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Maternal Mental Health and Peripartum Depression

  • Gislene Valadares
  • Austen Venancio Drummond
  • Carolina Cassiano Rangel
  • Eduardo Santos
  • Gisele Apter
Chapter
  • 20 Downloads

Abstract

Maternal mental health (MMH) and peripartum depression (PPD) are considered as a major public health concern. PPD and peripartum mental illness (PMI) has been recognized since the fifth century BCE by Hippocrates. Peripartum, instead of perinatal, is the term internationally standardized today. Peripartum means “relating to the time immediately before and after birth”. It is a critical period in a woman’s life. A wider definition stretches the peripartum from preconception and pregnancy up to 1 year after delivery. During this period women experience several and significant normal or pathological physiological, hormonal, emotional and social changes. Peripartum vulnerability to mental disorders is now a well-known fact. It is hypothesized that this is due to both biological (hormonal), psychological and environmental (social) aspects. Teasing out each mechanism, knowing that they most certainly interact to buffer or potentiate each other is complex. We are currently unable to understand the exact processes involved and can only try to describe evidence-based heightened/lowered risk/protection factors and current state-of-the-art care.

Worldwide, it is estimated that the rate of mental disorders, primarily depression, is approximately 10% for women during pregnancy and 13% during the postpartum. In low- and middle-income countries (LMIC), prevalence is even higher, ranging between 19% and 25%, associated to anxiety and lack of energy.

Early development and children’s health and mental health are at heightened risk of negative outcome in part due to lack of timely responses to infant needs and lack of adequate bonding. In the most severe cases, women can commit suicide and/or infanticide.

In order to provide evidence-based knowledge and scaffolding for prevention, early identification and efficacious management of PPD, the present chapter will describe maternal PPD. A secondary objective will be to stimulate creativity in different settings in favour of integrative, tailored, gender-sensitive, cost-effective programmes in order to promote biopsychosocial care for women and mothers, children and their families. Disseminating evidence to uphold better mental health for future generations is essential.

Abbreviations

5-HTTPLR

Serotonin transporter

AAD

Antenatal anxiety and depression

ALLO

Allopregnanolone

BC

Before Christ

BDNF

Brain-derived neurotrophic factor

COMP

Cartilage oligomeric matrix protein

COMT

Catechol-O-methyl transferase

DSM-5

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition

EBV

Epstein–Barr virus

ECT

Electroconvulsive therapy

ELBW

Extremely low birth weight

EPDS

Edinburgh Postnatal Depression Scale

ESR1

Oestrogen receptor alpha gene

fMRI

Functional magnetic resonance imaging

GABAARS

Gamma aminobutyric acid A receptors

HIC

High-income countries

HPA AXIS

Hypothalamic-pituitary-adrenal axis

IL-1RA

Interleukin-1 receptor antagonist

IL-6

Interleukin-6

IP

Intimate partner

IPT

Interpersonal therapy

IPV

Intimate partner violence

IUL

Intrauterine life

KM

Kangaroo method

LBW

Low birth weigh

LGBT

Lesbian, gay, bisexual, and transgender

MAO

Monoamine oxidase

MAO-A

Monoamine oxidase A

MLIC

Medium- and low-income countries

MRS

Magnetic resonance spectroscopy

NB

Newborn

NICU

Neonatal intensive care unit

PET

Positron emission tomography

PMDD

Premenstrual dysphoric disorder

PMI

Peripartum mental illness

PNAS

Postnatal adaptation syndrome

PND

Prenatal depression

PPD

Peripartum depression

PPND

Paternal perinatal depression

PPTD

Postpartum depression

PPTDS

Postpartum depressive symptoms

PTNB

Preterm newborns

SSRIS

Selective serotonin reuptake inhibitors

TH1 OR TH2

T helper cells type 1 or 2

TMS

Transcranial magnetic stimulation

TPH2

Tryptophan hydroxylase-2

WHO

World Health Organization

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Gislene Valadares
    • 1
  • Austen Venancio Drummond
    • 2
  • Carolina Cassiano Rangel
    • 3
  • Eduardo Santos
    • 4
  • Gisele Apter
    • 5
    • 6
  1. 1.Women’s Mental Health Clinic, Incestuous Families Treatment Clinic of Clinica’s Hospital, Federal University of Minas GeraisBelo HorizonteBrazil
  2. 2.Fundação Hospitalar do Estado de Minas GeraisBelo HorizonteBrazil
  3. 3.Brazilian Air ForceRio de JaneiroBrazil
  4. 4.UFMG Clinical HospitalBelo HorizonteBrazil
  5. 5.Rouen Normandy UniversityRouenFrance
  6. 6.Le Havre HospitalLe HavreFrance

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