• Français

Depression and other mood disorders

Maternal pregnancy complications


Some numbers

It is estimated that 1 in 5 women will experience an episode of major depression in their lives.

Mood disorders are common during pregnancy and the postpartum period, affecting an estimated 7% to 12% of women.

Women with bipolar disorder are at high risk of developing a mood disorder during the postpartum period. Sleep disorders experienced during pregnancy and the postpartum period may contribute to the onset of mood disorders.


Consequences on pregnancy and the postpartum period

Women with untreated mood disorders are at high risk for serious complications such as inability to take care of themselves and others, psychotic ideation, and even suicide and homicide.

Smoking, alcohol, and other drug use are common in this population, and this increases the risk of complications in the development of the fetus.

Psychiatric disorders such as bipolar disorder and schizophrenia are associated with serious pregnancy complications (perinatal death of the unborn child, low birth weight, and prematurity, among others).

Some medications used for these psychiatric conditions are associated with a risk of birth defects:

  • Mood stabilizing anticonvulsants (valproic acid and carbamazepine) and the standard treatment for bipolar illness (lithium).
  • Serotonin inhibitors such as paroxetine also appear to be associated with a risk of birth defects, particularly heart defects.
  • Serotonin inhibitors are also associated with a risk of persistent pulmonary hypertension in children.
  • There appears to be an association between in utero exposure to antipsychotic agents and neurodevelopmental delay. In addition, some antipsychotic agents are associated with an increased risk of gestational diabetes due to insulin resistance and the weight gain they can cause.

Diagnosis

Diagnosis is based on the presence of at least 5 of the 9 key symptoms for most of the day over a period of at least 2 weeks. Several scales are used to evaluate these symptoms: Edinburgh Postnatal Depression Scale (EPDS), Inventory of Depressive Symptomatology (IDS), or Primary Care Evaluation of Mental Disorders (PRIME-MD).


Follow-up care

Medical monitoring in the postpartum period should be done in collaboration with a psychiatrist, psychologist, nurse, and obstetrician.

The use of medication can be essential and necessary during pregnancy to ensure a favorable outcome for both the mother and the unborn child. However, caution should be exercised with the use of lithium because of its potential effects on the newborn, including difficulty breathing, neuromuscular complications, arrhythmias, and renal and hepatic dysfunction. Some experts recommend stopping lithium 24 hours before birth to avoid maternal complications of intoxication post-partum.

Breastfeeding is ideal for its nutritional, cognitive, and psychological benefits and protection against infections. Most drugs can be used during the lactation period, however it is important to check with the obstetrician and the pediatrician if breastfeeding is possible while taking any medication.


Prevention

To prevent birth defects, the use of folic acid (1 mg per day) is recommended during the periconceptional period.

Before becoming pregnant, make sure that you are managing any medical conditions well with the fewest medications possible and at the lowest doses possible.

Adopt healthy habits:

  • Do not use tobacco, alcohol and other illicit substances
  • Exercise or meditate and try to get plenty of sleep
Fiche par

Dre Lucie Morin

About this page
Updated on 12/18/2017
Created on 12/18/2017
Alert or send a suggestion
 

Every dollar counts!

Thank you for your generosity.

It is thanks to donors such as you that we are able to accelerate research discoveries, to heal more children every year and to continue to offer world-class care.

It is also possible to give by mail or by calling toll-free

1-888-235-DONS (3667)

Contact Us

514 345-4931

Legal

© 2006-2014 CHU Sainte-Justine.
All rights reserved. 
Terms of Use,  Confidentiality,  Security

Warning

All information contained within the CHU Sainte-Justine site should not be used as a substitute for the advice of a duly qualified and authorized medical practitioner or any other health professional. The information provided on this site is intended for educational and informational purposes only.

Consult your physician if you feel ill or call 911 for any medical emergency.

CHU Sainte-Justine