Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, NY USA.
Am J Psychiatry. 2013 Jan;170(1):12-20. doi: 10.1176/appi.ajp.2012.12040440.
The treatment of depression during pregnancy can be challenging for patients and providers alike. An increasing attention to perinatal mood disorders has led to an expanding literature that is often difficult for providers to navigate. It can be a challenge for providers to feel comfortable reviewing the broad scope of the risks and benefits of treatments in the context of the limitations of the literature. Women who are depressed during pregnancy have been found to have an elevated risk of poor obstetrical outcomes, although studies of the relationship between depression and outcomes are limited. Women who are treated with antidepressants during pregnancy are also at risk for a host of poor obstetrical and fetal outcomes. The risks for these outcomes are often confused by confounding factors and study design limitations. Understanding the current data and their limitations will allow providers to guide their patients in choosing treatment options. Consistent and simple strategies should be used when discussing the risk-benefit analysis with the patient.
治疗妊娠期抑郁症对患者和医务人员来说都是一个挑战。人们越来越关注围产期情绪障碍，这导致了相关文献的大量增加，而医务人员往往难以理解这些文献。由于文献的局限性，医务人员在权衡治疗的风险和益处时，可能会感到难以应对。研究发现，妊娠期抑郁的女性发生不良产科结局的风险升高，尽管关于抑郁与结局之间关系的研究有限。妊娠期使用抗抑郁药的女性也面临一系列不良产科和胎儿结局的风险。这些结局的风险往往受到混杂因素和研究设计局限性的影响。了解当前的数据及其局限性将有助于医务人员指导患者选择治疗方案。在与患者讨论风险效益分析时，应采用一致且简单的策略。
