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Citation |
Etchegoyen A. Womens Health Med. 2005; 2(2): 44-46. |
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Copyright |
(Copyright © 2005, Elsevier Publishing) |
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DOI |
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PMID |
unavailable |
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Abstract |
Antenatal psychiatric disturbance is an area of increasing clinical and research interest. There is evidence that women suffering from major psychiatric disorder in pregnancy are more likely to receive poor antenatal care and to suffer from malnutrition and obstetric complications. Whilst postnatal depression has been widely studied, antenatal pathology has received very little attention until recently, when studies have highlighted the significance of depression and anxiety in pregnancy. Further research has shown an association between antenatal anxiety and a higher risk of behavioural and emotional problems in 4-year-old children. The overall management of antenatal conditions should include pharmacological, psychological and social aspects as appropriate. Clinically a risk-benefit approach should be taken, including an initial discussion with the parents, regular support with a specialist perinatal team, if available, and close liaison with the obstetric and midwifery team. From a psychological perspective, pregnancy is considered a developmental process, which demands emotional work and change in preparation for motherhood. Regarding social factors it is well known that marital discord and social adversity are aetiologically significant. There is now robust evidence on the importance of (often undisclosed) domestic violence in pregnancy and the puerperium. Specialist services with a strong obstetric liaison component for early detection and treatment of antenatal conditions are recommended. |