The Neurobiological Impact of Postpartum Maternal Depression: Prevention and Intervention Approaches

Stacy S. Drury, Laura Scaramella, Charles H. Zeanah

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations

Abstract

Maternal depression is a pervasive public health problem with substantial economic and health costs mothers and their offspring. Although universal screening efforts seem to increase PPD identification, to date these interventions have been ineffective at reducing PPD and no data exist demonstrating positive downstream impacts on infants. Given this, research focused on defining existing barriers to effective PPD treatment by women identified by universal screening is a high priority. Selected interventions have demonstrated minimal effectiveness on maternal mood symptoms and maternal-infant interactions; unfortunately, there is no evidence of a positive impact on infant neurobiological outcomes, again highlighting needed next research steps. Both dyadic and individual psychotherapies have demonstrated efficacy in the treatment of PPD. A growing body of research indicates that these treatments also improve maternal-infant interactions. There remains a paucity of research, however, exploring the short-term and long-term neurobiological consequences of these interventions on infants. This research gap is somewhat striking given the increasing focus on health and neuroscience across medicine and funding agencies. Studies specifically designed to capture both maternal and infant outcomes are needed. Novel therapies that leverage evidence-based existing dyadic therapies and integrate alternative therapies that address caregiving behaviors influenced by PPD, such as sleep, nutrition, and play, may have synergistic benefits for both mothers and their infants. Efforts to determine shared neurobiological pathways linked to elevated risk for PPD, maternal exposure to child maltreatment, and decreased maternal sensitivity with mothers' own children have the potential to uncover innovative preventive and therapeutic targets. As burgeoning data suggest that the impact of PPD may span generations, improved efficacy of interventions also may result in lasting effects across future generations.

Original languageEnglish (US)
Pages (from-to)179-200
Number of pages22
JournalChild and Adolescent Psychiatric Clinics of North America
Volume25
Issue number2
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

Keywords

  • Dyadic interventions
  • Early life stress
  • Infants
  • Neurobiology
  • Postpartum depression
  • Psychotherapy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Psychiatry and Mental health

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