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Psychiatric medications in pregnancy

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https://read.qxmd.com/read/30849358/maternal-self-harm-deaths-an-unrecognized-and-preventable-outcome
#1
REVIEW
Kimberly Mangla, M Camille Hoffman, Caroline Trumpff, Sinclaire O'Grady, Catherine Monk
Maternal mortality continues to be a public health priority in national and international communities. Maternal death rates secondary to medical illnesses such as cardiovascular disease, preeclampsia, and postpartum hemorrhage are well documented. The rates of maternal death secondary to self-harm, including suicide and overdose, have been omitted from published rates of maternal mortality, despite growing attention to the prevalence of perinatal mood disorders, estimated at up to 15% of pregnant and postpartum women in the United States...
March 5, 2019: American Journal of Obstetrics and Gynecology
https://read.qxmd.com/read/30794709/recurrence-of-depression-in-the-perinatal-period-clinical-features-and-associated-vulnerability-markers-in-an-observational-cohort
#2
Nina M Molenaar, Marlies E Brouwer, Astrid M Kamperman, Huibert Burger, Alishia D Williams, Witte J G Hoogendijk, Claudi L H Bockting, Mijke P Lambregtse-van den Berg
OBJECTIVE: Antidepressant medication is commonly used for the prevention of depression recurrence in the perinatal period, yet it is unknown what vulnerability markers may play a role in recurrence. The objective of the current study was to provide a descriptive overview of the associated characteristics of women who experienced a perinatal recurrence of depression despite ongoing antidepressant use, and further, to identify clinically measurable vulnerability markers associated with recurrence...
2019: PloS One
https://read.qxmd.com/read/30790331/associations-of-antepartum-suicidal-behaviour-with-adverse-infant-and-obstetric-outcomes
#3
Qiu-Yue Zhong, Bizu Gelaye, Elizabeth W Karlson, Paul Avillach, Jordan W Smoller, Tianxi Cai, Michelle A Williams
BACKGROUND: Relatively little is known about antepartum suicidal behaviour and pregnancy outcomes. We examined associations of antepartum suicidal behaviour, alone and in combination with psychiatric disorders, with adverse infant and obstetric outcomes. METHODS: We included 188 925 singleton livebirths from a retrospective cohort (1996-2016). Suicidal behaviour, psychiatric disorders, and outcomes were derived from electronic medical records. We performed multivariable logistic regressions with generalised estimating equations to estimate adjusted odds ratios (aOR) with 95% confidence intervals (95%CI)...
February 20, 2019: Paediatric and Perinatal Epidemiology
https://read.qxmd.com/read/30765329/the-psychopathology-of-nmdar-antibody-encephalitis-in-adults-a-systematic-review-and-phenotypic-analysis-of-individual-patient-data
#4
Adam Al-Diwani, Adam Handel, Leigh Townsend, Thomas Pollak, M Isabel Leite, Paul J Harrison, Belinda R Lennox, David Okai, Sanjay G Manohar, Sarosh R Irani
BACKGROUND: Early immunotherapy administration improves outcomes in patients with N-methyl-D-aspartate receptor (NMDAR)-antibody encephalitis. As most patients with NMDAR-antibody encephalitis present to psychiatrists, the psychopathology of NMDAR-antibody encephalitis needs to be clearly defined to encourage accurate clinical identification and prompt treatment. METHODS: For this systematic review, we searched PubMed for all studies published in English between Jan 1, 2005, and Oct 7, 2017, to identify individually reported adult patients (≥18 years) who satisfied consensus criteria for definite NMDAR-antibody encephalitis...
February 11, 2019: Lancet Psychiatry
https://read.qxmd.com/read/30758784/the-role-of-pre-peri-and-postnatal-risk-factors-in-bipolar-disorder-and-adult-adhd
#5
Franziska Tole, Juliane Kopf, Katrin Schröter, Viola Stella Palladino, Christian P Jacob, Andreas Reif, Sarah Kittel-Schneider
Gene-environment-development interactions are suggested to play a crucial role in psychiatric disorders. However, it is not clear if there are specific risk gene interactions with particular pre-, peri-, and postnatal risk factors for distinct disorders, such as adult attention-deficit-/hyperactivity disorder (aADHD) and bipolar disorder (BD). In this pilot study, the first aim was to investigate retrospective self-reports of pre-, peri-, and postnatal complications and risk factors from 126 participants (aADHD, BD, and healthy controls) and their mothers...
