Risk Of Bias Assessment
After the literature screening, a bias evaluation of the studies was performed by two evaluators independently to clarify ambiguous differences between the reporting quality and research quality. Different evaluation methods were applied according to the study design. RCT studies were examined using the risk-of-bias 2 tool , and the NRS were examined using the Risk of Bias Assessment Tool for Non-randomized Studies . Case reports and series were evaluated used the methodological quality tool because they could be adopted as evidence of new treatments . The final judgment on the overall risk of bias was agreed upon between the two evaluators, and publication bias was visually reviewed through funnel plots, and additionally, statistically confirmed through Eggers regression.
Risk Factors For Antepartum Depression
- High stress levels
- A history of depressive episodes
- Anxiety, whether its generalized anxiety disorder or something more specific such as miscarriage anxiety
- Little to no support inside or outside the home
- An abusive relationship
- Unexpected pregnancy
Tms And Pregnancy: Safe And Effective Treatment
One of the best things you can do as a mother is to take care of yourself, so that you can be there for your baby. You should talk to your doctor if you have any concerns and ask for a mental health screening at your next appointment to get started with a safe, effective treatment.
TMS is one of the most effective treatments for depression, with response rates that are consistently higher than those observed in clinical trials of antidepressants.
Standard treatment approaches of perinatal depression include talk therapy and medication. Transcranial magnetic stimulation is an alternative option which lacks the systemic effects that are typically associated with medications, making it an ideal intervention for those who are pregnant or nursing.
TMS is an FDA indicated treatment for depression that is noninvasive and uses magnetic fields to gently nurture specific areas of the brain responsible for mood.
Unlike other forms of brain stimulation, TMS therapy is non-invasive and non-sedating. Patients can drive themselves to and from treatments and get back to their day right away, including work or school.
Tms For Depression During Pregnancy And Postpartum
Women who suffer from depression during pregnancy or in the postpartum period might not seek treatment if they assume medication is the only treatment option available to them. Although concerns about taking medication while pregnant or breastfeeding are understandable, untreated depression can also be very dangerous.
Women who want to avoid or limit the use of antidepressants may consider Transcranial Magnetic Stimulation as a safe and effective treatment option. Approved by the FDA in 2008 for treating depression, TMS works by delivering electromagnetic pulses to specific areas of the brain that regulate mood.
A standard treatment course is five sessions a week for four-to-six weeks. Each session lasts about one hour. Patients remain awake and alert during the treatment, and there are minimal side effects.
Several research findings have shown that TMS is a safe and viable treatment for women who are pregnant or postpartum.
- A University of Pennsylvania study of TMS and pregnancy found that among 10 pregnant women treated with TMS, 70 percent responded well within just 20 sessions, with no adverse effects on pregnancy or fetal outcomes. The only side effect was a mild headache in four of the patients.
- Another study that focused on TMS during postpartum found that eight of the nine women who were treated with TMS experienced complete remission of their depression.
Why Antepartum Depression Shouldnt Be Ignored
Treating depression while pregnant is vital for you and your baby. Untreated depression can take its toll on your mind and body, which are already in overdrive to meet the demands of carrying a baby. You may feel too exhausted or unmotivated to take care of yourself. As a result, you could stop eating a well-balanced diet, start skipping your doctors appointments or even turn to alcohol or drugs to try to cope.
All of these decisions can potentially harm your baby. For instance, low birth weight and preterm birth have been linked to maternal depression during pregnancy, and those two conditions raise the risk of infant hospitalization or death.
Depression is treatable, and its essential for expecting mothers to get help. Talk therapy can be beneficial. Cognitive behavioral therapy helps women change their negative thoughts or behavior patterns to help ease depression symptoms. With interpersonal therapy, women examine their relationships and support networks to see how they influence mood.
There are some safety concerns when it comes to another first-line depression treatment. Antidepressants may not be advisable in some cases. Conventional wisdom on the use of selective serotonin reuptake inhibitors during pregnancy has fluctuated, based on limited or conflicting data.
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Find Joy In Pregnancy With Brain Therapy Tms
You deserve to enjoy every moment of your pregnancy. If you are experiencing depression during pregnancy, it is time to seek help. TMS is a safe way to find relief from the most severe symptoms of prenatal depression.
If you are ready to see if TMS is right for you, Brain Therapy TMS would love to help. The professionals at Brain Therapy have had success in delivering TMS to pregnant women. If youre curious, schedule a free consultation and see if TMS is right for you.
What Causes Heartburn During Pregnancy
When you’re pregnant, your bodys hormone levels experience changes. Some may act as a muscle relaxant that helps to prepare your body for childbirth. The downside? The increase of some hormones may also relax the lower esophageal sphincter, or LES. That’s the valve responsible for keeping stomach acid from moving up into the esophagus, where it doesn’t belong. If the acid moves into that area, it can irritate the esophagus and cause heartburn.2
As your pregnancy progresses and your baby grows, there may be more pressure on your stomach. This too can push the acid in your stomach past the LES and back into the esophagus, causing heartburn.
