Perinatal depression can be prevented

Mental health is essential for everyone including pregnant women. Perinatal or pregnancy depression affects about 1 in 8 new mothers annually in the United States. It can have a devastating effect on the mother as well as the infant.

Risk factors that can be used to identify individuals at risk for perinatal depression include:

  • a history of depression
  • history of physical or sexual abuse
  • unplanned or unwanted pregnancy
  • stressful life events
  • intimate partner violence
  • complications during pregnancy

Additionally, low socioeconomic status, lack of social support, and bearing children during adolescence have been associated with a greater risk of developing perinatal depression after delivery.

The Edinburgh postpartum depression test can screen effectively for your risk of having postpartum depression.

In addition, the interactive Zhung Self-Rating Depression Scale Quiz checks the level of depression to help decide how severe it could be.

Coronavirus 2019-COVID & Pregnancy

Pregnancy and Coronavirus COVID-19

UPDATE AS OF February 2020

There is still much unknown about 2019-COVID and pregnancy. Probably for now the best and most recent answers on 2019-COVID and pregnancy can be found on the CDC website.

On 2/3/2020 it was reported that a pregnant woman with Coronavirus infection was delivered by cesarean section in China at 37 weeks. Both mother and baby are doing well.

On 2/12/2020 The Lancet reported on 9 cases of COVID-19 in the third trimester pregnant women. All were delivered by cesarean section. Symptoms of COVID-19 infections in pregnant women were similar to non-pregnant individuals. There was no evidence for intrauterine infection in these 9 cases caused by transmission from the women to the baby. Also, there is no evidence that a cesarean delivery is needed to protect the mother or the fetus.

In February 2020, most information we have on pregnancy and coronavirus derives from information on MERS and SARS coronaviruses.

One was a report of 5 pregnant women from Saudi Arabia which concluded that MERS-CoV may pose serious health risks to both mothers and infants during pregnancy. Two of the 5 mothers infected with the virus died.

Pregnant women with severe acute respiratory syndrome (SARS) appear to have a worse clinical outcome and a higher mortality rate compared to non-pregnant women.

Though there were a limited number of pregnant women among these cases, it seems pregnant women are more likely to become infected and those who became infected with SARS were more likely to get sick.

Pregnancy is a time of low immune function which generally includes:

  • older people
  • diabetics
  • people with HIV infection
  • people with long-term use of immunosuppressive agents
  • pregnant women

What pregnancy complications result from donated eggs?

A study published in the American Journal of Obstetrics and Gynecology revealed complications associated with pregnancy with a maternal age of 44 and over. The study involved about 80,000 women in which about 175 women aged 45 and over  gave birth, many of these births resulted from the use of egg donors.

These older women had a higher incidence of maternal complications than younger counterparts. About 17% of the older women were diagnosed with gestational diabetes as compared to only 6% of younger women. Higher blood pressure was a problem for 9% of older women but only 3% of younger pregnant participants. The rate of C-section also doubled in the older population.

In addition to complications during pregnancy, older women presented with an increased rate of complications after birth including fever, excessive bleeding, extended stays in the hospital and more occurrences of intensive care. Infants born to older mothers even showed decreased health with metabolic problems reported in 4% of the newborns born to older mothers compared to 2% born to younger mothers.

 

 

Infertility treatment may increase the risk of maternal morbidity and mortality in pregnancy

A study published in the Canadian Medical Association Journal (CMAJ) reported that women who became pregnant with infertility treatment (e.g. ovulation induction, intrauterine insemination or in vitro fertilization with or without intracytoplasmic sperm injection) showed an increased risk of maternal morbidity or maternal death (30.8 per 1,000 in infertility treatment women versus 22.2 per 1,000 in women who became pregnant unassisted).

According to this publication:

“Severe maternal morbidity refers to a broad set of conditions that identify women who experience a near-fatal event during, or within 42 days of a pregnancy. The association between assisted reproductive technologies and severe maternal morbidity has been investigated recently in 3 studies in the United States, each reporting an approximate doubling of the risk of severe maternal morbidity among women with pregnancies conceived through assisted reproductive technologies compared to those with pregnancies conceived without.”

Wang ET, Ozimek J, Greene N, et al. Impact of fertility treatment on severe maternal morbidity. Fertil Steril 2016;106:423–6.Google Scholar
Belanoff C, Declercq ER, Diop H, et al. Severe maternal morbidity and the use of assisted reproductive technology in Massachusetts. Obstet Gynecol 2016; 127:527–34.Google Scholar
Vandenbroucke JP, von Elm E, Altman D, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Epidemiology 2007;18:805–35.CrossRefPubMed. Google Scholar