Depression during the first year postpartum (postpartum depression) impacts millions of women and their families worldwide. In this narrative review, we provide a summary of postpartum depression, examining the etiology and consequences, pharmacological and psychological treatments, and potential mechanisms of change and current barriers to care. Psychological treatments are effective and preferred by many perinatal patients over medications, but they often remain inaccessible. Key potential mechanisms underlying their effectiveness include treatment variables (e.g., dosage and therapeutic alliance) and patient behaviors (e.g., activation and avoidance and emotional regulation). Among pharmacological treatments, the selective serotonin reuptake inhibitor (SSRI) sertraline is generally the first-line antidepressant medication recommended to women in the postpartum period due to its minimal passage into breastmilk and the corresponding decades of safety data. Importantly, most antidepressant drugs are considered compatible with breastfeeding. Neurosteroids are emerging as an effective treatment for postpartum depression, although currently this treatment is not widely available. Barriers to widespread access to treatment include those that are systematic (e.g., lack of specialist providers), provider-driven (e.g., lack of flexibility in treatment delivery), and patient-driven (e.g., stigma and lack of time for treatment engagement). We propose virtual care, task-sharing to non-specialist treatment providers, and collaborative care models as potential solutions to enhance the reach and scalability of effective treatments to address the growing burden of postpartum depression worldwide and its negative impact on families and society.
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http://dx.doi.org/10.1007/s40265-024-02038-z | DOI Listing |
Best Pract Res Clin Anaesthesiol
September 2024
Department of Anesthesiology, University Hospital Basel, Basel, Switzerland.
The issue of obesity continues to reach new levels globally, affecting individuals across the age continuum. Obesity in pregnancy is associated with myriad comorbidities which may negatively impact the fetus, particularly dysfunctional labor and failure to progress ending in unplanned cesarean delivery. Neuraxial anesthesia represents the gold standard for cesarean delivery anesthesia and is increasingly beneficial for obese patients due to the risk of difficult airway.
View Article and Find Full Text PDFAfr J Reprod Health
December 2024
Department of Nursing Obstetrics and Gynaecology Nursing Department, Istanbul-Turkey.
This was a randomised controlled study to investigate the effect of web-based breastfeeding education given to primiparous pregnant women on postpartum breastfeeding. The study included a total of 120 primiparous pregnant women, including control group (n:60) and experimental group (n:60). The study was conducted in a district in northern Turkey.
View Article and Find Full Text PDFInternet Interv
December 2024
Center for Community Health, Northwestern University Feinberg School of Medicine, United States of America.
Background: Depression that occurs in pregnancy or postpartum (perinatal depression) impacts 1 in 5 mothers, yet access to effective and high-quality preventative interventions remains elusive for most. Digital interventions are a promising solution to this treatment gap because of the ubiquity of mobile devices and internet access. The Mothers and Babies Online Course (eMB) is an online adaptation of Mothers and Babies, an evidence-based preventative program for postpartum depression.
View Article and Find Full Text PDFIssues Ment Health Nurs
January 2025
Department of Applied and Computational Mathematics and Statistics, University of Notre Dame, Notre Dame, Indiana, USA.
To decrease the high rates of mental health-related maternal morbidity and mortality among rural-dwelling women, it is critical to identify those experiencing postpartum depression (PPD) and provide necessary follow-up care. To effectively screen for PPD, clinicians must utilize instruments which account for context-specific factors and maintain validity across diverse populations. The Edinburgh Postnatal Depression Scale (EPDS) is the most commonly used depression screening tool in perinatal settings, but has not been validated for use within rural American settings.
View Article and Find Full Text PDFArch Womens Ment Health
January 2025
Centre of Excellence in Early Intervention and Family Studies, Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, Copenhagen K, DK-1353, Denmark.
Purpose: This study investigated whether maternal antenatal attachment (MAA) in the third trimester was associated with self-reported problematic infant crying at eight weeks postnatally and explored links with postnatal depressive symptoms.
Methods: A prospective cohort study was conducted with 1287 pregnant participants in Danish general practice. MAA was measured using the Maternal Antenatal Attachment Scale (MAAS) in the third trimester.
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