What We're Reading
By Joy Burkhard, MBA
Founder and Executive Director, 2020 Mom
Many important articles were released these first two weeks of the new year including a study highlighting the wealthiest of Black women still have higher maternal death rates than the poorest of White women. And a new research study confirms that paid leave is critical in supporting mothers with maternal mental health disorders and that generous paid leave can prevent maternal depression.
PREVENTING PREGNANCY
More Women Seek Permanent Contraception After Supreme Court Abortion Decision
"We are experiencing a significant increase in requests for consultations about the option of permanent contraception from women who want to remain child-free. They are expressing serious concern about their ability to have control over their reproductive health.” Permanent contraception includes procedures such as removal of a woman's fallopian tubes. This permanently prevents pregnancy, but without changing a woman's hormones or periods like removal of her ovaries would do.
MATERNAL MORTALITY / SUICIDE
Study: Wealthiest Black Moms More Likely To Die In Childbirth Than Poorest White Moms
Even the wealthiest Black women can’t escape the effects of structural racism.
Maya Rossin-Slater, Ph.D., an associate professor of health policy at the Stanford University School of Medicine and a senior fellow at the Stanford Institute for Economic Policy Research (SIEPR) used California administrative data to show for the first time that household income plays absolutely no role in determining maternal and infant health outcomes.
Folic Acid Associated With Fewer Suicide Attempts, Preliminary Study Finds
Folic acid (vitamin B9) treatment was associated with a lower suicide attempt rate in patients, according to study results published in JAMA Psychiatry. “These results warrant the conduct of a [randomized clinical trial] with suicidal ideation and behavior as outcomes of interest,” authors noted. “If confirmed, folic acid may be a safe, inexpensive, and widely available treatment for suicidal ideation and behavior.”
SCREENING & TREATMENTS
Prenatal Depression Screening, Referral Improves After Online Provider Training
Throughout the study, the group that received the training reported improved satisfaction working with mental health services as well as enhanced self-efficacy. Providers also reported increased screening, counseling, and referral for prenatal depression after undergoing the training, according to the study.
“Findings from our study suggest a brief online training may enhance the likelihood of providers screening, treating, and/or referring at-risk patients for follow-up care for prenatal depression,” researchers advised.
Depression Tests May Miss Black Women’s Symptoms
Black women with symptoms of depression more often report sleep disturbances, self-criticism, and irritability than stereotypical symptoms such as depressed mood, according to a new study.
Brief Cognitive Training May Extend the Antidepressant Effects of Ketamine
Consistent with previous findings, the two groups that received the ketamine infusion showed a drop in depression symptom scores within 24 hours. However, for participants who received ketamine and the placebo cognitive training, those depression scores gradually rose over the following 30 days. By comparison, depression scores remained low and stable for those who received ketamine and the implicit association training.
Reunion Will Present Findings to the FDA
Reunion Neuroscience Inc. (NASDAQ: REUN) reported that it has completed the interim data analysis for its Phase 1 clinical trial with its lead asset RE104, a unique 4-OH-DiPT prodrug treating postpartum depression. The RE104 is a proprietary, novel serotonergic psychedelic compound that Reunion is developing as a potential fast-acting and durable treatment for patients suffering from postpartum depression and other mental health conditions.
The study included 32 healthy volunteers across four ascending dose cohorts, with two of the eight subjects in each cohort receiving a placebo. The company said that RE104 showed robust and pervasive pharmacodynamic effects with a shorter duration of psychedelic experience relative to published data with psilocybin (approximately three to four hours for RE104 versus six to eight hours for psilocybin). This was the first human, Phase 1 study, and RE104 was shown to be safe and well tolerated, with no serious or severe adverse events.
PSYCHOSIS
What Causes Postpartum Psychosis?
Roughly 1-2 in 1000 births trigger a psychotic episode, known as ‘postpartum psychosis’. Symptoms appear acutely, usually within the first two weeks of delivery, and present as a mixture of psychotic (delusions, hallucinations) and mood (mania, affective lability) symptoms. Where delusions are present, they often centre on the newborn baby.
