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Prospective Cohort Study of Depression During Pregnancy and the Postpartum Period in Women With Epilepsy vs Control Groups.
Meador, Kimford J; Stowe, Zachary N; Brown, Carrie; Robalino, Chelsea P; Matthews, Abigail G; Kalayjian, Laura A; Voinescu, P Emanuela; Gerard, Elizabeth E; Penovich, Patricia; Gedzelman, Evan R; Cavitt, Jennifer; Pennell, Page B.
Afiliação
  • Meador KJ; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
  • Stowe ZN; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
  • Brown C; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
  • Robalino CP; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
  • Matthews AG; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
  • Kalayjian LA; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
  • Voinescu PE; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
  • Gerard EE; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
  • Penovich P; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
  • Gedzelman ER; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
  • Cavitt J; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
  • Pennell PB; From the Stanford University (K.J.M.), CA; University of Wisconsin at Madison (Z.N.S.); Emmes Company (C.B., C.P.R., A.G.M.), Rockville, MD; University of Southern California (L.A.K.), Los Angeles; Brigham & Women's Hospital (P.E.V.), Harvard Medical School, Boston, MA; Northwestern University (
Neurology ; 99(15): e1573-e1583, 2022 10 11.
Article em En | MEDLINE | ID: mdl-35977832
ABSTRACT
BACKGROUND AND

OBJECTIVES:

Assess the incidence and factors associated with major depressive episodes (MDEs) and symptoms of depression and anxiety during pregnancy and postpartum periods in pregnant women with epilepsy (PWWE) compared with healthy pregnant women (HPW) and nonpregnant women with epilepsy (NPWWE) in comparable timeframes. Previous studies have reported higher rates of postpartum depression in women with epilepsy compared with women without epilepsy. However, the incidence of MDE using a structured interview during pregnancy and postpartum has not been directly compared with control groups, and the comparison of depression and anxiety symptoms and the role of associated factors remain ambiguous.

METHODS:

The Maternal Outcomes and Neurodevelopmental Effects of Antiepileptic Drugs study is a multicenter NIH-funded prospective observational parallel group cohort study of PWWE and their children. This report examines mood disorders. Unlike previous epilepsy pregnancy studies, the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV (SCID) provided lifetime diagnoses, and repeated SCID mood modules assessed for MDE, the a priori primary outcome. Symptoms of depression (Beck Depression Inventory [BDI] and Edinburg Postnatal Depression Scale [EPDS]) and anxiety (Beck Anxiety Inventory [BAI]) were also assessed along with multiple clinical factors.

RESULTS:

This study included PWWE (n = 331) and HPW (n = 102) during pregnancy and postpartum and NPWWE (n = 102) at comparable times. No difference in SCID-diagnosed MDE incidence was found across groups, but BDI depressive symptoms were worse during pregnancy in PWWE vs NPWWE and during postpartum vs HPW and NPWWE. BAI anxiety symptoms were worse during pregnancy in PWWE vs HPW and NPWWE and during postpartum vs HPW. Factors associated with MDE during pregnancy/postpartum for PWWE included >1 seizure/90 days, anticonvulsant polytherapy, unplanned pregnancy, and lifetime history of mood disorder. Suicidal ideation from BDI or EPDS was related to BAI anxiety symptoms.

DISCUSSION:

Although SCID-based MDE did not differ across groups, this prospective study confirms higher rates of psychiatric symptoms in patients with epilepsy during pregnancy and postpartum, provides new data on associated factors, and underscores the importance of anxiety in risk for depression and thoughts of death/dying or suicide. Given the risks, PWWE should be routinely assessed and symptomatic patients should be offered treatment. TRIAL REGISTRATION INFORMATION This study is registered at ClinicalTrials.gov as NCT01730170.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Depressão Pós-Parto / Transtorno Depressivo Maior / Epilepsia Tipo de estudo: Clinical_trials / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Qualitative_research / Risk_factors_studies Limite: Child / Female / Humans / Pregnancy Idioma: En Ano de publicação: 2022 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Depressão Pós-Parto / Transtorno Depressivo Maior / Epilepsia Tipo de estudo: Clinical_trials / Etiology_studies / Guideline / Incidence_studies / Observational_studies / Qualitative_research / Risk_factors_studies Limite: Child / Female / Humans / Pregnancy Idioma: En Ano de publicação: 2022 Tipo de documento: Article