February 5th, 2010 
Mothers who suffer from ‘baby blues’ while pregnant are four times as likely to have children who become violent teenagers, a new study shows.
The link remained even if the mothers did not suffer depression after their children were born.
Research has previously suggested that postnatal depression can affect a child’s subsequent behavior.
But experts from Cardiff and Bristol universities and King’s College London believe that theirs is one of the first studies to look at the effects of suffering depression before a child’s birth.
Many women are depressed during their pregnancy and research by Tommy’s, the baby charity, suggests that it may even be more common before the birth of a child than after.
It is estimated that as many as between 10 and 15 per cent of women could suffer the condition while they are expecting.
Prof Dale F Hay, from Cardiff University, who led the latest study, said: “Much attention has been given to the effects of postnatal depression on young infants, but depression during pregnancy may also affect the unborn child.”
The study looked at 120 mothers from the Bristol area.
The researchers interviewed the women while they were pregnant, after they gave birth and when their children were aged four, 11, and 16 years old.
Their findings, published in the journal Child Development, show that women who were depressed while they were pregnant were four times as likely to have children who were violent by the age of 16 as the other mothers.
The children were also more likely to exhibit other forms of anti-social behavior, the research found.
However, the study also found that women who had been angry or disruptive teenagers themselves were more likely to go on to be depressed while they were pregnant.
Prof Hay added: “Although it’s not yet clear exactly how depression in pregnancy might set infants on a pathway toward increased anti-social behavior, our findings suggest that women with a history of conduct problems who become depressed in pregnancy may be in special need of support.”
Related
- Stress, Anxiety Can Up Risk of Depression in Pregnancy
Stress, history of depression, lack of social support and unintended pregnancy are among the major factors that contribute to increased risk of depression in pregnant women, a new study shows.
Other important factors are maternal anxiety, domestic violence and having public insurance coverage, said the University of Michigan researchers, who reviewed 159 studies conducted between 1980 and 2008.
The study appears in the January issue of the American Journal of Obstetrics & Gynecology.
Depression, which occurs in about 12.7 percent of pregnant women, can cause problems for mothers and babies, including pre-term delivery, preeclampsia, sleep disturbances and disrupted mother-infant bonding.
It’s important for physicians to know how to identify depression in pregnant women, said the study authors, who noted that not all women who test positive on depression screening tests have or will develop clinical depression.
“We are hoping that [health-care] providers can use the presence or absence of risk factors such as those identified in our study to enhance their assessments for depression in addition to the information they obtain from the screening test,” study author Dr. Christie A. Lancaster, a clinical lecturer in the obstetrics and gynecology department at U-M, said in a news release.
- Massage Reduces Depression in Pregnant Women
New research shows massage therapy reduced depression in pregnant women, and also reduced the incidence of massaged women’s babies being born prematurely.
The study was conducted by researchers at the Touch Research Institutes, where pioneering research about massage has been conducted since 1992.
Pregnant women diagnosed with major depression were given 12 weeks of massage, twice per week, by their significant other. A control group did not receive massage, according to an abstract published on www.pubmed.gov.
The massage-therapy group versus the control group not only had reduced depression by the end of the massage-therapy period, they also had reduced depression and cortisol levels during the postpartum period.
The massaged women’s newborns were also less likely to be born prematurely and low birthweight, pubmed noted, and they had lower cortisol levels and performed better on the Brazelton Neonatal Behavioral Assessment habituation, orientation and motor scales.
- Smoking During Pregnancy Linked to Behavioral Problems in Children
New research set to be published in the Journal of Epidemiology and Community Health suggests that mothers who smoke while pregnant are essentially toying with the brain chemistry of their future children.
“There are 4000 toxic substances in cigarette smoke, and many of these will pass into the brain of the fetus, and it is possible that they could have an effect on how the brain chemistry works,” said Professor Alan Maryon-Davis, president of the Faculty of Public Health, to the BBC.
The research involved more than 14,000 pairs of mothers and their children, all participants in the Millennium Cohort Study, a study that focused on children born in the U.K. between 2000 and 2001.
First, mothers were put into categories based upon the amount of cigarettes they smoked during pregnancy. Then, using a validated questionnaire called Strengths and Difficulties, mothers were asked to grade their children’s level of hyperactivity, type of temperament, frequency of fights, and ease of distraction. Taking into account factors that might influence the results, including socioeconomic status, mother’s age, and level of education, the researchers began analyzing the data.
It was found that nearly one in ten women smoked heavily during pregnancy, 12.5 percent smoked lightly during pregnancy, and 12.4 percent said they stopped smoking while pregnant.
Boys of mothers who smoked heavily while pregnant were almost twice as likely to have behavioral problems, while boys of mothers who smoked lightly while pregnant had an 80 percent increased likelihood of having an attention deficit disorder.
Researchers found a significant increase in likelihood that those girls of mothers who smoked lightly or heavily had conduct issues.