February 13, 2019: Journal of Neural Transmission
https://read.qxmd.com/read/30737767/trial-of-labor-after-cesarean-section-in-risk-pregnancies-a-population-based-cohort-study
#6
Sjur Lehmann, Elham Baghestan, Per Engebret Børdahl, Lorentz Muller Irgens, Svein Arvid Rasmussen
INTRODUCTION: In most pregnancies after a cesarean section, a trial of labor is an option. The objective of the study was to explore trial of labor and its failure in pregnancies with medical risk conditions, in a population with a high trial of labor rate. MATERIAL AND METHODS: In a cohort study (n=57 109), using data from the Medical Birth Registry of Norway 1989-2014, women with a second delivery after a first pregnancy cesarean section were included. Preterm, multiple, and non-cephalic deliveries were excluded...
February 8, 2019: Acta Obstetricia et Gynecologica Scandinavica
https://read.qxmd.com/read/30679959/low-empowerment-and-diabetes-regimen-distress-are-related-to-hba1c-in-low-income-type-1-diabetes-patients-in-a-brazilian-tertiary-public-hospital
#7
M S V M Silveira, A Moura Neto, A C Sposito, L Siminerio, E J Pavin
Background: Adults with type 1 diabetes (T1D) have a high risk of developing depressive symptoms and diabetes-related distress (DD). Low socioeconomic level is associated with increased risk of poor self-management, treatment difficulties and psychological distress. The goals of this study were to document the frequency of major depressive disorder (MDD), high depressive symptoms and high DD, to assess levels of empowerment and to determine the association with each of these measures and glycemic control in a low-income Brazilian sample of adults with T1D...
2019: Diabetology & Metabolic Syndrome
https://read.qxmd.com/read/30679192/-is-it-better-not-to-know-certain-things-views-of-women-who-have-undergone-non-invasive-prenatal-testing-on-its-possible-future-applications
#8
Hilary Bowman-Smart, Julian Savulescu, Cara Mand, Christopher Gyngell, Mark D Pertile, Sharon Lewis, Martin B Delatycki
Non-invasive prenatal testing (NIPT) is at the forefront of prenatal screening. Current uses for NIPT include fetal sex determination and screening for chromosomal disorders such as trisomy 21 (Down syndrome). However, NIPT may be expanded to many different future applications. There are a potential host of ethical concerns around the expanding use of NIPT, as examined by the recent Nuffield Council report on the topic. It is important to examine what NIPT might be used for before these possibilities become consumer reality...
January 24, 2019: Journal of Medical Ethics
https://read.qxmd.com/read/30646190/association-of-prenatal-exposure-to-valproate-and-other-antiepileptic-drugs-with-risk-for-attention-deficit-hyperactivity-disorder-in-offspring
#9
Jakob Christensen, Lars H Pedersen, Yuelian Sun, Julie Werenberg Dreier, Isabell Brikell, Søren Dalsgaard
Importance: Valproate is an antiepileptic drug (AED) used in the treatment of epilepsy and many other neurological and psychiatric disorders. Its use in pregnancy is associated with increased risks of congenital malformations and adverse neurodevelopment in the offspring and may be associated with an increased risk of attention-deficit/hyperactivity disorder (ADHD). Objective: To determine whether prenatal exposure to valproate and other AEDs is associated with an increased risk of ADHD in the offspring...
January 4, 2019: JAMA Network Open
https://read.qxmd.com/read/30643953/-perinatal-and-postnatal-treatment-of-traumatized-parents-with-mental-disorders-impact-on-parents-and-their-children
#10
REVIEW
Johanna Klinger-König, Hans J Grabe
BACKGROUND: In traumatized parents with mental disorders, pregnancy and related medical examinations can lead to high emotional distress and flashbacks and increase the already tense emotional situation. Besides psychiatric burdens, parental insecurity concerning dealing with and reduced sensitivity for the child often exist. The children themselves have a higher risk of being neglected or abused and to also develop mental disorders. OBJECTIVE: How does interventional research take the special needs of traumatized parents with mental disorders into account? What kind of interventions predominate and what impact do they have on parents and children? MATERIAL AND METHODS: Publications on perinatal and postnatal interventions for traumatized and mentally disordered parents were included in the review if at least one intervention was explicitly described, a parental trauma was discussed and the impact of the intervention on the parents and children was analyzed...
