Millennial women are more likely than their mothers to experience antenatal depression, or depression during pregnancy, according to a JAMA Network Open Study. Prepartum depression is fairly common, affecting between 10 and 15% of pregnant women.1

“It’s estimated that about 1 in 7 pregnant women is depressed,” says Katherine L. Wisner, MD, professor of psychiatry and behavioral sciences and obstetrics and gynecology at Northwestern University in Evanston, Illinois. “The depression is a whole-body physiologic disorder that affects the pregnancy.”

The signs of depression in pregnancy can range from a loss of interest in pleasant activities and feelings of worthlessness to changes in appetite and fatigue, explains Amy Kranzler, PhD, attending psychologist in the department of psychiatry and behavioral sciences at Montefiore Medical Center/The University Hospital for Albert Einstein College of Medicine in New York City.

“The symptoms of depression during pregnancy are largely the same as depression that occurs in other times of life,” Dr. Kranzler says.  “The pregnant woman may also have worries about the delivery of her baby or about her inadequacy as a mother.”

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Pregnant women who have anxiety issues, who have an unplanned pregnancy, or who feel stressed about the well-being of the baby are at an increased risk for depression while pregnant, according to Mitchell S. Kramer, MD, FACOG, chairman of the department of obstetrics and gynecology at Northwell Health’s Huntington Hospital in Huntington, New Yorl. “Women who receive fertility treatment are at an increased risk as well,” he says. “They may worry about the effect of the treatment on the pregnancy and they may consider the pregnancy as a ‘premium’ pregnancy’.”

The JAMA Network Open Study comprised a two-generation cohort: mothers (first generation) and their daughters (second generation) who later got pregnant. Some 17% of the first generation mothers reported experiencing high depression symptoms, while 25% of the second generation reported being depressed while pregnant. The moms in both groups were between the ages of 19 and 24 when they were surveyed.

Why would younger moms like those in the JAMA Network Open Study be depressed? “We know that financial stress and inadequate support increase the risk of depression, and younger moms may be less likely to have those financial and interpersonal resources,” Dr. Kranzler says. “However, depression during pregnancy can affect women of all ages.”

Can Maternal Depression Affect an Unborn Baby?

If not treated, depression in a mom can adversely affect the baby, Dr. Kranzler says. “There are risks to the developing fetus,” she says. “When the mother is under stress, cortisol is produced and can adversely affect the baby’s development.” A baby of a depressed mother can be born too small or too early, according to the study.

Experts say that pregnant women suffering from depression should be aware that there are effective treatments to help them learn how to combat depression.

The JAMA Network Open Study says that the rate of depression in young pregnant women is higher than it was in the 1990s and that steps should be taken to provide support for these mothers-to-be. “The (study) findings highlight the need for increased screening and resources to support young pregnant women and minimize the potentially far-reaching impact of depression on mothers, their children, and future generations,” the study authors wrote.

Is There an Effective Treatment?

Both medication and psychotherapy are effective treatments for depression in pregnancy, experts say. What tends to happen, Dr. Krantzer says, is that when a woman finds out she is pregnant, she stops taking her psychiatric medication. Unfortunately, this is not necessarily indicated.

“There are risks involved with both medication and with untreated depression,” she says. “Pregnant women should always consult with a psychiatrist but oftentimes, especially in cases of severe depression, the benefits of antidepressants can outweigh the risks.”

In addition to medication, social support is crucial for a pregnant woman who is experiencing depression, Dr. Kranzler says. A formal support group may help, or simply connecting with peers and reaching out to friends can be key in helping a mom-to-be not feel isolated. Treatments like Interpersonal Psychotherapy and Cognitive Behavioral Therapy (CBT) have also been shown to be helpful. Bright morning light therapy may also be suggested, Dr. Wisner says.

To determine what course of treatment is best for you, have a discussion with your health care provider to discuss benefits and risks. The goal is to come up with a plan that is meant to optimize overall health for mother and baby, Dr. Wisner says.

New dads-to-be can really be on the frontline in terms of providing social support during a pregnancy, Dr. Kranzler says. “The men are also the ones to notice that there may be some depression going on, and to encourage women to speak to their doctor about it,” she says.

Does Depression End When the Baby is Born?

Depression in pregnancy typically does not resolve with delivery, Dr. Kramer says. “Depression is likely to get worse before it gets better, necessitating more aggressive treatment,” he says. That’s why it is so important to seek treatment sooner rather than later.”

For a free consultation about medication during pregnancy from a government-funded organization, visit MotherToBaby and for support and additional information, visit Postpartum Support International.

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Last Updated: Mar 7, 2019