“Smoking during pregnancy may damage the developing structure and function of the fetal brain, which has already been shown to be the case in animals”, said the authors.
“The fetal development of boys may also be more sensitive to this kind of chemical assault, which might explain why boys are more likely to have behavioral problems than girls.”
- Talk, drug therapy may ease depression in pregnancy
Women who are depressed during pregnancy can take hope that antidepressants and/or “talk therapy” may be safe and appropriate treatment options, according to new professional guidelines made public this week.
“Depression in pregnant women often goes unrecognized and untreated in part because of concerns about the safety of treating women during pregnancy,” lead author of the guidelines, Dr. Kimberly Ann Yonkers, from Yale University, New Haven, Connecticut, said in a statement.
The guidelines on depression in pregnancy, which are based on an extensive review of prior research, were issued by the American Psychiatric Association and the American College of Obstetricians and Gynecologists.
There are both pros and cons to using antidepressants during pregnancy, the report states. The drugs can effectively treat mom’s depression, which has been linked to problems in the newborn. However, there is also evidence tying them to birth defects and reduced birth weight.
Psychotherapy may be a suitable alternative to antidepressants for some women with mild-to-moderate depression, the report indicates.
According to the report, women thinking about becoming pregnant may possibly taper or discontinue their antidepressants if they have had mild or no symptoms for 6 months or longer.
However, they may need to continue their medications if they have a history of severe, recurrent depression or other major psychiatric illness.
The guidelines suggest that women see a psychiatrist for aggressive treatment if suicidal or acute psychotic symptoms are present.
Pregnant women currently taking antidepressants may be able to remain on the medications if they discuss the pros and cons with their doctors, the guidelines state.
Depending on their mental health history, these women may attempt tapering and going off their medications if symptom-free. Pregnant women taking antidepressants may benefit from psychotherapy if symptoms are still apparent, according to the document.
Pregnant women not currently taking antidepressants may consider psychotherapy as alternative to antidepressants, the report indicates.
- Drugs for depression, anxiety tied to preterm birth
Pregnant women who take certain drugs for depression or anxiety may have heightened risks of preterm delivery or other birth complications, according to a new study.
Researchers found that among nearly 3,000 women who gave birth in Washington State, those who started taking antidepressants known as selective serotonin reuptake inhibitors (SSRIs) in the second or third trimester had a higher risk of preterm birth.
Compared with their counterparts not on the medications, these women were nearly five times more likely to deliver prematurely.
The same risk was not seen, however, among women who started on an SSRI before pregnancy or during the first trimester. SSRIs include drugs like sertraline (Zoloft), paroxetine (Paxil) and fluoxetine (Prozac).
The researchers also found a higher risk of preterm delivery among women who took anti-anxiety drugs known as benzodiazepines, regardless of when they began treatment.
Those drugs, which include medications like lorazepam (Ativan) and alprazolam (Xanax), were linked to higher risks of other complications as well – including low birth weight, newborn respiratory distress and a low Apgar score, a standard measure of newborn health.
The findings of the study are published in the American Journal of Obstetrics & Gynecology.
Exactly what the study means for women on SSRIs or benzodiazepines is not entirely clear. A major limitation is that it could not estimate the benefits of treatment, lead researcher Dr. Ronit Calderon-Margalit, of the Hebrew University-Hadassah School of Public Health in Jerusalem, noted in an email to Reuters Health.
Any risks of using the medications during pregnancy need to be balanced against the risks of leaving depression and anxiety disorders untreated.
“It is very important to have other studies of the risks associated with (these) drugs, but also of benefits associated with treating mothers,” said Calderon-Margalit, who was at the University of Washington in Seattle at the time of the study.
In addition, SSRIs did not appear to present equal risks for all women. Calderon-Margalit described the antidepressant findings as “mostly reassuring” for women who start the drugs before pregnancy or in the first trimester — as most SSRI users in the study had.
The study included 2,793 pregnant women, 11 percent of whom used a psychiatric medication during pregnancy. Of these, 138 were on an SSRI, while 85 used a benzodiazepine.
Among women who were not on any medication, 9 percent gave birth prematurely, versus nearly half of women on benzodiazepines.
Meanwhile, 14 percent of women on SSRIs had a preterm birth, but the elevated risk turned out to be concentrated among those who started an antidepressant after the first trimester. Of those 21 women, 16 delivered prematurely.
Several other birth complications, often related to preterm birth, were also higher-than-average among women on benzodiazepines.
Seventeen percent of their newborns suffered respiratory distress syndrome and one-third ended up in the neonatal intensive care unit. Those figures were 3 percent and 6 percent, respectively, among newborns whose mothers had not used psychiatric medications during pregnancy.
Calderon-Margalit pointed out that most women on benzodiazepines used lorazepam (Ativan), so it is possible that the risks are associated mainly with that drug. However, further research is needed to determine whether any particular medications carry particular risks.
