Depression & SSRIs Flashcards
What is IUGR?
Intrauterine growth restriction
IUGR refers to a condition where a fetus does not grow to its full potential during pregnancy.
What are the effects of exposure to traumatic events during pregnancy?
Associated with IUGR, HPA axis dysregulation, and increased risk of psychiatric disorders in offspring
HPA stands for hypothalamic-pituitary-adrenal axis.
What is the role of Corticotropin Releasing Hormone (CRH) in fetal development?
Can lead to fetal growth restriction and increased risk of preterm delivery
CRH is involved in the stress response and can affect fetal development.
How does increased exposure to glucocorticoids affect fetal development?
Leads to decreased fetal growth, insulin resistance, and increased blood pressure
Glucocorticoids are a class of steroid hormones that can impact fetal health.
What is the function of placental 11β-HSD2?
Provides a barrier to maternal glucocorticoids
This enzyme helps protect the fetus from excess maternal stress hormones.
What is the incidence of postpartum depression (PPD) in women in the United States?
Affects 10-15% of women
This translates to nearly 1,000,000 women each year.
What are some biological factors influencing postpartum depression?
Hormonal factors, particularly estrogen and progesterone sensitivity
Hormonal shifts postpartum can affect mood and mental health.
What psychosocial factors are associated with postpartum depression?
Stressful life events, inadequate social support, socio-economic stressors, unplanned pregnancy
These factors can increase the risk of developing PPD.
What are the risks associated with untreated depression during pregnancy?
Increased incidence of preterm birth, low birth weight, adverse neurodevelopmental outcomes
Untreated depression can significantly impact both maternal and infant health.
What are SSRIs?
Selective serotonin reuptake inhibitors, commonly prescribed antidepressants
SSRIs are used to treat depression by increasing serotonin levels in the brain.
What is the relationship between anxiety, stress, and pregnancy outcomes?
Increased incidence of preterm birth and low birth weight
Chronic stress and anxiety during pregnancy can adversely affect fetal health.
What are common side effects of SSRIs?
Headaches, sexual dysfunction, nausea, CNS stimulation
Side effects can vary among individuals and medications.
What is postpartum psychosis?
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.
What is the effect of maternal mood disorders on newborn development?
Potential long-term effects include increased risk for depression and other mental illnesses in children
Maternal mental health is crucial for child development.
Fill in the blank: The risk of neonatal abstinence syndrome (NAS) is reported to be _______.
20% - 30%
NAS can occur when infants withdraw from substances they were exposed to in utero.
What are the long-term effects of SSRIs on newborns?
No gross neuroteratogenic effects identified thus far
Studies are ongoing to evaluate the long-term safety of SSRIs during pregnancy.
What is the association between SSRIs and cardiac malformations?
Dose-related increased risk for cardiac disease, mainly septal defects
Research continues to assess the risks of SSRIs during pregnancy.
True or False: Untreated depression during pregnancy can lead to increased incidence of preterm birth.
True
Both untreated depression and certain treatments can impact pregnancy outcomes.
What are the main components of treatment for depression during pregnancy?
Awareness, risk assessment, education, coordination of care, psychotherapy, pharmacology
A comprehensive approach is necessary for effective treatment.
What is the significance of the ‘Andrea Yates’ bill?
Requires healthcare providers to educate women about postpartum depression and treatment
This legislation aims to improve awareness and care for maternal mental health.
What is PPHN?
Persistent Pulmonary Hypertension of the Newborn
In which year did Chambers and colleagues publish their article linking SSRI use during late pregnancy with increased risk of PPHN?
2006
What type of medication is associated with increased risk of PPHN when used during late pregnancy?
SSRIs
How many studies reviewed the association between PPHN and SSRI exposure according to the 2012 review?
Six studies
What proportion of studies showed an increased risk of PPHN in SSRI-exposed infants?
Three studies
What was the estimated odds ratio range for PPHN in SSRI-exposed infants?
2.4 to 6.1
What factors were not controlled for in the studies linking SSRI exposure to PPHN?
Smoking, obesity, delivery between 34 and 36 weeks, untreated depression
How many infants with PPHN were reported among an estimated 25,000 infants exposed to SSRIs?
50 infants
What effect may SSRIs have on pulmonary vascular smooth muscle endothelium?
Influence serotonin effects and increase vasoconstriction
True or False: All studies reviewed showed an association between SSRI exposure and PPHN.
False
