Pearlstein Teri
Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA; Women's Behavioral Medicine, Women's Medicine Collaborative, 146 West River Street, Providence, RI 02904, USA.
Best Pract Res Clin Obstet Gynaecol. 2015 Jul;29(5):754-64. doi: 10.1016/j.bpobgyn.2015.04.004. Epub 2015 Apr 17.
A proportion of women enter pregnancy with active psychiatric symptoms or disorders, with or without concomitant psychotropic medication. Studies report that exposure to untreated depression and stress during pregnancy may have negative consequences for birth outcome and child development. Studies also report that antenatal exposure to antidepressant medications may have adverse consequences for birth outcome and child development. Antidepressant medication use during pregnancy leads to a small increased risk of miscarriage, a possible small increased risk of congenital cardiac malformations, a small increased risk of preterm birth, a small increased risk of persistent pulmonary hypertension of the newborn (PPHN), and transient neonatal symptoms in up to one-third of neonates. In addition, there is a possible increased risk of delayed motor development in children. Several recent systematic reviews and meta-analyses of the existent literature emphasize that there are minimal definitive conclusions to guide treatment recommendations. This review describes best practices for the management of depression in pregnancy, and it provides suggestions for future research.
一部分女性在怀孕时伴有活跃的精神症状或疾病，无论是否同时服用精神药物。研究报告称，孕期暴露于未经治疗的抑郁和压力下可能会对分娩结局和儿童发育产生负面影响。研究还报告称，孕期接触抗抑郁药物可能会对分娩结局和儿童发育产生不良后果。孕期使用抗抑郁药物会导致流产风险略有增加、先天性心脏畸形风险可能略有增加、早产风险略有增加、新生儿持续性肺动脉高压（PPHN）风险略有增加，并且多达三分之一的新生儿会出现短暂的新生儿症状。此外，儿童运动发育延迟的风险可能会增加。最近对现有文献进行的几项系统评价和荟萃分析强调，指导治疗建议的明确结论极少。本综述描述了孕期抑郁症管理的最佳实践，并为未来研究提供了建议。