The good news is that heartburn will likely stop for most women after they give birth. If you have heartburn while pregnant, however, you may be at an increased risk of having heartburn later in life.
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Can Prenatal Depression Effect The Baby
Women with depression may struggle to take care of themselves. They may not get enough sleep, eat the proper nutrition, or continue taking essential prenatal vitamins. A failure to take care of oneself during pregnancy can have implications for your babys growth and development.
Children born of depressed mothers often have a lower birth weight. They are more likely to be born prematurely. Sadly, depression in pregnant women can also increase the risk of miscarriage.
Prenatal depression not addressed can progress and become postpartum depression. Women who struggle with depression after the birth of their child can fail to bond appropriately with their child. It may lead to issues with feeding and attachment.
Whats Involved In Tms Therapy
Depression is treatable, and its essential for expecting mothers to get help. If youre concerned about the use of antidepressant medications while pregnant, its helpful to know that there are other alternatives available, such as TMS therapy.
TMS treats depression at the source.During TMS treatment, patients recline in a treatment chair and remain awake and alert. A TMS magnet is positioned over the patients head to deliver gentle pulses to specific areas of the brain that are underachieve in depression. Patients report that the pulses feel like taps on the head.
TMS is well tolerated. Sometimes patients experience mild scalp discomfort or mild headache during active treatment. Each treatment session lasts about 20 minutes, after which patients can immediately return back to their daily routines.
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Why Is It Important To Seek Treatment For Depression While Pregnant
People are who are depressed are oftentimes less likely to seek treatment or take steps in practicing self-care. For women who are pregnant, this may translate to not seeking appropriate prenatal care and not eating healthy foods that are essential for the health of the mother and the developing baby. Moreover, depression in either the mother or the father during pregnancy is associated with premature birth, which can result in long-term health complications for the child.
When Prenatal Depression Develops
Depression during pregnancy is more common than most people believe. Still, it can be difficult to recognize and can cause expecting mothers to doubt themselves. Experts estimate that between 14 and 23 percent of expecting mothers have depression symptoms during their pregnancy. Some women feel ashamed to admit they’re struggling. Despite improved openness about depression, the stigma still exists. This can be especially challenging when pregnancy and motherhood are portrayed as only positive experiences. Further, emotional depression symptoms can be easy to write off as an overreaction to pregnancy hormones. Physical symptoms such as fatigue and appetite changes can also mimic typical aspects of pregnancy. Pregnant women most at risk for developing depression typically have experienced one or more of these issues:
- High levels of stress in daily life
- One or more current or previous mental health conditions, especially anxiety or depression
- Low levels of social support
- Involvement in an abusive or violent relationship
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What Is Tms Therapy
TMS is a treatment for depression that uses magnetic fields to stimulate parts of the brain responsible for your mood disorder. The doctor will use a unique coil to direct the magnetic frequency. Sessions are painless, and many individuals find them relaxing.
TMS therapy has proven to be an effective mechanical treatment for prenatal depression. Most women experience relief after two or three weeks of treatment. When effective, TMS relief can last longer than a year.
The procedure is painless and does not result in any side effects. For in-depth information on TMS therapy, visit What Is TMS?.
What Are The Dangers Of Tms Therapy
There do not appear to be major risks or long-term dangers associated with TMS therapy, provided that measures have been correctly checked before the procedure has occurred and provided that there are no contraindications present that could put the patient at an increased risk of danger during treatment.
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How Prenatal Depression Affects Women Of All Backgrounds
While some women feel ashamed to admit theyve been struggling with prenatal depression, mental health experts estimate that between 14 and 23 percent of expectant mothers have shown clear signs of depression symptoms throughout their pregnancy.
Often, seeking treatment for depression during pregnancy can feel overwhelming and stigmatized, as society often labels pregnancy and motherhood as exclusively positive experiences.
Unfortunately, emotional depression symptoms can be easily written off as a hormonal overreaction, and the physical symptoms of depression, such as fatigue and changes in appetite, can also mimic typical side effects of pregnancy.
To help you differentiate between typical pregnancy symptoms and signs of prenatal depression, keep a watchful eye on your personal experience with the following factors:
- High levels of stress in daily life
- One or more current or prior mental health conditions, especially mood disorders like anxiety and depression
- Low levels of social support
- Involvement is an abusive or violent relationship
Emotional ups and downs are extremely common both throughout pregnancy and following childbirth, but ongoing sadness, constant crying, or feelings of disconnection are signs of something more serious. Talking with your doctor can help you understand if you may be experiencing prenatal depression.