January 14, 2019: Der Nervenarzt
https://read.qxmd.com/read/30642952/barriers-and-stigma-experienced-by-gay-fathers-and-their-children
#11
Ellen C Perrin, Sean M Hurley, Kathryn Mattern, Lila Flavin, Ellen E Pinderhughes
BACKGROUND: Gay men have become fathers in the context of a heterosexual relationship, by adoption, by donating sperm to 1 or 2 lesbian women and subsequently sharing parenting responsibilities, and/or by engaging the services of a surrogate pregnancy carrier. Despite legal, medical, and social advances, gay fathers and their children continue to experience stigma and avoid situations because of fear of stigma. Increasing evidence reveals that stigma is associated with reduced well-being of children and adults, including psychiatric symptoms and suicidality...
February 2019: Pediatrics
https://read.qxmd.com/read/30630948/inflammatory-bowel-disease-and-new-onset-psychiatric-disorders-in-pregnancy-and-post-partum-a-population-based-cohort-study
#12
Simone N Vigod, Paul Kurdyak, Hilary K Brown, Geoffrey C Nguyen, Laura E Targownik, Cynthia H Seow, M Ellen Kuenzig, Eric I Benchimol
OBJECTIVE: Patients with inflammatory bowel disease (IBD) have an elevated risk of mental illness. We determined the incidence and correlates of new-onset mental illness associated with IBD during pregnancy and post partum. DESIGN: This cohort study using population-based health administrative data included all women with a singleton live birth in Ontario, Canada (2002-2014). The incidence of new-onset mental illness from conception to 1-year post partum was compared between 3721 women with and 798 908 without IBD, generating adjusted HRs (aHR)...
January 9, 2019: Gut
https://read.qxmd.com/read/30627950/risk-factors-for-postpartum-emergency-department-visits-in-an-urban-population
#13
Jean-Ju Sheen, Heather A Smith, Brian Tu, Ying Liu, Desmond Sutton, Peter S Bernstein
Objectives To identify risk factors associated with urban postpartum emergency department utilization. Methods This case-control study included 100 matched pairs of postpartum women who had delivered at a large, integrated urban medical system in Bronx, New York, in 2012-2013, with the cases having had an emergency department visit within 42 days of delivery. The cases, identified utilizing administrative and billing data, were matched 1:1 with controls by labor unit, delivery mode and date, excluding nonviable pregnancies...
January 9, 2019: Maternal and Child Health Journal
https://read.qxmd.com/read/30626235/neurodevelopmental-disorders-in-children-exposed-in-utero-to-synthetic-progestins-analysis-from-the-national-cohort-of-the-hhorages-association
#14
Marie-Odile Soyer-Gobillard, Laura Gaspari, Philippe Courtet, Mauricette Puillandre, Françoise Paris, Charles Sultan
The medical and scientific communities have not yet fully acknowledged the undesirable effects of the synthetic hormones that have been administered to pregnant women for decades. The somatic effects of in utero exposure to diethylstilbestrol (DES), such as genital malformations, infertility, and cancer, have long been recognized but this has not been the case concerning psychiatric disorders. The progestins used in contraception and hormone replacement therapy are known to affect the adult brain, but no data exist on their effects due to in utero exposure of children...
January 9, 2019: Gynecological Endocrinology
https://read.qxmd.com/read/30611411/prepregnancy-counseling-committee-opinion-no-762
#15
(no author information available yet)
The goal of prepregnancy care is to reduce the risk of adverse health effects for the woman, fetus, and neonate by working with the woman to optimize health, address modifiable risk factors, and provide education about healthy pregnancy. All those planning to initiate a pregnancy should be counseled, including heterosexual, lesbian, gay, bisexual, transgender, queer, intersex, asexual, and gender nonconforming individuals. Counseling can begin with the following question: "Would you like to become pregnant in the next year?" Prepregnancy counseling is appropriate whether the reproductive-aged patient is currently using contraception or planning pregnancy...
