Review Maternal depression: risk factors and treatment options during pregnancy

Key content: Psychiatric illness was identified as the leading cause of indirect death in the fifth and sixth CEMACH reports; the decrease in the rate of suicide in the seventh report may indicate that previous recommendations are having a beneficial effect. Half of the women identified in the earlier reports had a history of serious mental illness. Depression during pregnancy is complex and difficult to treat. Learning objectives: To learn about the background diagnosis and management. Ethical issues: How aggressive should any active approach be to reduce the risk of maternal death? Can the use of pharmacological agents which can cause fetal toxicity and neonatal withdrawal problems be justified?