Department of Psychiatry, Northwestern University Feinberg School of Medicine, 676 North St. Clair St. Suite 1000, Chicago, IL, United States.
Department of Psychiatry, Northwestern University Feinberg School of Medicine, 676 North St. Clair St. Suite 1000, Chicago, IL, United States; Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Semin Perinatol. 2020 Apr;44(3):151229. doi: 10.1016/j.semperi.2020.151229. Epub 2020 Jan 25.
Depression during pregnancy is associated with adverse maternal, pregnancy, and infant outcomes. Treatment during pregnancy requires a balanced discussion of the risks of both drug exposure and untreated depression. An updated review of the epidemiology, outcomes, and management of maternal depression is presented. Adverse outcomes are associated with both maternal depression and antidepressants. Research gaps include data on the longitudinal developmental trajectory of offspring exposed to antidepressants compared to depression, with assessment of in utero symptom exposure and environmental exposures. Additionally, neonatal syndrome associated with antidepressant use during pregnancy has no consensus definition or mechanistic explanation. With sophisticated large-scale epidemiologic studies, there has been progress in distinguishing the impact of depression processes from medication used for treatment. Optimal treatment of perinatal depression includes close symptom monitoring and medication adjustments to maintain symptom remission. This evolving field requires frequent consultation with reproductive data sources included in this article.
怀孕期间的抑郁与不良的母婴、妊娠和婴儿结局有关。怀孕期间的治疗需要平衡讨论药物暴露和未治疗的抑郁的风险。本文对孕产妇抑郁的流行病学、结局和管理进行了更新综述。不良结局与母亲抑郁和抗抑郁药都有关。研究空白包括与抑郁相比，暴露于抗抑郁药的后代的纵向发育轨迹的数据，以及对宫内症状暴露和环境暴露的评估。此外，与怀孕期间使用抗抑郁药相关的新生儿综合征尚无共识定义或机制解释。通过复杂的大规模流行病学研究，已经在区分抑郁过程的影响和用于治疗的药物方面取得了进展。围产期抑郁的最佳治疗包括密切的症状监测和药物调整以维持症状缓解。这个不断发展的领域需要经常咨询本文中包含的生殖数据源。
