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Perinatal Mental Health Community of Practice
February Newsletter of Literature, Calls for Submissions, Events, and More!
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Dear PMH Community of Practice Members,
We are transitioning from a literature roundup to a newsletter this month! We have found that there are a lot of exciting things happening in perinatal mental health around the globe - from movies and webinars to peer reviewed articles and news stories. We feel this community could benefit from having all of this information in one place. Please enjoy the following:
- Journal Articles and Studies
- News Articles and Blogs
- Calls for Journal Submissions
- Upcoming Events
- Webinar and Video Recordings
- Materials from MOMENTUM Country and Global Leadership
We encourage you to forward this email to your networks or anyone interested in learning more about global perinatal mental health! For those not already members, you can sign-up here.
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JOURNAL ARTICLES AND STUDIES
Prioritizing Maternal Mental Health in Addressing Morbidity and Mortality
Wisner KL, Murphy C, Thomas MM. Prioritizing Maternal Mental Health in Addressing Morbidity and Mortality. JAMA Psychiatry. Published online February 21, 2024. doi:10.1001/jamapsychiatry.2023.5648
Concrete programmatic and policy changes are needed to reduce perinatal stress and address trauma, standardize the collection of social determinant of health data among perinatal patients, increase access to reproductive psychiatry curricula among prescribers, reduce perinatal mental health and obstetrical deserts, institute paid parental leave, and support seamless integration of perinatal and behavioral health care. Moreover, instead of focusing on a relatively minor portion of the contributors to health that current medical practice targets, fortifying the social foundation strengthens the prospects for the health of families for our current and future generations. (Source: JAMA Psychiatry)
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Perinatal Depression and Risk of Suicidal Behavior
Yu H, Shen Q, Bränn E, et al. Perinatal Depression and Risk of Suicidal Behavior. JAMA Network Open.2024;7(1):e2350897. doi:10.1001/jamanetworkopen.2023.50897
The study addresses the lack of prospective data on the long-term risk of suicidal behavior in women with perinatal depression (PND), which is depression during and after pregnancy. Conducted in Sweden over 16 years, the research involved 86,551 women with PND and 865,510 unaffected women, individually matched for age and calendar year at delivery. The study found that women with PND had a significantly higher risk of suicidal behavior, both in the short and long term, compared to unaffected women. This risk remained elevated even when compared to their PND-free sisters. The study underscores the importance of closely monitoring and providing clinical support to women with PND, particularly in the first year after diagnosis, and highlights the persistent risk over an 18-year follow-up period. (Source: JAMA Network Open)
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The lived experiences of individuals with postpartum psychosis: A qualitative analysis
Vanderkruik R, Kobylski LA, Dunk MM, Arakelian MH, Gaw ML, Dineen H, Kanamori M, Freeman MP, Cohen LS. The lived experiences of individuals with postpartum psychosis: A qualitative analysis. J Affect Disord. 2024 Mar 1;348:367-377. doi: 10.1016/j.jad.2023.12.069. Epub 2023 Dec 29. PMID: 38160890.
Postpartum psychosis (PP) is a severe psychiatric condition affecting 1 to 2 per 1000 individuals in the perinatal period. Prior qualitative research on PP focused on specific aspects, with limited samples and geographical scope. The Massachusetts General Hospital Postpartum Psychosis Project (MGHP3), initiated in 2018, includes a large, international sample to comprehensively study PP. With 130 participants reporting on 133 episodes, the analysis explored participants' narratives, covering broad psychosocial experiences, impact on the mother-baby dyad, treatment, and recovery. The findings provide valuable insights into the diverse ways PP affects individuals globally, emphasizing the need for international perspectives in future research and clinical efforts to support individuals with PP and their families. (Source: Journal of Affective Disorders)
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Maternal antipsychotic use during pregnancy and congenital malformations
Liu X, Kolding L, Momen N, Gasse C, Pedersen LH. Maternal antipsychotic use during pregnancy and congenital malformations. Am J Obstet Gynecol MFM. 2023 Jun;5(6):100950. doi: 10.1016/j.ajogmf.2023.100950. Epub 2023 Apr 2. PMID: 37015311.
This study in Denmark looked at the potential risks of birth defects when pregnant individuals took antipsychotic medications during the first trimester. They analyzed data from over 500,000 pregnancies, finding that 0.2 per cent involved the use of antipsychotics. The study discovered that 7.3 per cent of pregnancies with antipsychotic exposure had major malformations, with a 23 per cent higher risk compared to those without such exposure. However, when comparing with pregnancies where antipsychotics were used before but not during pregnancy and considering siblings, this risk was less pronounced. The overall findings suggest there might be limited or no significant risk of birth defects from first-trimester antipsychotic use, though more research is needed, especially for specific medications. (Source: American Journal of Obstetrics & Gynecology MFM)
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The efficacy of zuranolone in postpartum depression and major depressive disorder: a review & number needed to treat (NNT) analysis
Cha DS, Kleine N, Teopiz KM, Di Vincenzo JD, Ho R, Galibert SL, Samra A, Zilm SPM, Cha RH, d'Andrea G, Gill H, Ceban F, Meshkat S, Wong S, Le GH, Kwan ATH, Rosenblat JD, Rhee TG, Mansur RB, McIntyre RS. The efficacy of zuranolone in postpartum depression and major depressive disorder: a review & number needed to treat (NNT) analysis. Expert Opin Pharmacother. 2024 Jan 2. doi: 10.1080/14656566.2023.2298340. Epub ahead of print. PMID: 38164653.
