The decision to treat the pregnant depressed woman presents a dilemma for both the patient and the physician. Few guidelines exist primarily because antepartum depression has been underdiagnosed. Therefore, few treatment trials have been conducted. In addition, the unknown effects of stress, depression, and anxiety on the fetus must be considered and may contribute substantially to fetal distress or neonatal outcome. Therefore, the decision to treat depression during gestation must be determined by balancing maternal well-being with fetal safety.
Recent data suggest that depression during pregnancy increases perinatal risk.
Therefore, the seriousness of the mother's illness, the likelihood of recurrence, and the available support systems all must be considered by the physician, patient, and significant other. 20 Another treatment alternative is psychotherapy, which is an appropriate choice as an initial noninvasive treatment modality. It has been shown to be effective in decreasing the neurovegetative symptoms of depression and improving interpersonal skills. The role of the pregnant woman changes rapidly in both family and society. Of the 10 subjects located in the third postpartum month, none suffered a postnatal depression.