Postpartum Depression: What Do Pediatricians Need to Know?

Abstract

1. Natasha K. Sriraman, MD, MPH* 2. Do-Quyen Pham, MD† 3. Reeti Kumar, MD‡ 1. *Division of General Academic Pediatrics, The Children’s Hospital of the King’s Daughters; Department of Pediatrics, Eastern Virginia Medical School, Norfolk, VA 2. †Division of Adolescent Medicine, Seattle Children’s Hospital, University of Washington, Seattle, WA 3. ‡Division of Nephrology, Nationwide Children’s Hospital, Columbus, OH * Abbreviations: EPDS: : Edinburgh Postnatal Depression Scale PPD: : postpartum depression and anxiety SSRI: : selective serotonin reuptake inhibitor TCA: : tricyclic antidepressant Although pediatricians are aware of the effect of postpartum depression on their patients, it is seldom screened for in the setting of the well-child visit. After completing this article, readers should be able to 1. Describe the different types and phases of postpartum depression and anxiety (PPD). 2. List the risk factors for developing PPD. 3. Detail the different types of validated screening tools to detect PPD. 4. Describe the effects of PPD on the mother-infant dyad interaction. 5. Discuss the different treatment options available for mothers experiencing PPD. 6. List available resources to help mothers, fathers, and their families. Postpartum depression and anxiety (PPD), also known as postpartum mood and anxiety disorders , is a common medical condition that can significantly affect the health and well-being of mothers, infants, and family units. PPD affects 10% to 25% of mothers, making it the most common underdiagnosed obstetric complication. Nationally, it is estimated that every year, more than 400,000 infants are born to mothers who are depressed. Although pediatricians are aware of this condition, it may not be the foremost thought in their minds at the well-child visit. However, pediatricians have the greatest opportunity of encountering the infant and caregivers regularly. Therefore, we have a responsibility to screen mothers for PPD and offer the most appropriate resources. (1) The postpartum spectrum of psychiatric syndromes can be classified into 3 major categories: postpartum blues, postpartum depression, and postpartum psychosis (Fig 1). (2) Postpartum blues are a common emotional experience for women after delivery that affects 30% to 80% of women. Symptoms include emotional lability, difficulty sleeping, decreased appetite, and excessive anxiety. The onset is typically in …