Doctors need to be more proactive in diagnosing the condition, study says
FRIDAY, Sept. 28 (HealthDay News) -- One in seven women suffers from depression before, during or after pregnancy, a new study finds.
The consequences of depression can be devastating to the mother, her baby and her entire family, according to the report in the October issue of The American Journal of Psychiatry.
"The prevalence of women diagnosed with depression before, during and after pregnancy was pretty similar," said lead author Patricia Dietz, an epidemiologist at the U.S. Centers for Disease Control and Prevention's Division of Reproductive Health.
"There are a lot of women who are becoming pregnant with depression, and that's really important for people providing prenatal care to be aware of," she said.
Screening for depression needs to occur during pregnancy and right afterward, Dietz said.
The consequences of postpartum depression, which affects 400,000 women in the United States, can be significant. It can inhibit a woman's ability to bond with her baby, relate to the child's father, and perform daily activities, according to background information for the study.
For the study, sponsored by Kaiser Permanente, Dietz's team collected data on 4,398 women who gave birth between 1998 and 2001. They found that 8.7 percent of the women experienced depression in the nine months before pregnancy, 6.9 percent during pregnancy, and 10.4 percent in the nine months following childbirth.
Some 15.4 percent of the women were depressed during at least one of these periods. Almost 75 percent of women with postpartum depression also suffered from depression before pregnancy. And more than 50 percent of women who were depressed before pregnancy were depressed during pregnancy, Dietz said.
"For many women, it's a chronic condition," she said.
In addition, 93.4 percent of the women who were diagnosed with depression before, during or after pregnancy had seen a mental health professional or were taking antidepressants.
Among women with depression, 75 percent had taken antidepressants -- 77 percent before pregnancy, 67 percent during pregnancy and 82 percent after delivery, the researchers found.
Women should report any signs of depression to their doctor, Dietz said.
"There is effective treatment out there for women. You are supposed to be elated when you've had a baby. It is sometimes difficult to even bring depression up," she said. "But doctors should ask."
Dr. David L. Katz, director of Yale University School of Medicine's Prevention Research Center, said the finding that depression is very common before and after, as well as during, pregnancy is of clear importance.
"There are two potential explanations. Either the challenges of pregnancy -- from hormonal changes to psychological adjustment -- induce depression, or the medical monitoring that occurs around the time of pregnancy identifies depression that otherwise would have gone undiagnosed. Of course, both factors may be in play," he said.
There are opportunities for prevention if pregnancy is causing depression, Katz said. "If pregnancy is merely unmasking depression in the population at large, it highlights the need to screen more effectively. Finding depression is prerequisite to treating it," he said.
Dietz thinks that before a woman starts a program of antidepressants, she should discuss the risks and benefits with her doctor.
According to the March of Dimes, a woman who is depressed feels sad or "blue" for two weeks or longer. Other symptoms of depression include:
To learn more about depression and pregnancy, visit the March of Dimes.
SOURCES: Patricia Dietz, Dr.P.H., epidemiologist, Division of Reproductive Health, U.S. Centers for Disease Control and Prevention, Atlanta; David L. Katz, M.D., M.P.H., director, Prevention Research Center, Yale University School of Medicine, New Haven, Conn.; October 2007, American Journal of Psychiatry
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