Perinatal Risks of Untreated Depression During Pregnancy

被引:370
|
作者
Bonari, Lori [1 ,2 ]
Pinto, Natasha [1 ,2 ]
Ahn, Eric [1 ,2 ]
Einarson, Adrienne [1 ]
Steiner, Meir [3 ]
Koren, Gideon [1 ,2 ,4 ]
机构
[1] Hosp Sick Children, Motherisk Program, Toronto, ON M5G 1X8, Canada
[2] Univ Toronto, Dept Pharmacol, Toronto, ON, Canada
[3] McMaster Univ, Hamilton, ON, Canada
[4] Univ Western Ontario, London, ON, Canada
来源
CANADIAN JOURNAL OF PSYCHIATRY-REVUE CANADIENNE DE PSYCHIATRIE | 2004年 / 49卷 / 11期
关键词
untreated depression; pregnancy outcome; perinatal development; etiology; prevalence; hypothalamo-pituitary-adrenal axis;
D O I
10.1177/070674370404901103
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Objective: To review the literature on the perinatal risks involved in untreated depression during pregnancy. Method: We searched Medline and medical texts for all studies pertaining to this area up to the end of April 2003. Key phrases entered were depression and pregnancy, depression and pregnancy outcome, and depression and untreated pregnancy. We did not include bipolar depression. Results: While there is wide variability in reported effects, untreated depression during pregnancy appears to carry substantial perinatal risks. These may be direct risks to the fetus and infant or risks secondary to unhealthy maternal behaviours arising from the depression. Recent human data suggest that untreated postpartum depression, not treatment with antidepressants in pregnancy, results in adverse perinatal outcome. Conclusion: The biological dysregulation caused by gestational depression has not received appropriate attention: most studies focus on the potential but unproven risks of psychotropic medication. No in-depth discussion of the role of psychotherapy is available. Because they are not aware of the potentially catastrophic outcome of untreated maternal depression, this imbalance may lead women suffering from depression to fear teratogenic effects and refuse treatment. (Can J Psychiatry 2004;49:726-735)
引用
收藏
页码:726 / 735
页数:10
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