Tms In Comparison With Other Forms Of Depression Treatment
TMS therapy does not appear to cause any major long-term life-altering effects in comparison to other types of medication and procedures for treating depression during pregnancy. In contrast, anti-depressant medications may cause weight gain, dry mouth, problems with the sex drive, sedation, and issues within the intestines.
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Don’t Treat Tums Like Candy
As with most things, moderation is key. The manufacturer advises pregnant people to limit themselves to a maximum of 15 TUMS Regular Strength 500 within any 24-hour period. The maximums differ from product to product, so be sure to read the bottle carefully and consult with a healthcare provider if you have any questions or concerns.
Dr. Clark suggests keeping an eye on intake and symptoms. “If you find you are using TUMS daily or they do not relieve your symptoms, be sure to let your obstetrical care provider know.”
If TUMS aren’t working to relieve your symptoms after a while, don’t fret. “It may be time to consider alternative therapy for your symptoms of GERD, like a prescription medication,” says Dr. Clark.
Inclusion And Exclusion Criteria
In general, the studies used for the meta-analysis were randomized controlled trials , but non-randomized studies were also included in the meta-analysis, and case studies were included in the systematic review because only a small number of randomized trials provided evidence of the effects of the interventions associated with pregnancy. Before inclusion, the non-randomized studies were evaluated to verify that the patients, interventions, comparisons, and outcomes were set appropriately by the Cochrane algorithm. If systematic reviews or meta-analyses were included, we checked the included studies and references. The criteria for exclusion were experimental studies with animals, studies not published in English, studies that were not original , symptoms of baby blues or postpartum psychosis, and major depressive disorder that did not occur from pregnancy to 1 year after childbirth.
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Who Experiences Prenatal Depression
Women who have gone through a traumatic pregnancy have an increased risk of experiencing prenatal depression. This includes women who have had miscarriages or have experienced a stillbirth in the past. Unrelated trauma from your childhood might also play a role.
Those with an existing history of depression or other mental health challenges are more likely to struggle with depression during pregnancy. You may also experience symptoms if your pregnancy is stressful. Women who are lacking support or struggling financially might also become depressed.
Which Depression Treatments Can Be Safely Administered During Pregnancy
Currently, primary treatments for depression include antidepressant medication and therapy. In addition to benefits, there are significant risks associated with antidepressant medications. For example, if taken during the third trimester, babies can experience withdrawal symptoms from the discontinuation of the antidepressant medication, including jitters and respiratory distress.
Additionally, while some antidepressants may be safely administered throughout pregnancy, there is conflicting evidence as to whether certain antidepressants, like SSRIs, are associated with a higher risk of birth defects.
If youre currently taking antidepressant medication and learn that youre pregnant, make an appointment to see your doctor before making any changes. You may be able to keep taking your medication. Discontinuing the use of your antidepressant can cause a relapse of symptoms or unwanted side effects.
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Can I Take Tums While Pregnant
Pregnant women may experience heartburn for the first time.
We know there are many surprises along the road to motherhood like heartburn. More than 50% of all pregnant women report symptoms of heartburn, particularly during their second and third trimesters. Pregnant women may experience heartburn because of changes to diet, fluctuating hormone levels, and crowding of the abdomen.1
The Dangers Of Depression For Pregnant Mothers
The dangers that may face depressed mothers who do not receive TMS treatment or any other form of effective treatment to address their depression during pregnancy may include giving birth to children with lower birth weight. It may increase the chance of the woman experiencing a miscarriage, and they might also be at higher risk of facing a preterm birth .
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Electroconvulsive Therapy For Pregnant Women
Electroconvulsive Therapy or ECT has been shown to be an effective treatment for people suffering from depression. Moreover, it can be used safely to treat women who have experienced a major depressive episode, or who are experiencing continuing depression during pregnancy. It has also been shown to be particularly beneficial for patients who have previously had ECT therapy and experienced positive results.
Studies suggest that ECT is predominately safe for pregnant women as a form of therapy for depression. However, in some rare cases, it has led to premature births, miscarriages, and overall problems within the uterus. These instances were minimal, however, and it would appear that ECT is overall a safe treatment for women experiencing depression during pregnancy.
Treating Depression During Pregnancy: Safe Options For You And Your Baby
Erika Krull, MSEd, LMHP
Dr. Kimberly CressTexas Regional Medical Director
Pregnancy is supposed to be a happy time, so why do some expecting mothers have feelings of overwhelming doubt and anxiety? If you’re feeling unsettled or sad, you may think there’s something wrong with you as a parentbut these feelings are actually common. You may be one of the many mothers quietly struggling with depression during pregnancy. If so, you may feel hesitant to speak up about it, but getting treatment for depression is essential. You deserve to feel healthy and well as you prepare for childbirth. Prenatal depression can be challenging, but it is treatableand getting better starts with understanding your treatment options. If you’re concerned about taking antidepressants while pregnant and want to learn about other treatment methods, Transcranial Magnetic Stimulation could be worth considering.
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