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Abstract
Perinatal depression is one of the most common medical complications during and after pregnancy, occurring in up to 20% of new mothers in the USA. It can have both short- and long-term effects on the mother, child, and family. Multiple etiologies have been proposed for perinatal depression, and there are many reported genetic, epigenetic, environmental, socioeconomic, and psychosocial risk factors. Perinatal depression can be treatable but remains underdiagnosed and undertreated for a variety of reasons, including inconsistent clinical definitions, inconsistent screening, social stigma, and logistic/financial barriers to evidence-based treatments. The diagnosis and treatment of perinatal depression can be complicated by the frequent need for coordination among multiple care providers before and after childbirth. Among the care providers who may encounter perinatal depression, obstetricians are uniquely positioned to provide anticipatory guidance at regular prenatal visits and to identify symptoms and coordinate care, as they follow patients at multiple encounters throughout pregnancy and into the postpartum period. While obstetricians are already among the most common healthcare professionals who diagnose and treat perinatal depression, an opportunity for obstetricians to enhance early detection and treatment of perinatal depression exists. Professional societies and patient advocacy organizations support implementation of universal screening during the perinatal period, and validated clinical tools can detect nearly 50% more patients than more informal methods. This review outlines our current knowledge of perinatal depression and highlights the vital role of obstetricians in screening and treatment.
Acknowledgements
MCH thanks Emily S. Miller, MD, MPH, Northwestern University Feinberg School of Medicine for comments on initial versions of this manuscript.
Disclosure statement
Dr. Hoffman has no conflicts of interest to disclose beyond Sage Therapeutics, Inc. providing funding for the development (i.e. editorial support) of this manuscript. Dr. Hoffman has no financial disclosures. MCH has no conflicts of interest to disclose beyond Sage Therapeutics, Inc providing funding for the development (i.e. editorial support) of this manuscript.