What We're Reading
By Joy Burkhard, MBA
Founder and Executive Director, 2020 Mom
The following articles caught my eye in the first part of February, most notably, we are close to having a pill form of brexanolone (Zulresso), called zuranolone. Zulresso was the first drug on the market developed specifically for maternal depression, which exists only in an intravenous form. We’re also highlighting an article from Health Affairs that describes an increase in PCP visits for mental health concerns, something we surely are seeing in obstetrics too. Finally, the tragedy in Massachusetts involving a suspected case of postpartum psychosis (likely triggered not only by lack of sleep, but the 10+ drugs this mother was prescribed) has inspired a lawmaker to introduce a bill to put such mothers in intensive treatment programs rather than in jail.
ABORTION
The State of Reproductive Health in the United States
In June 2022, the Supreme Court overturned Roe v. Wade, ruling in Dobbs v. Jackson Women’s Health Organization that nothing in the United States Constitution guarantees a women’s right to abortion. Within six months of the decision, 15 states had banned abortion. More are anticipated to do so in the 2023 state legislative sessions that will commence this month. For this study, researchers evaluated the state of reproductive health and wellbeing in the U.S. by applying the framework adopted by the global community in the 2030 Agenda for Sustainable Development, specifically Sustainable Development Goal 3, which calls for all nations to “ensure healthy lives and promote wellbeing for all at all ages.”
SUBSTANCE USE / ADDICTION
Alcohol Use Disorder (AUD) Diagnoses After COVID Infection Higher at Certain Points in the Pandemic
— Social context of pandemic offers most plausible explanation, researchers say
Fentanyl in Labor Epidural Can Affect Results of Maternal and Neonatal Toxicology Tests
Epidural anesthesia should always be considered as a possible cause of a positive maternity or neonatal toxicology test to avoid false assumptions of nonprescribed use.
MATERNAL MORTALITY / SUICIDE
Homicides, Drugs Drove Rise in Pregnancy-Associated Deaths During the Pandemic
— Deaths from obstetric causes in 2020 also increased by 28%
EQUITY
Barriers Often Keep Black Community From Seeking Help for Mental Health
"Black Americans were effectively disenfranchised from any discussion about mental health."
TREATMENTS
Biogen and Sage Therapeutics Announce FDA Accepts Filing of New Drug Application and Grants Priority Review of Zuranolone in the Treatment of Major Depressive Disorder and Postpartum Depression
The FDA is currently reviewing 14-day oral zuranolone for the treatment of major depressive disorder and postpartum depression, with a Prescription Drug User Fee Act (PDUFA) action date set for early August, Biogen and Sage Therapeutics announced.
Repetitive TMS Effective for Comorbid Depression, Substance Use
Repetitive transcranial magnetic stimulation (rTMS) is associated with reduced symptom severity in patients with comorbid major depressive disorder (MDD) and substance use disorders (SUDs), new research suggests.
Some Moms Are Microdosing Mushrooms for Anxiety and Depression
Many women hope to treat their depression, anxiety and trauma with therapeutic psychedelic medicine
COVERAGE & ACCESS
Adult Primary Care Physician Visits Increasingly Address Mental Health Concerns
More and more patients are raising mental health concerns at primary care appointments. "These findings emphasize the need for payment and billing approaches ... as well as organizational designs and supports ... that enable primary care physicians to adequately address mental health needs," researchers wrote in Health Affairs.
POLICY
Mass. Bill Could Help Postpartum Defendants Like Lindsay Clancy Get Therapy, Not Jail Time
Women who take the lives of their children while experiencing postpartum depression or psychosis, among other mental illnesses, could be afforded legal protections in court — and ultimately be connected to intensive treatment — should a pending bill gain support in the Massachusetts Legislature this session.
Here's How to End the U.S. Health Disadvantage
— Let's focus on prevention and social policy, not sick care
Two recently released reports on the status of U.S. health spending and healthcare quality and equity describe an all-too-familiar picture: U.S. healthcare spending has continued to increase; health disparities have persisted or even widened; and the majority of Americans live in areas where health professional shortages threaten their access to much needed preventive care. The National Healthcare Quality and Disparities Report showed that the U.S. experienced a much larger drop in life expectancy between 2018 and 2020 than other high-income countries, with Hispanic and non-Hispanic Black populations showing the greatest decreases. This drop is so pronounced and concerning that it has a name: the U.S. health disadvantage. This disadvantage persisted despite the fact that the U.S. spent a staggering 18.3% of its economy on healthcare -- equivalent to $4.3 trillion or $12,914 per person.
RESEARCH
Offspring of Mothers With Primary Immunodeficiencies at an Increased Risk of Psychiatric Disorders
A new analysis shows offspring of mothers with primary immunodeficiencies are at an increased risk of several psychiatric disorders, including anxiety and depression, as well as suicidal behavior.
Even Low Levels of Air Pollution Could Be Bad for Mental Health
— Median exposure levels enough to put someone at higher depression, anxiety risk
It’s Time to Rebrand “Mommy Brain”
Objective differences in mothers' memory function rarely have been seen in empirical studies and the term "mommy brain" needs to be rebranded, opens in a new tab or window researchers argued.
Maternal Depression Associated With Offspring Brain Age
Maternal stress, anxiety, and depression have been associated with offspring development, increasing the risk of behavioral and emotional problems in children, and anxiety and depression in adulthood. Brain structure changes throughout different stages of life, making it possible to use age-dependent changes in brain structure to estimate brain age in an individual.