"The biggest news here is that we need to manage depression as a chronic condition in women of childbearing age, rather than assume depression is a temporary condition that can be either triggered or relieved by getting pregnant or giving birth," Whitlock said. "Women with a history of depression should be closely monitored for depressive symptoms during prenatal and postpartum care. And, given recent evidence showing that relapse of depression is twice as common in pregnant women with major depression who stop taking antidepressants after becoming pregnant as women who continue treatment, a choice of effective and safe treatment options for depressed pregnant women is very important."
The study also found that 93.4 percent of the women identified with depression before, during, or after pregnancy had a mental health visit or received antidepressants. Nearly three-fourths of depressed women received an antidepressant -- 77 percent before pregnancy, 67 percent during pregnancy and 82 percent after delivery. Selective serotonin reuptake inhibitor antidepressants (SSRIs) were the most common type of antidepressants prescribed, and 180 women (4 percent of all pregnant women) received them during pregnancy. The authors note that women received these medications before concerns were publicized about possible effects of SSRIs on persistent pulmonary hypertension in newborns and on cardiovascular malformations.
The study was funded by a contract from the Centers for Disease Control and Prevention. The contract as administered by America's Health Insurance Plans. The study's authors are affiliated with the Centers for Disease Control and Prevention or with Kaiser Permanente's Center for Health Research.
About Kaiser Permanente
Kaiser Permanente is America's leading integrated health plan. Founded
in 1945, it is a not-for-profit; group practice prepayment program
headquartered in Oakland,
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