Saturday 20 January 2018

One in four pregnant women suffers from mental health problems

Depression and anxiety were among the most common disorders among pregnant women. Stock image
Depression and anxiety were among the most common disorders among pregnant women. Stock image

One in four pregnant women suffers from mental health problems, research has revealed, and scientists say identifying issues early could be vital for a healthy pregnancy.

Although in line with the national average, the research by scientists at King's College London further debunked the myth that pregnancy boosts physical and mental health.

Nationally an average of one in five women experience some form of mental health disorder during their lifetimes, while this jumps to one in four in young women.

Depression and anxiety were among the most common disorders among pregnant women but eating disorders and obsessive compulsive disorders both made up 2% of cases.

The study, the first of its kind in the UK, aimed to identify how common disorders were during pregnancy and how midwives can best identify them to ensure a speedy referral to mental health services.

One of the study's authors, Louise Howard, professor of women's mental health at King's College, said: "We wanted to establish the prevalence of the range of disorders because there has been a tendency to focus on depression in the past.

"As mental disorders in general can affect women and their families, it was important to know just how common all the disorders were."

She continued: "Our findings support the idea that pregnancy is not protective, which is what people used to think.

"There was a myth that pregnancy was a time of great blooming health and it was the postnatal period that was the one to be concerned about when people were thinking about mental disorders."

She emphasised that pregnancy was not necessarily a cause of a mental health problem but said it could provide medical professionals with a great opportunity to identify an issue.

"It can be a way to prevent a mental health problem becoming chronic and prevent problems during the postnatal period," she said.

The research was funded by the National Institute of Health Research and focused on a sample of 545 pregnant women over the age of 16 attending a south-east London maternity clinic.

Participants were assessed through the Edinburgh Postnatal Depression Scale (EPDS) - a series of 10 questions on a form filled out by the patient, or the Whooley questions.

The Whooley questions are simply "During the past month have you often been bothered by feeling down, depressed or hopeless?" and "During the past month have you often been bothered by having little interest or pleasure in doing things?"

Instead of being part of a form, they are asked face-to-face by a midwife, and although the EPDS is widely used internationally, the Whooley questions were found to be equally effective at identifying underlying mental health issues.

Professor Howard said: "What we wanted to see was one of them better than the other and how did they compare against the gold standard [of mental health care] and what did that mean for services."

She added: "We're not saying it has to be the Whooley questions over the EPDS but in terms of logistics two questions might be easier than 10 self-complete questions."

It has been proven that mental illness during pregnancy is associated with adverse outcomes for women, the pregnancy itself and the child, so early identification could be key to mitigating the worst effects.

Professor Howard said: "There's research that shows that having a mental health problem is associated with impacts on birth weight and also on delivering earlier than otherwise might be the case.

"There's all sorts of mechanisms that could potentially explain those associations and there is some evidence to suggest that it might be the stress of having the disorder and the associated stresses that caused the disorder that are leading to an impact on stress hormones, leading to an impact on the baby growing in utero."

She continued: "It's not as if all women with mental disorders will have problems in the pregnancy outcome but we know that there is an increased risk of that occurring, so that's one potential thing that we want to try to prevent.

"We also know that if things continue into the postnatal period, that if somebody has got a problem it might interfere with their ability to interact with their baby in the way they would otherwise do and that potentially could impact on the child's development."

Maria Bavetta, co-founder of charity Maternal OCD, said: "This study shows how vital it is for pregnant women to be asked the right questions at the right time with a non-judgemental space to be listened to.

"I wish I had been given the opportunity to share my thoughts in a way that would have helped me access specialist maternal mental health services quicker - this is a duty we need to fulfil as every mum should have the right to be the mummy they want to be."

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