would be valuable. Objectives To test whether adverse perinatal outcomes are associated with postpartum AL and if including vitamin D deficiency (serum 25(OH)D < 20 ng/ml) as an additional marker of postpartum AL increases the association.

Lower prenatal vitamin D status and postpartum depressive symptomatology in African American women: Preliminary evidence for moderation by inflammatory cytokines.

Vitamin D deficiency and elevated pro-inflammatory cytokines have each been associated individually with postpartum depression (PPD). African American women are at increased risk for prenatal vitamin D deficiency, inflammation, and prenatal and postpartum depressive symptoms, but biological risk factors for PPD in this population have rarely been tested. This prospective study tested whether low prenatal vitamin D status (serum 25-hydroxyvitamin D, 25[OH]D) predicted PPD symptomatology in pregnant African American women and whether high levels of prenatal inflammatory cytokines interacted with low 25(OH)D in effects on PPD symptoms.

Prenatal depression and adverse birth outcomes: an updated systematic review.

Complications related to preterm birth (PTB) and low birth weight (LBW) are leading causes of infant morbidity and mortality. Prenatal depression is a hypothesized psychosocial risk factor for both birth outcomes. The purpose of this systematic review was to examine evidence published between 1977 and 2013 on prenatal depression and risks of these primary adverse birth outcomes.

Pregnant women screening positive for depressive symptoms at 24-28 weeks may have increased risk of preterm birth but more precise research is needed.

Context: The prevalence of prenatal depression and anxiety ranges between 5% and 16% and the consequences are extensive. In addition to negative maternal effects, research points to detrimental fetal effects, and higher rates of PTB and LBW. Postpartum symptoms of depression and anxiety are often experienced by women prenatally and may lead to maternal suffering and parenting ineffectiveness.

Diagnosing premenstrual dysphoric disorder: the reliability of a structured clinical interview.

Premenstrual dysphoric disorder (PMDD), a diagnosis included for further study in the DSM-IV-TR (American Psychiatric Association 2000), lacks a structured interview. The reliability of a Structured Clinical Interview for DSM-IV-TR-Defined PMDD (SCID-PMDD) was assessed with 96 participants who spanned the full range of premenstrual problems. All individual SCID-PMDD items had high inter-rater agreement, and the overall reliability of diagnosis was high (kappa = 0.

Women and major depressive disorder: clinical perspectives on causal pathways.

Background And Aims: Epidemiological data on the prevalence of mood disorders demonstrate that major depressive disorder (MDD) is approximately twice as common in women as in men and that its first onset peaks during the reproductive years. We aimed to review key social, psychological, and biological factors that seem strongly implicated in the etiology of major depression and to focus on sex-specific aspects of depression, such as the role of a woman's reproductive life cycle in depressive symptomatology.

Methods: A review of the literature, from 1965 to present, was conducted.

Frontal EEG asymmetry and premenstrual dysphoric symptomatology.

Resting frontal electroencephalographic (EEG) asymmetry has been hypothesized to tap a diathesis toward depression or other emotion-related psychopathology. Frontal EEG asymmetry was assessed in college women who reported high (n = 12) or low (n = 11) levels of premenstrual negative affect. Participants were assessed during both the follicular and the late luteal phases of the menstrual cycle.