January 2019: Fertility and Sterility
https://read.qxmd.com/read/30575679/acog-committee-opinion-no-762-prepregnancy-counseling
#16
(no author information available yet)
The goal of prepregnancy care is to reduce the risk of adverse health effects for the woman, fetus, and neonate by working with the woman to optimize health, address modifiable risk factors, and provide education about healthy pregnancy. All those planning to initiate a pregnancy should be counseled, including heterosexual, lesbian, gay, bisexual, transgender, queer, intersex, asexual, and gender nonconforming individuals. Counseling can begin with the following question: "Would you like to become pregnant in the next year?" Prepregnancy counseling is appropriate whether the reproductive-aged patient is currently using contraception or planning pregnancy...
January 2019: Obstetrics and Gynecology
https://read.qxmd.com/read/30575672/acog-committee-opinion-no-762-summary-prepregnancy-counseling
#17
(no author information available yet)
The goal of prepregnancy care is to reduce the risk of adverse health effects for the woman, fetus, and neonate by working with the woman to optimize health, address modifiable risk factors, and provide education about healthy pregnancy. All those planning to initiate a pregnancy should be counseled, including heterosexual, lesbian, gay, bisexual, transgender, queer, intersex, asexual, and gender nonconforming individuals. Counseling can begin with the following question: "Would you like to become pregnant in the next year?" Prepregnancy counseling is appropriate whether the reproductive-aged patient is currently using contraception or planning pregnancy...
January 2019: Obstetrics and Gynecology
https://read.qxmd.com/read/30513062/postpartum-depression-a-medical-or-a-social-problem
#18
Katarzyna Wszołek, Joanna Żurawska, Jadwiga Łuczak-Wawrzyniak, Beata Kopaszewska-Bachorz, Aleksandra Głowińska, Beata Pięta
OBJECTIVE: The aim of the study was to identify a group of women needed psychological support after delivery by identifying the medical and social factors that may influence the emotional changes during the postpartum period. MATERIALS AND METHOD: A group of 835 pregnant women in second, third trimester of pregnancy and during the postpartum period completed the Edinburgh Postnatal Depression Scale and the questionnaire consisting of difficulties that might occur in the four life fields: practical, family, emotional and physical...
December 4, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://read.qxmd.com/read/30457176/neuroticism-is-associated-with-higher-antenatal-care-utilization-in-obstetric-low-risk-women
#19
Cathrine Axfors, Charlotte Hellgren, Helena Volgsten, Agneta Skoog Svanberg, Lisa Ekselius, Anna-Karin Wikström, Mia Ramklint, Alkistis Skalkidou, Inger Sundström-Poromaa
INTRODUCTION: Elevated neuroticism is associated with higher health care utilization in the general population. This study aimed to investigate the association between neuroticism and the use of publicly financed antenatal care in obstetric low-risk women, also considering predisposing and need factors for health care utilization. MATERIAL AND METHODS: Participants comprised 1052 obstetric low-risk women (no chronic diseases or adverse pregnancy conditions) included in several obstetrics/gynecology studies in Uppsala, Sweden...
November 20, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://read.qxmd.com/read/30383108/association-of-autism-spectrum-disorder-with-prenatal-exposure-to-medication-affecting-neurotransmitter-systems
#20
Magdalena Janecka, Arad Kodesh, Stephen Z Levine, Shari I Lusskin, Alexander Viktorin, Rayees Rahman, Joseph D Buxbaum, Avner Schlessinger, Sven Sandin, Abraham Reichenberg
Importance: Prenatal exposure to certain medications has been hypothesized to influence the risk of autism spectrum disorders (ASD). However, the underlying effects on the neurotransmitter systems have not been comprehensively assessed. Objective: To investigate the association of early-life interference with different neurotransmitter systems by prenatal medication exposure on the risk of ASD in offspring. Design, Setting, and Participants: This case-control study included children born from January 1, 1997, through December 31, 2007, and followed up for ASD until January 26, 2015, within a single Israeli health maintenance organization...
October 31, 2018: JAMA Psychiatry
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