Zuranolone, an oral neuroactive steroid and positive allosteric modulator of GABAA receptors, has been recently FDA approved as a promising rapid-acting antidepressant in September of 2023 for the treatment of postpartum depression (PPD). This article focuses on reviewing zuranolone (SAGE217) with an emphasis on available clinical studies in individuals with major depressive disorder (MDD) and postpartum depression (PPD). The paper contributes to the existing literature by presenting efficacy data as Number Needed to Treat (NNT), allowing for indirect comparisons with other antidepressants. Zuranolone is described as a novel rapid-acting oral antidepressant designed for the treatment of adults with MDD and PPD. The two-week course duration is highlighted, and zuranolone is reported to be well-tolerated, with no significant safety concerns identified in completed clinical trials. Additionally, there is an expectation that zuranolone will be scheduled by the Drug Enforcement Agency (DEA). (Source: Expert Opinion on Pharmacotherapy)
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Effect of esketamine on postpartum depression after labor analgesia and potential mechanisms: a randomized, double-blinded controlled trial
Wang W, Ling B, Zhao H, He J, Xu H, Lv J, Wang Q. Effect of esketamine on postpartum depression after labor analgesia and potential mechanisms: a randomized, double-blinded controlled trial. BMC Anesthesiol. 2024 Jan 2;24(1):4. doi: 10.1186/s12871-023-02377-6. PMID: 38166663; PMCID: PMC10759400.
The study aimed to assess the impact of combining esketamine with ropivacaine hydrochloride on postpartum depression (PPD) occurrence following labor analgesia through epidural analgesia pump and to explore potential mechanisms. Involving 120 women, randomly divided into esketamine (Group E) and control (Group C), the study measured visual analogue scale (VAS) scores, labor duration, Apgar scores, postpartum hemorrhage, and substance consumption. Esketamine-ropivacaine significantly lowered VAS scores at various time points and notably reduced the incidence of PPD at 1 and 6 weeks post-delivery compared to the control group. Leptin levels were higher, while norepinephrine (NE) and epinephrine (E) levels were lower in the esketamine group. No significant differences were observed in labor duration, Apgar scores, postpartum hemorrhage, or side effects between the two groups. The findings suggest that combining esketamine with ropivacaine in labor analgesia may reduce PPD incidence without additional side effects, potentially linked to the regulation of leptin, NE, and E levels. (Source: BMC Anesthesiol)
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NEWS ARTICLES AND BLOGS
- Yetunde Oladejo-Adeseluka. “The silent threat of perinatal depression: Why holistic care is needed to improve maternal and newborn health in Nigeria.” AlignMNH. (February 14, 2024).
- Jane E. Dee. “YSPH Researcher studies climate change’s negative effects on mental health.” Yale School of Public Health. (February 5, 2024).
- "Black Maternal Mental Health: the Data, the Barriers, and Organizations to Support." Maternal Mental Health Leadership Alliance. (February 1, 2024).
- Rodolfo Bonnin, Leonard M. Gralnik and Nathaly Shoua-Desmarais. “Suicide has reached epidemic proportions in the US − yet medical students still don’t receive adequate training to treat suicidal patients.” The Conversation. (February 1, 2024).
- Clara Angela Brascia. “Susana Carmona, neuroscientist: ‘We know more about the universe than women’s brains.’” El Pais. (January 23, 2024).
- Anna Demming. "The left hand doesn’t know what the right is doing’: the barriers to UK maternal mental healthcare." The Guardian. (January 20, 2024).
- Davi Merchan. "As more states pass laws addressing maternal mental health, barriers to access continue." ABC News. (January 5, 2024).
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CALLS FOR JOURNAL SUBMISSIONS
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WEBINAR AND VIDEO RECORDINGS
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MATERIALS FROM MOMENTUM COUNTRY AND GLOBAL LEADERSHIP
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Email PMH...@jhpiego.org if you would like to include something in our next monthly newsletter (March 2024). Requests are considered by the PMH CoP Secretariat.
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This content is made possible by the generous support of the American people through
the U.S. Agency for International Development (USAID) under the terms of the Cooperative Agreement #7200AA20CA00002, led by Jhpiego and partners. The contents are the responsibility of MOMENTUM Country and Global Leadership and do not necessarily reflect the views of USAID or
the United States Government.
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