Sunday 24 September 2017

New test could prevent baby blues for many

A simple blood test may be available to detect those who are a risk of post-natal depression (PND)
A simple blood test may be available to detect those who are a risk of post-natal depression (PND)

Patricia Casey

News is emerging that for the first time a simple blood test may be available to detect those who are a risk of post-natal depression (PND) even before they develop it. The scientist pioneering this work of Professor Dimitris Grammatopoulos, a molecular biologist from the University of Warwick.

He has identified specific genetic abnormalities in the receptors for glucocorticoids and corticotrophin releasing hormone.

These are among the hormones that are involved in the stress response, and abnormalities in these might signal an increased risk of developing PND among pregnant women exposed to environmental stressors.

They exemplify the interaction that occurs between biology and environment and they behave in a unique way during pregnancy.

A blood test is now being developed to identify those women who have this genetic vulnerability.

Identifying women at risk would enable additional support systems to be put in place during pregnancy in order to mitigate the effect of the environmental stressors associated with post-natal depression.

Alternatively, treatment could be initiated early in the course of the illness while symptoms are emerging rather than having to wait until the full blown syndrome is evident as is presently the case.

The prospect of early detection followed by support and/or treatment would be hugely important step for many pregnant women, of whom 10pc are likely to develop PND, a figure that has been replicated across Europe.

A much smaller percentage, 1pc, develops a severe form of the illness known as puerperal psychosis. The symptoms are much more incapacitating than those found in PND.

Prompt treatment is essential because depression has a negative impact on the baby, on her partner or spouse and on the woman herself.

A mother who is depressed will have trouble responding physically or emotionally to the baby when it cries.

Everything from feeding to bathing the infant will be an effort. At times the woman may be so sleep-deprived that thoughts of harming the baby couls occur, especially if the baby wakes frequently.

The relationships between a baby and its mother during the early period in life are crucial. The more loving the relationship, the better the ability to make and sustain healthy relationships later in life.

Depressed mothers have been shown to play less with their children, to use less baby talk and to be less affectionate. These in turn increase the mother's sense of failure and guilt.

Towards partners, depressed mothers can be irritable, disinterested in socialising and experience loss of libido. These relationships often crumble due to untreated depression.

No doubt the scientific evaluation of this proposed test will begin soon. The Department of Health in Britain has welcomed this innovative investigation. The question is, will pregnant women?

Some may fear that if they test positive they will be stigmatised by future employers or insurance companies.

They may also worry unduly about the risk of depression and may exhibit a worrisome and fatalistic belief that it will occur, despite the additional supports that would be offered to them.

I suspect however that most pregnant women will welcome this test and will be reassured that preventive or early remedies are preferable to delayed diagnosis and even later treatment.

A word of caution also needs to be sounded. PND has a number of causes and this test is designed only to identify the risk of one particular type.

For some women it is likely that, even with a negative test, they may continue to be at risk. Yet despite this, the availability of a possible biological screen for PND is one to be welcomed.

Irish Independent

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