University of Pittsburgh Department of Anesthesiology & Perioperative Medicine.
University of Pittsburgh Department of Obstetrics & Gynecology, University of Pittsburgh Medical Center, UPMC Magee-Women's Hospital, Pittsburgh, Pennsylvania, USA.
Curr Opin Anaesthesiol. 2021 Jun 1;34(3):233-237. doi: 10.1097/ACO.0000000000000998.
Perinatal depression is a common and debilitating complication of pregnancy and childbirth. Recent studies have elucidated relationships between acute birth events on depression risk, and novel treatments for postpartum depression have been discovered and approved. This article reviews current understandings about birth events on depression, new screening standards, and novel treatments for postpartum depression.
Pain, analgesia, and depression are complex traits that are inter-related during and after pregnancy. Certain individuals may benefit more than others from addressing pain and suffering around childbirth. Exposures to general anesthesia or postdural puncture headache are associated with postpartum depression symptoms, although a causal relationship is unlikely. Brexanolone, ketamine and its related compounds, and nonpharmacologic options offer new or alternative therapies for depression, although safety information for some of these treatments in pregnancy and lactation are needed. Maternal health bundles call for close attention to perinatal mental health screening with validated instruments, and for timely treatment referrals in the 'fourth trimester'.
Clinical monitoring and timely treatment of depression in the perinatal and postpartum periods is critical for maternal postpartum health and recovery. Perinatal specialists and researchers should continue to focus on tailored treatments specific to this special population.
围产期抑郁是妊娠和分娩的常见且使人虚弱的并发症。最近的研究阐明了急性分娩事件与抑郁风险之间的关系，并且已经发现并批准了新的产后抑郁症治疗方法。本文综述了关于分娩事件对抑郁症的最新认识、新的筛查标准和产后抑郁症的新治疗方法。
疼痛、镇痛和抑郁是在怀孕和分娩期间及之后相互关联的复杂特征。某些人可能比其他人更受益于解决分娩时的疼痛和痛苦。全身麻醉或硬膜外穿刺后头痛的暴露与产后抑郁症症状有关，但不太可能存在因果关系。Brexanolone、氯胺酮及其相关化合物以及非药物选择为抑郁症提供了新的或替代治疗方法，但需要了解这些治疗方法在妊娠和哺乳期的安全性信息。产妇保健套餐呼吁密切关注使用经过验证的工具进行围产期心理健康筛查，并在“第四个三月期”及时进行治疗转诊。
围产期和产后期间抑郁的临床监测和及时治疗对产妇产后健康和恢复至关重要。围产期专家和研究人员应继续关注针对这一特殊人群的量身定制的治疗方法。
