Depression in women is more common than in women due to several factors, of which hormonal imbalances could be one. If they happen to be married and wanting children, there are issues that arise which need to be addressed so that optimal care can be rendered to them.
Risk factors for depression in pregnancy are insufficient social support, living alone, marital discord, an unwanted pregnancy, or multiple children. Age is another risk factor and adolescent pregnancy can be associated with major depression in almost 26%. A positive personal or family history can be associated too. As many as 12-15% women report depression at some point in pregnancy or post-delivery. leaving it untreated has many consequences for both the mother and child.
Untreated women have higher chances of substance abuse and frequent hospitalizations. The child also suffers depression, poor development, prematurity and poor social skills.Thus they should be treated similar to the non pregnant counterparts with medications, cognitive behavioural therapy, supportive therapy and nutrition and excercise.
The SSRI ‘s are commonly used medications during pregnancy along with support groups to make therapy effective. These may need to be continued during pregnancy especially second and third trimesters and even postpartum if needed. Sadly these are not free of side effects for the neonate who can have jitteriness, crying, poor feeding and sleep. They also have autonomic instability, however, the good news is that they only need supportive care.
Electro-convulsive therapy too is seldom used for major depression but has many side effects.
So overall it would be best to opine that if they choose to get pregnant, then proper care in tertiary centers with a multidisciplinary team to take care of the mother and baby should be recommended.
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