Analysis: Pregnancy depression neglected

By ED SUSMAN, UPI Correspondent  |  May 7, 2007 at 8:10 PM
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SAN DIEGO, May 7 (UPI) -- About one in 10 women suffer depression during or immediately after pregnancy -- and much of the time that illness goes untreated or undertreated, medical researchers said Monday.

"Unfortunately, it seems that pre-natal and post-natal depression only gets attention in tragedies or when celebrities are involved," said Stanley Zinberg, vice president for practice activities for the American College of Obstetricians and Gynecologists.

"We screen for many diseases that occur far less often than peri-partum depression," Sharon Phelan, professor of obstetrics and gynecology at the University of New Mexico in Albuquerque, told United Press International.

Speaking at the 55th annual clinical meeting of the American College of Obstetricians and Gynecologists in San Diego, Phelan said depression is overlooked because it is assumed that pregnancy protects women from depression and that postpartum depression is within a woman's control. "These are unrealistic expectations and only add to the stigma associated with depression," she said.

In a study presented at the meeting Monday, researchers at the University of Louisville found that treatment of depression among pregnant women not only improved their depression, but also improved the women's ability to care for their children.

Cynthia Logsdon, professor of nursing, and colleagues studied 27 women out of a group of 106 patients diagnosed with depression and determined through videotape studies that eight weeks of treatment with either nortriptyline or sertraline resulted in improved mothering functions.

"Overall, mothering improved with antidepressant treatment," she explained in her presentation. When the mothers were being treated, they spent more time with their infants, said they were more gratified by their role as a mother and their efficacy in mothering also improved. She found no differences in effects with either drug.

"That is not a surprising result," Phelan told UPI. "We have seen similar outcomes with women on antidepressants. If you feel better, the sunny days seem brighter and it is easier to be a good parent to both the children you already have and to the new child."

In Florida, a statewide program has been under way for about five years to get obstetricians to screen for depression among their pregnant women. Paul Gluck, associate professor of obstetrics and gynecology at the University of Miami School of Medicine, said he took an informal survey of doctors in his area to see if an emphasis on screening would be necessary. He found that two of 50 doctors said they routinely screened women for depression.

When the program was emphasized the number of doctors doing screening increased to about 30. "We just recently did another survey and found we have some recidivism and only about 15 doctors said they regularly screened women," he told UPI. "It means we have to reinforce the notion that screening is important."

Phelan said she is confident in prescribing drugs known as selective serotonin reuptake inhibitors to women with peri-partum depression. In cases where these drugs are unsuccessful in controlling symptoms, she refers patients to psychiatrists.

"Depression during pregnancy and postpartum depression are hidden disease," she said. "You might expect a woman who had several children at home, is worried about the rent and has little social support to be at risk of depression, but not a woman from an upper middle class home with a husband, who has a good job and who knows where her next meal is coming from.

"But this disease hits everyone across all classes," she said.

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