While pregnancy often evokes overwhelming joy, it is also a stressful event for most women. For those whose fetus is at high risk of developing malformations and other hereditary diseases, the stress is increased. Throughout pregnancy, physiological and hormonal changes create a totally different and sometimes uncomfortable feeling to most mothers. Added to that, when pregnancy is nearing term, stress may be appreciably increased as anxiety builds up concerning the outcome of the pregnancy, child care, and lifestyle changes that come after delivery. Pregnancy is indeed a major stressor that can produce or even unmask depressive tendencies of some women.

• Depression is a mental disorder wherein the patient presents with depressed mood, loss of interest to almost everything including pleasure, feelings of low self-worth, disturbed sleep, altered appetite, low energy and poor concentration.

• It is estimated that 15 to 20% of pregnant women have mental health issues, particularly depressive symptoms. Hormones of pregnancy were once believed to protect women from depression, but recent findings proved this is not true. Hormones can even trigger emotions that can make it more difficult to cope with depression.

• Most women with depressive symptoms tended to be younger (<25 years old), unmarried, African-American, with less education and have lower family income. They are also more likely to have had prior pregnancies and a history of preterm deliveries and subfertility.

•  Depressed pregnant women are not properly identified and given ample attention. Worse, a recent study has shown that these under-recognized severe depressive symptoms in pregnant women are known to double the risk of preterm delivery (delivery before 37 weeks of completed gestation). Researchers are looking into the possibility that depression during pregnancy may influence the level of placental hormones, which in turn can trigger premature contractions leading to the premature delivery of the fetus. [1]
• Apart from the risk of preterm delivery, depression during pregnancy will also put the mother and the baby’s health at risk. If you are depressed, you may not eat healthy foods which your baby needs. You may lose interest in taking care of yourself, which may cause you to miss prenatal check-ups. You may even turn to smoking or drinking alcohol, which are harmful to the baby.

• Among the many untoward effects discussed between the medical professional and the pregnant woman during prenatal check-up, depression is one point that   should not be missed out. The health care provider and the pregnant woman should share equal responsibility in talking about depression in pregnancy because the earlier depression is diagnosed and identified, the easier it is to treat. Treatment options include :
  1. support from families and friends
  2. counseling which includes talking with family or seeking referral to a    counselor
  3. self-care advice by the primary care giver paying attention to diet, exercise, and sleep.

• Medication is not the first line of treatment for this class of patients, since most antidepressant medications are teratogenic and can cause fetal malformations and limb defects.

Reference:

1. Busko, Marlene (2008). Depression in Early Pregnancy Can Double Risk for Preterm Delivery. http://www.medscape.com/viewarticle/582595