January 26th, 2010 
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.
Related
- Depression while pregnant ‘linked to violent behaviour in children’
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.”
- 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.
- Acupuncture Found Effective Against Depression During Pregnancy
In a study to be presented February 4 at the Society for Maternal-Fetal Medicine’s (SMFM) annual meeting, The Pregnancy Meeting ™, in Chicago, researchers will unveil findings that show that acupuncture may be an effective treatment for depression during pregnancy.
“Depression during pregnancy is an issue of concern because it has negative effects on both the mother and the baby as well as the rest of the family,” said Dr. Schnyer, one of the study’s authors.
About 10% of pregnant women meet criteria for major depression and almost 20% have increased symptoms of depression during pregnancy. The rates of depression in pregnant women are comparable to rates seen among similarly aged non-pregnant women and among women during the postpartum period, but there are far fewer treatment studies of depression during pregnancy than during the postpartum period.
Dealing with depression is difficult for pregnant women because the use of anti-depressants poses concerns to the developing fetus and women are reluctant to take medications during pregnancy.
In the study, an evaluator-blinded randomized trial, 150 participants who met the Diagnostic & Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for Major Depressive Disorder were randomized to receive either acupuncture specific for depression (SPEC, n=52) or one of two active controls: control acupuncture (CTRL, n=49) or massage (MSSG, n=49). Treatments lasted eight weeks (12 sessions). Junior acupuncturists masked to treatment assignment needled participants at points prescribed by senior acupuncturists. Massage therapists and patients were not blinded. The primary outcome was the Hamilton Rating Scale for Depression, administered by blinded raters at baseline and after four and eight weeks of treatment. Data were analyzed using mixed effects models and by intent-to-treat.
The results showed that the women who received SPEC experienced a significantly greater decrease in depression severity compared to the combined controls or CTRL acupuncture alone. They also had a higher response rate (63.0%) than the combined controls or CTRL acupuncture alone. Symptom reduction and response rates did not differ significantly between controls (CTRL 37.5% and MSSG 50.0%). Mild and transient side effects were reported by 43/150 participants (4 in MSSG; 19 in CTRL, 20 in SPEC). Significantly fewer participants reported side-effects in MSSG than the two acupuncture groups.
“The results of our study show that the acupuncture protocol we tested could be a viable treatment option for depression during pregnancy” said Dr. Schnyer.
- 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.
- Depressed Pregnant Women at Greater Risk from Flu Infection
Pregnant women with significant symptoms of depression tend to have a stronger biological reaction to the seasonal flu vaccine than do women with lower depression levels, according to a new study.
An internal inflammatory response to vaccination is not uncommon — it’s an essential part of the process the immune system initiates to prepare for a successful fight against an actual infection. But it’s also expected to be a weak and brief response.
“Inflammatory responses to vaccination do no harm, are mild, and typically go away within a few days. But an extended inflammatory response to vaccination, such as the one seen in women with the most depressive symptoms, isn’t expected, and it serves as a way to estimate how somebody might respond to an actual infection or illness,” said Lisa Christian, an assistant professor of psychiatry at Ohio State University and lead author of the research.
She and colleagues also recently published a study in the same journal indicating that pregnant women experiencing depressive symptoms and certain stressors had higher levels of inflammatory markers in their blood than did pregnant women with lower depression and stress levels.
Though this mind-body connection is well established in people with chronic stress, Christian said few studies have examined the effects of depression and stress during pregnancy. Research has shown that pregnancy suppresses certain functions of the immune system to prevent rejection of the fetus and to protect the fetus from inflammation that accompanies fevers and other illnesses.
In the flu vaccine study, 22 pregnant women completed questionnaires about their depressive symptoms and gave blood samples before they received a seasonal influenza shot. Between six and nine days later, a second round of blood samples was collected.
Researchers assessed the women’s depressive symptoms using the Center for Epidemiologic Studies Depression Scale, a series of 20 questions about physical, emotional and cognitive symptoms. The women were classified in three groups: having either no or minimal depression; mild or moderate depressive symptoms; and significant depressive symptoms. A diagnosis of depression can be made only after an interview with a doctor.
The scientists analyzed the post-vaccination blood samples for the presence of macrophage migration inhibitory factor, or MIF, a protein that promotes inflammation by suppressing other substances in the blood that fight inflammation.
A week after receiving the flu shots, the women with the highest scores on the depression scale had about twice as much MIF in their blood as did women reporting minimal symptoms.
Christian’s previous study on inflammatory markers in the blood during pregnancy involved 60 women, including the 22 who participated in the flu study.
In this study, researchers assessed the women using a variety of measures: the depressive symptom scale, a perceived stress scale measuring experiences of stress and coping with stress in the past month; a questionnaire gauging how much social support the women had; tests for frequency of stressful social interactions; and a short survey of how happy the women and their partners were about the pregnancy.
Blood samples were taken to measure levels of two proteins, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-a). Both are proinflammatory cytokines, chemical messengers that are mobilized when the body is injured or has an infection, and they cause inflammation in their effort to make repairs in the body.
When these proteins circulate without an infection to fight, the body experiences excess inflammation, which is associated with a variety of diseases depending on which cells are producing the proteins. Previous studies have shown that such inflammation during pregnancy can increase the risk of preterm birth and preeclampsia, a high blood pressure condition that can occur during the last half of pregnancy.
Overall, the women reporting more depressive symptoms had significantly higher levels of IL-6 in their blood than did women with fewer symptoms. The association between depressive symptoms and TNF-a was not as strong, but was still considered significant.
In both studies, the researchers assessed a variety of health behaviors and measures, such as body mass index, cigarette smoking, prenatal vitamin use and physical activity, to gauge whether these factors might affect the presence of inflammation markers. None of the measures had a significant effect, Christian said.
