VIDEO: Recognizing and managing depression in pregnant women can begin in primary care

WASHINGTON — Depression is not uncommon among pregnant women, but in most cases treatment does not present significant safety risks, underscoring the importance of screening, said Jeffrey Levine, MD, from the Albert Einstein College of Medicine, at the American College of Physicians Internal Medicine Meeting.

The US Task Force on Preventive Services has recognized the importance of screening for depression based on increasing understanding of morbidity for both the mother and the child as a result of depression and its prevalence – affecting between 9% and 13% of women during pregnancy, he said.

While there is concern about the use of medications in general, and antidepressants in particular, in pregnant women, “overall the data are very reassuring with regard to bad outcomes,” according to Levine.

Treatment with antidepressants may be associated with increases in pulmonary hypertension, preeclampsia and peripartum bleeding, but the absolute risks are extremely low, he added. Ultimately, the decision to treat must be individualized to the patient with her approval.

In managing depression during pregnancy, collaborative care has been shown to be effective, but is also difficult, and may not be practical in every practice setting.