Perinatal Depression

Abstract

Key Points Perinatal mood and anxiety disorders affect 15% to 20% of mothers from conception to 1 year postpartum and 4% to 25% of fathers.Infants of affected mothers are at risk for impaired social interaction, delays in language and cognitive development, failure to thrive, reactive attachment disorder of infancy, early discontinuation of breastfeeding, and neglect and abuse; longer-term adverse effects can be seen in the child’s learning, memory, behavioral, and emotional adaptation.Formal screening for perinatal depression at infant preventive visits, consistent with the peaks of occurrence, is recommended by Bright Futures, 4th Edition; US Preventive Services Taskforce (2016); and Centers for Medicare & Medicaid Services (2016).Caregivers with a positive screen result and/or symptoms of depression should be triaged for a psychiatric or social emergency and their infants should be screened and followed for potential social-emotional problems.Management is 2-generational.For the parents, demystification, brief interventions to promote the mother-infant relationship and encourage social connections, and referral for evidence-based therapy (individual or couple), emergency medical services, or hospitalizationFor the child, regular monitoring of social-emotional development and Early Intervention Part C servicesFor the mother-infant dyad, evidence-based therapy by a pediatric mental health specialist with expertise in treating infants and young children (0–5 years of age).