Depression during pregnancy and treatment notes

This is an automatically translated article.

The article is professionally consulted by Specialist Doctor II Huynh Thi Hien - Obstetrician and Gynecologist - Department of Obstetrics and Gynecology - Vinmec Nha Trang International General Hospital


You've probably heard a lot about postpartum depression. But in fact, many women are also experiencing depression during pregnancy. Research shows that about 7% of women experience depression during pregnancy. This percentage may be higher in low- and middle-income countries.

1. Why is depression during pregnancy often unrecognized?

Depression is a mood disorder that causes prolonged feelings of sadness and loss of interest. The condition occurs twice as often in women as in men, and the onset of depression peaks during a woman's reproductive years.
Some symptoms of depression, such as sleep changes, boredom, fatigue, appetite and libido, are similar to the symptoms of pregnancy. As a result, we often confuse these symptoms of depression with symptoms of pregnancy. People will assume this is a sign of pregnancy, rather than a symptom of depression. So depression during pregnancy is often not recognized.
Pregnant women should talk to their medical professionals about their condition if their mood changes during pregnancy.

2. Risk factors for depression during pregnancy

Some risk factors for depression during pregnancy include:
Anxiety Stressful life A history of depression Not sharing from family or friends Unplanned pregnancy Family violence.

3. Signs of depression during pregnancy

Signs of depression during pregnancy as well as signs of depression in normal people with the disease. However, some typical signs of depression in pregnant women include:
Excessive worry about the fetus Or low self-esteem, such as feeling that you are not worthy to be a father mother Doesn't derive pleasure from enjoyable activities Easily demoralized Does not take good care of herself before giving birth Smoking, drinking or using illegal drugs Poor weight gain due to diet inadequate or picky eaters often have negative thoughts and look to death Depression is common in the first and third trimesters for pregnant women.

4. Treatment of depression during pregnancy

If you have untreated depression, you won't get optimal prenatal care or eat the foods you and your baby need. Experiencing depression during pregnancy can increase the risk of premature birth, low birth weight, decreased fetal growth, or other problems for the baby. Depression during pregnancy also increases the risk of postpartum depression, the mother not having enough breast milk and difficulty bonding with the baby.
Depending on the severity of your depression, your doctor will recommend treatments that may include psychotherapy or antidepressants.

5. Are antidepressants an option during pregnancy?

The decision to use antidepressants during pregnancy is based on a balance of risks and benefits. In general, the risk of birth defects and other problems for the baby of mothers who take antidepressants during pregnancy is very low. Certain medications have been shown to be safe during pregnancy, and some antidepressants are associated with a higher risk of complications for the baby.
If you use antidepressants during pregnancy, your doctor will try to minimize your baby's exposure to the drug. This can be done by prescribing a drug (monotherapy) at the lowest effective dose, especially during the first trimester.
Certain antidepressants are selected for use during pregnancy such as:
Certain selective serotonin reuptake inhibitors (SSRIs): SSRIs are generally considered an option during pregnancy, include citalopram (Celexa), fluoxetine (Prozac), and sertraline (Zoloft). Potential complications include an increased risk of heavy bleeding after delivery (postpartum haemorrhage), preterm delivery, and low birth weight. Most studies show that SSRIs are not associated with birth defects. However, paroxetine (Paxil) appears to be associated with an increased risk of fetal heart defects. Serotonin and norepinephrine reuptake inhibitors (SNRIs): SNRIs also considered an option during pregnancy include duloxetine (Cymbalta) and venlafaxine (Effexor XR). However, research shows that taking SNRIs in late pregnancy is associated with postpartum bleeding. Bupropion (Wellbutrin): This drug is used for both depression and smoking cessation. Although bupropion is not generally considered a first-line treatment for depression during pregnancy, it may be an option for women who have not responded to other medications. Research shows that taking bupropion during pregnancy may be associated with heart defects. Tricyclic antidepressants: This class of drugs includes nortriptyline (Pamelor). Although tricyclic antidepressants are not generally considered a first- or second-line treatment, they may be an option for women who have not responded to other medications. The tricyclic antidepressant Clomipramine may be associated with birth defects in the fetus, including heart defects. Using these drugs during the second or third trimester also carries a risk of postpartum bleeding. Certain types of antidepressants should be avoided during pregnancy:
Paroxetine SSRIs (Paxil) are generally not recommended during pregnancy. Some studies suggest that paroxetine may be associated with a small increase in fetal heart defects. In addition, monoamine oxidase inhibitors (MAOIs) — including phenelzine (Nardil) and tranylcypromine (Parnate) — are generally not recommended during pregnancy. MAOIs can limit fetal growth. If you take antidepressants during the third trimester of pregnancy, your baby may experience temporary discontinuation symptoms - such as restlessness, irritability, poor appetite and respiratory distress for up to a month. at birth. However, there is no evidence that stopping or reducing the dose near the end of pregnancy reduces the infant's risk of these symptoms. In addition, it can increase your risk of a relapse of postpartum depression.
The link between antidepressant use during pregnancy and the risk of autism in children is still inconclusive, but most studies have shown that the risk is small, and studies Others show no risk at all.
Your decision to continue or change your antidepressant will be based on the stability of your mood. Concerns about potential risks must be weighed against the possibility of an alternative drug because it can fail and cause recurrent depression.
If you stop taking antidepressants during pregnancy, you have an increased risk of depression relapse with more serious complications, an inability to care for yourself or become pregnant, and an increased risk of depression postpartum or postpartum psychosis.
If you are depressed and are pregnant or thinking about becoming pregnant, consult your doctor. Deciding how to treat depression during pregnancy is not easy. The risks and benefits of taking the drug during pregnancy must be carefully weighed. Consult with your doctor to make informed choices that give you and your baby the best chance for long-term health.
At Vinmec International General Hospital, there is a package maternity service as a solution to help pregnant women feel secure because of the companionship of the medical team throughout the pregnancy. When choosing Maternity Package, pregnant women can:
The pregnancy process is monitored by a team of qualified doctors Regular check-up, early detection of abnormalities Maternity package helps to facilitate the process. birthing process Newborns receive comprehensive care.

Please dial HOTLINE for more information or register for an appointment HERE. Download MyVinmec app to make appointments faster and to manage your bookings easily.

Reference source: Mayoclinc.org