Pregnancy depression tied to past abuse

UNC-CHAPEL HILL (US) — Women with a history of eating disorders or abuse may be at higher risk of suffering from depression during and after pregnancy.

The findings, published in the Journal of Women’s Health, could help doctors identify at-risk patients and refer them to treatment early on.

A survey of 158 pregnant and postpartum women undergoing treatment for depression found that one-third of the patients reported a history of eating disorders; in addition, many had a history of physical or sexual abuse.

Mental health screening tools that include questions about eating disorders, abuse, and other factors should be incorporated into routine prenatal care, says Samantha Meltzer-Brody, associate professor of psychiatry at the University of North Carolina at Chapel Hill.

“Screening by obstetrical providers is really important because they can refer patients for appropriate treatment,” she says. “And that can prevent long-lasting problems for mom and baby.”

Children of depressed mothers are more likely to develop mental health problems themselves as are children of mothers with an active eating disorder. Making sure mothers struggling with mental health issues receive adequate assessment and treatment is critical to breaking that cycle.

“The message we need to get out is that these things are incredibly common and routine screenings need to occur,” says Meltzer-Brody. “The prevalence of abuse and eating disorder histories may be much higher than people appreciate.”

A staggering 25 percent of women experience physical or sexual abuse during their lifetime—and an estimated 6-8 percent are at some point affected by an eating disorder, with binge eating and bulimia nervosa being the most common, followed by anorexia and other disorders.

“Pregnancy and the postpartum period is a very vulnerable time for women,” says Meltzer-Brody. Rapid changes in body shape, weight, and hormone levels, combined with major lifestyle changes during the transition to motherhood, can take a toll on women—especially those with a history of previous psychiatric issues.

By conducting mental health screens during prenatal care, doctors can help curb pregnancy-related depression, she says.

Pregnancy “is a time when people are really motivated to make changes and get treatment, because that can have serious consequences for how you do and for how your children do.”

Support for the research came from the National Institutes of Health.

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