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Although it is well know that the substance use during pregnancy has a negative impact on mother and child health, there are few data on pregnancy - related substance use as a risk factor for postpartum depression and child outcomes.
Aims: To determine maternal and child outcomes at 8 and 32 weeks postpartum of women who reported substance use during pregnancy.
This is a cohort study of 1804 Caucasian women in postpartum. Exclusion criteria: psychiatric disorders during pregnancy. Women were evaluated at 2-3 days, 8 and 32 weeks postpartum. Socio-demographic, obstetric, personal and family psychiatric history and substance use during pregnancy; the Edimburgh Postpartum Depression Scale (EPDS) were assessed. All women with EPDS>9 at 8 and 32 weeks were evaluated by a structured interview (DIGS) for DSM-III major depression.
The mean (SD) age was 31.7 (4.6). Forty-six percent of them were primiparous. Thirty-one percent has a family and 16% a psychiatry history. Fifty percent of women reported substance use during pregnancy: 42% caffeine, 21.6% nicotine, 8% alcohol and 0.6% cannabis. Incidence of major postpartum depression was: 12.7%. Incidence of: Apgar scores < 7 at 5 min after birth:0.4%, gestational age at delivery < 37 weeks:7.3%, birth weigt < 2.5 Kg:7.3%, and congenital malformations:1.4%.
In the presentation, the maternal and child perinatal outcomes of women exposed to licit and ilicit drugs will be summarize and will include a discussion of the future clinical and research implications. This work has been done in part with Grants: GO3/184;FIS:PI04178;PI041635,PI041783,PI041779,PI041758,PI041761,PI041791,PI041766,PI041782,RD06/0001/1009; CIBER-SAM.
Previous research has linked OCPD with increased distress levels that may lead to differences in treatment response.
The present study aimed to investigate the influence of pre-treatment distress on patient's response to groupbased cognitive-behavioral therapy (CBT) for OCPD.
116 out-patients who met DSM-IV-TR diagnostic criteria for OCPD completed a pre-treatment assessment including BDI, STAI, STAXI-2, GRAI and Rosemberg Self-Esteem Scale. Pre-treatment distress was operationalized as depression and anxiety levels.
Intervention was comprised of ten group sessions including psychoeducation, specific CBT techniques and relapse prevention. in order to assess treatment response after intervention, the sample was divided in two groups:
1) discharged patients -responders and
2) patients who needed to continue treatment -non responders.
Assessment scores were compared using t test in order to analyze differences between groups. The extent to which potential predictor variables were related to treatment response was assessed using logistic regression.
Results showed statistically significant differences (p < 0.05) in depressed mood and state anxiety scores between responder and non-responder groups. Initial variable selection for logistic regression model included age, sex, depression, anxiety, anger, assertiveness and selfesteem scores. The final model included state anxiety as a significant predictor of treatment response.
Our findings indicate that responder patients had lower pre-treatment distress levels than non-responder patients and that state anxiety score is a significant predictor of group-based CBT response in OCPD. According to this, pretreatment distress levels might be considered for treatment planning, despite more research in this direction would be necessary.
Variables such as the mother's personality, social support, coping strategies and stressful events have been described as risk factors for postpartum depression. Structural Equation Modelling (SEM) analysis was used to examine whether neuroticism, perceived social support, perceived life events, and coping strategies are associated with postpartum depressive symptoms at the 8th and 32nd weeks.
A total of 1626 pregnant women participated in a longitudinal study. Different evaluations were performed 8 and 32 weeks after delivery. Several measures were used: the Edinburgh Postnatal Depression Scale (EPDS), the Diagnostic Interview for Genetic Studies (DIGS), the Eysenck Personality Questionnaire (EPQ-RS), the St. Paul Ramsey life events scale and the Duke-UNC Functional Social Support Questionnaire. The brief COPE scale was used to measure coping strategies. SEM analysis was conducted for all women and in those women with a clinical diagnosis of postpartum depression.
Passive coping strategies were associated with postpartum depressive symptoms at both visits (8th and 32nd weeks). Neuroticism was associated with more passive coping strategies and less active coping strategies. Neuroticism and life stress were positively correlated, and social support was negatively correlated with life stress and neuroticism.
Early identification of potential risk for symptomatology of depression postpartum should include assessment of neuroticism, life events, social support and coping strategies.
Polymorphic variations in the serotonin transporter gene (5-HTT) moderate the depressogenic effects of tryptophan depletion. After childbirth there is a sharp reduction in brain tryptophan availability, thus polymorphic variations in 5-HTT may play a similar role in the post-partum period.
To study the role of 5-HTT polymorphic variations in mood changes after delivery.
One thousand, eight hundred and four depression-free Spanish women were studied post-partum. We evaluated depressive symptoms at 2–3 days, 8 weeks and 32 weeks post-partum. We used diagnostic interview to confirm major depression for all probable cases. Based on two polymorphisms of 5-HTT (5-HTTLPR and STin2 VNTR), three genotype combinations were created to reflect different levels of 5-HTT expression.
One hundred and seventy-three women (12.7%) experienced major depression during the 32-week post-partum period. Depressive symptoms were associated with the high-expression 5-HTT genotypes in a dose–response fashion at 8 weeks post-partum, but not at 32 weeks.
High-expression 5-HTT genotypes may render women more vulnerable to depressive symptoms after childbirth.