COVERAGE & ACCESS
Medicaid Expansion Led To Reductions In Postpartum Hospitalizations
The Affordable Care Act (ACA) Medicaid expansions increased preconception and postpartum insurance coverage among low-income birthing people, ..
SDoH
Effects Of The 2021 Expanded Child Tax Credit On Adults’ Mental Health: A Quasi-Experimental Study
To provide financial assistance during the pandemic, Congress temporarily expanded the Child Tax Credit to reach more families and provide a larger credit per child.
Using survey data, Akansha Batra and coauthors find that this expansion was associated with "reduced anxiety symptoms among low-income adults with children, as well as greater mental health benefits among Black and Hispanic people than among White people."
SUD
US Trends in Drug Overdose Mortality Among Pregnant and Postpartum Persons
This newly published study suggested the COVID-19 pandemic has an outsized effect on overdoses among pregnant and postpartum people. In 2020, pregnancy-associated over deaths saw a 46% spike in one year and an 81% increase since 2017, largely attributed to fentanyl and polysubstance use. This research highlights the urgent need for increased access to stigma-free treatment and non-punitive systems of support.
EQUITY
Experiencing Racism Tied to Doubled Odds of Depression During Pregnancy
Postpartum Depression Up With Family History of Psychiatric Disorder › · Pregnant Obese, Overweight Women Have Higher Risk of Perinatal Death › …
POLICY
HHS Awards Nearly $245 Million to Support Youth Mental Health and Help the Health Care Workforce Meet Families’ Mental Health Needs
The U.S. Department of Health and Human Services (HHS) has awarded nearly $245 million in Bipartisan Safer Communities Act funding – $185.7 million from the Substance Abuse and Mental Health Services Administration (SAMHSA) and nearly $60 million from the Health Resources and Services Administration (HRSA) – to support youth mental health, help the health care workforce address mental health needs, and fund other critical mental health supports.
RESEARCH
Generous Parental Leave Improves New Mothers’ Mental Health
"Parental leave was protective against poorer maternal mental health, including depressive symptoms, general mental health, psychological distress and burnout; however, improved mental health among mothers was associated with more generous parental leave policies [such as] those with longer length of leave or paid leave," said study author.
But according to a study publishe in The Lancet Public Health, fathers had lower rates of postpartum depression with just two weeks of paternity leave.
Almost all countries in the Organization for Economic Cooperation and Development -- except the United States -- provide new mothers with at least 14 weeks of paid leave around childbirth. New mothers can take up to nine months of paid maternity leave in the United Kingdom.
Intimate Partner Violence Associated With Poor Socioemotional Development in Children
Using the Caregiver Reported Early Development Instrument (CREDI) Poorer socioemotional development is seen in children with mothers who experienced intimate partner violence and Lower socioemotional development scores were also seen in children whose mothers had mild to severe depressive symptoms.
Endometriosis Links to Inflammatory Conditions and Other Diseases
One of the stronger comorbid associations is with autoimmune disease: "Endometriosis is not considered an autoimmune disease, but it has been consistently associated with several immune system abnormalities.
"Evidence is building that endometriosis does not simply affect gynecologic and reproductive health, but also impacts multiple systems and health across women's lives," said reproductive biologist Stacey A. Missmer. With more than 80% of patients at risk for such non-gynecologic symptoms as fatigue, hypertension, hypercholesterolemia, migraine, fibromyalgia, and joint pain, "gynecologists should be dialoguing with their patients about the many other systems affected," she said.
High Paternal Rates of Distress Seen in Fathers Exposed to Poor Fetal, Neonatal and Maternal Outcomes
Fathers who experience traumatic events such as fetal loss may experience post-traumatic stress symptoms (PTSS); after a fetal loss, previous studies have found up to 16% of fathers developing post-traumatic stress disorder in a subsequent pregnancy. Support systems in place for these fathers may help prevent poor mental health outcomes.