Depression & SSRIs

Question 1

What is IUGR?

Answer 1

Intrauterine growth restriction

IUGR refers to a condition where a fetus does not grow to its full potential during pregnancy.

Question 2

What are the effects of exposure to traumatic events during pregnancy?

Answer 2

Associated with IUGR, HPA axis dysregulation, and increased risk of psychiatric disorders in offspring

HPA stands for hypothalamic-pituitary-adrenal axis.

Question 3

What is the role of Corticotropin Releasing Hormone (CRH) in fetal development?

Answer 3

Can lead to fetal growth restriction and increased risk of preterm delivery

CRH is involved in the stress response and can affect fetal development.

Question 4

How does increased exposure to glucocorticoids affect fetal development?

Answer 4

Leads to decreased fetal growth, insulin resistance, and increased blood pressure

Glucocorticoids are a class of steroid hormones that can impact fetal health.

Question 5

What is the function of placental 11β-HSD2?

Answer 5

Provides a barrier to maternal glucocorticoids

This enzyme helps protect the fetus from excess maternal stress hormones.

Question 6

What is the incidence of postpartum depression (PPD) in women in the United States?

Answer 6

Affects 10-15% of women

This translates to nearly 1,000,000 women each year.

Question 7

What are some biological factors influencing postpartum depression?

Answer 7

Hormonal factors, particularly estrogen and progesterone sensitivity

Hormonal shifts postpartum can affect mood and mental health.

Question 8

What psychosocial factors are associated with postpartum depression?

Answer 8

Stressful life events, inadequate social support, socio-economic stressors, unplanned pregnancy

These factors can increase the risk of developing PPD.

Question 9

What are the risks associated with untreated depression during pregnancy?

Answer 9

Increased incidence of preterm birth, low birth weight, adverse neurodevelopmental outcomes

Untreated depression can significantly impact both maternal and infant health.

Question 10

What are SSRIs?

Answer 10

Selective serotonin reuptake inhibitors, commonly prescribed antidepressants

SSRIs are used to treat depression by increasing serotonin levels in the brain.

Question 11

What is the relationship between anxiety, stress, and pregnancy outcomes?

Answer 11

Increased incidence of preterm birth and low birth weight

Chronic stress and anxiety during pregnancy can adversely affect fetal health.

Question 12

What are common side effects of SSRIs?

Answer 12

Headaches, sexual dysfunction, nausea, CNS stimulation

Side effects can vary among individuals and medications.

Question 13

What is postpartum psychosis?

Answer 13

A severe mental illness affecting 1-2 in 1,000 women, often associated with bipolar disorder

It can occur shortly after childbirth and requires immediate attention.

Question 14

What is the effect of maternal mood disorders on newborn development?

Answer 14

Potential long-term effects include increased risk for depression and other mental illnesses in children

Maternal mental health is crucial for child development.

Question 15

Fill in the blank: The risk of neonatal abstinence syndrome (NAS) is reported to be _______.

Answer 15

20% - 30%

NAS can occur when infants withdraw from substances they were exposed to in utero.

Question 16

What are the long-term effects of SSRIs on newborns?

Answer 16

No gross neuroteratogenic effects identified thus far

Studies are ongoing to evaluate the long-term safety of SSRIs during pregnancy.

Question 17

What is the association between SSRIs and cardiac malformations?

Answer 17

Dose-related increased risk for cardiac disease, mainly septal defects

Research continues to assess the risks of SSRIs during pregnancy.

Question 18

True or False: Untreated depression during pregnancy can lead to increased incidence of preterm birth.

Answer 18

True

Both untreated depression and certain treatments can impact pregnancy outcomes.

Question 19

What are the main components of treatment for depression during pregnancy?

Answer 19

Awareness, risk assessment, education, coordination of care, psychotherapy, pharmacology

A comprehensive approach is necessary for effective treatment.

Question 20

What is the significance of the ‘Andrea Yates’ bill?

Answer 20

Requires healthcare providers to educate women about postpartum depression and treatment

This legislation aims to improve awareness and care for maternal mental health.

Question 21

What is PPHN?

Answer 21

Persistent Pulmonary Hypertension of the Newborn

Question 22

In which year did Chambers and colleagues publish their article linking SSRI use during late pregnancy with increased risk of PPHN?

Answer 22

2006

Question 23

What type of medication is associated with increased risk of PPHN when used during late pregnancy?

Answer 23

SSRIs

Question 24

How many studies reviewed the association between PPHN and SSRI exposure according to the 2012 review?

Answer 24

Six studies

Question 25

What proportion of studies showed an increased risk of PPHN in SSRI-exposed infants?

Answer 25

Three studies

Question 26

What was the estimated odds ratio range for PPHN in SSRI-exposed infants?

Answer 26

2.4 to 6.1

Question 27

What factors were not controlled for in the studies linking SSRI exposure to PPHN?

Answer 27

Smoking, obesity, delivery between 34 and 36 weeks, untreated depression

Question 28

How many infants with PPHN were reported among an estimated 25,000 infants exposed to SSRIs?

Answer 28

50 infants

Question 29

What effect may SSRIs have on pulmonary vascular smooth muscle endothelium?

Answer 29

Influence serotonin effects and increase vasoconstriction

Question 30

True or False: All studies reviewed showed an association between SSRI exposure and PPHN.

Answer 30

False