More women may suffer from depression during pregnancy

(Reuters Health) – Expectant moms are more likely than women of their mother's generation to become depressed during pregnancy, suggests a study.

The stress of the modern world could be the driving force behind the increase, said senior author of the study, Rebecca Pearson, a lecturer in psychiatric epidemiology at the University of Bristol UK.

"Our data suggest that the symptoms responsible for the increase in total scores were those related to feeling overwhelmed and stress and anxiety rather than feeling depressed and unmotivated" said Pearson. "This supports the theories that this is potentially a consequence of the hectic modern world."

While postpartum depression is a well-known problem, in the last decade there has been a paradigm shift to recognize that symptoms usually appear before the baby is born, said Dr. Priya Gopalan, head of Psychiatry at the Magee-Womens Hospital of the University of Pittsburgh Medical Center.

"What we traditionally call postpartum depression actually begins in the third quarter," said Gopalan, who is not affiliated with the new research. "The paradigm shift has eliminated all the myths that perpetuate pregnancy is a happy time for all moms."

As reported in JAMA Network Open, the Pearson team compared 2,390 women who had babies in the early 1990s to 180 next generation women who were either girls in the original group or partners of the sons of the original group. The average age in both groups of women was about 22 or 23 years old.

Among the oldest generations, 408 or 17% had high scores on depression screening tests, compared to 45 or 25% of the current generation.

Girls of women who became depressed during pregnancy had a particularly high risk of developing prenatal depression themselves. In fact, they were three times more likely to develop prenatal depression than women whose mothers were not depressed during pregnancy.

The factors that Pearson suspects lead to higher rates of depression among the younger generations: "The increase in the female workforce that puts pressure on young women to juggle between families and careers , social media and the Internet, which can increase social comparisons; information overload, financial pressures, including house prices and the need for joint income to provide life in the UK, and less family and community support and increased pressures on relationships intimate.

"Absolutely," said Gopalan. "We have certainly seen increased rates of depression over time."

Gopalan and other experts now recommend that women who develop depression during pregnancy obtain treatment, including medications if necessary, to protect both the health of women and their babies.

"We have a lot of studies that have been published over the last three years comparing depressed mothers who were not receiving treatment to those who were depressed but were receiving treatment, "said Gopalan." We now know that depressed mothers who take drugs have babies who do better in terms of development. Depressed moms (without treatment) do not bond with their babies like non-depressed moms.

Like Pearson, Inger Burnett-Zeigler believes that many depressive symptoms in young women are motivated by anxiety. "They are worried about expectations about motherhood and balancing that with their other obligations," said Burnett-Zeigler, clinical psychologist and assistant professor in the department of psychiatry at the Feinberg School of Medicine at Northwestern University in Chicago. "Many of them feel overwhelmed and worried about who will help them, they are worried about whether the baby will be fine and they will behave like moms." "

Another factor is that people do not live as close to their families as they have already done, Burnett-Zeigler said.

"Many are not surrounded by families to support them," she said. "Even if they have partners, they still feel isolated."

SOURCE: bit.ly/2KVMa1V JAMA Network Open, online on July 13, 2018.