February 12, 2019
The significance of postpartum depression is just beginning to get the proper acknowledgement, with as many as one in seven women experiencing it during pregnancy or in the year after giving birth.
On Tuesday, the United States Preventive Services Task Force, an influential panel of clinicians and researchers that makes recommendations for patient care, announced it had found that counseling can ward off perinatal depression, the New York Times reports.
The consequences of maternal depression can be severe, according to Taskforce member Karina Davidson, who describes a "cascading set of problems," including premature birth, low birth weight and failure to thrive. After childbirth, new mothers who are depressed can be neglectful and inattentive to their newborn, putting infants at risk for an even greater number of problems, NPR reports.
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This marks the first time a national health organization has recommended anything to fend off the most common complication of pregnancy, and it's calling publicly for health providers to seek out at-risk women and guide them to treatment.
Further, this recommendation, published in the journal JAMA, received a “B” rating, meaning that under the Affordable Care Act, counseling should be covered without co-payments for women, the Times reports.
According to NPR, the task force has taken its 2016 recommendation — which advised screening for depression among all adults — further by focusing on perinatal depression (depression before, during and after pregnancy) and recommending evidence-based interventions aimed at preventing it in the first place.
"We actually have evidence now that if you find women who are not currently depressed but who are at risk for becoming depressed during pregnancy or within a year after childbirth behavioral counseling can help them prevent getting this disease," says Davidson.
The task force does not make the recommendation lightly. It reviewed 50 studies examining a variety of different treatments including counseling, physical activity, education, and medication such as antidepressants and omega-3 fatty acids. There was convincing evidence that counseling interventions such as cognitive behavioral therapy and interpersonal therapy were effective in preventing perinatal depression, NPR reports.
In fact, both types of therapy reduced the risk of depression by 39 percent.
While Davidson says more research is needed to develop a checklist for doctors and healthcare providers to accurately screen pregnant women for depression, there are some known factors that put women at greater risk. A previous history of depression or depressive symptoms, a family history of depression or social stresses like teen or unwanted pregnancy, low income, unemployment and partner violence could be some of the factors, NPR notes.
The panel emphasized that perinatal depression “should not be confused with the less severe postpartum "baby blues," which is a common transient mood disturbance, the Times notes.