Depression In Pregnancy Undertreated?

Depression during pregnancy may too often be overlooked and undertreated, putting both mother and baby at risk.

A new study shows two-thirds of the pregnant women with depression aren't being treated for it with either drugs or talk therapy.

Researchers say depression affects between 10 percent and 15 percent of pregnant women and is the strongest risk factor for postpartum depression.

Depression during pregnancy can also make it harder for women to eat properly and get enough rest or prenatal care, which increases the risk of premature birth or low birth weight.

"These are women who meet the formal clinical criteria for the most severe form of depression," says researcher Heather Flynn, Ph.D., a psychologist at the University of Michigan, in a news release.

"No one would argue that these women would benefit from some form of intervention, but only 33 percent of them were [getting it]," she says.

Flynn says many pregnant women may not realize they're depressed or that their depressed feelings aren't normal during pregnancy.

"They attribute their fatigue, sleep, and other problems to pregnancy, or don't believe that they could be suffering from depression," she says.

"Others may suspect a problem but don't believe that treatment can work. But it can," says Flynn.

Common During Pregnancy

In the study, published in General Hospital Psychiatry, researchers surveyed more than 1,800 pregnant women in obstetricians' waiting rooms for symptoms of depression.

The results showed 276 of the women met the criteria for being at risk of depression.

They were then interviewed by a mental health professional to check for current or past depression and treatment history.

Overall, 17 percent were found to be in the throes of a major depression. Another 23 percent had a history of major depression, which put them at risk for a repeat episode.

Yet, the researchers found only 33 percent of those then experiencing major depression were receiving any treatment for it.

Of the 276 women at risk, only 20 percent were receiving any kind of treatment.

Researchers looked at the women receiving treatment for their depression. They found fewer than half of those who were taking antidepressants (either alone or in combination with talk therapy) had been taking them at the recommended dose for at least six weeks.

Most antidepressants must be taken for six to eight weeks to give relief.

Signs Of Depression

Researchers say many depressed pregnant women may write off their symptoms as a normal part of pregnancy.

But they say experiencing the following symptoms for two weeks or more may indicate depression that requires treatment:

  • Depressed mood
  • Decreased interest or pleasure in activities
  • Changes in appetite
  • Change in sleep pattern
  • Fatigue or loss of energy
  • Difficulty concentrating
  • Excessive feelings of worthlessness or guilt
  • Thoughts of suicide
  • Extreme restlessness
  • Irritability

    Pregnant women with symptoms of depression or who have a history of depression, should talk with their health care provider to discuss ways to ease their illness, such as medication, talk therapy, stress reduction, and exercise.

    SOURCES: Flynn, H. General Hospital Psychiatry, July-August 2006; Vol. 28: pp. 289-295. News release, University of Michigan Health System.

    By Jennifer Warner
    Reviewed by Louise Chang, MD
    © 2006, WebMD Inc. All rights reserved