Perinatal Psych: Final exam

What is postpartum depression (PPD)?

A type of clinical depression that can affect women after childbirth.

What are the strongest risk factors for postpartum depression?

Depression or anxiety during pregnancy, stressful life events, poor social support, and a previous history of depression.

What percentage of women experience depressive episodes three months postpartum?

About 12% of women.

What is the typical duration of postpartum depression?

PPD can last from 2 to 6 months.

Can men experience postpartum depression?

Yes, approximately 2-4% of male partners can experience PPD.

What are some common symptoms of postpartum depression?

Fatigue, sadness, hopelessness, difficulty sleeping, changes in appetite, and lack of interest in the baby.

What screening tool is commonly used for postpartum depression?

The Edinburgh Postnatal Depression Scale (EDPS).

What is the scoring range for the Edinburgh Postnatal Depression Scale?

Scores range from 0 to 3 depending on symptom severity.

What treatments are available for postpartum depression?

Pharmacological treatments, counseling or psychotherapy, and support groups.

What are some antidepressant options for treating postpartum depression?

SSRIs, SNRIs, Bupropion, TCAs, and Zuranolone.

What is psychotic depression (puerperal psychosis)?

A severe form of postpartum depression occurring in about 1 to 2 out of every 1,000 deliveries, with sudden onset and extreme symptoms.

What are the three primary phases of fetal development?

Embryonic phase, early fetal period, and late fetal period.

What significant development occurs during the embryonic phase?

Basic structures of the brain and central nervous system begin developing.

At what gestational week does the brain weigh approximately 20g?

At mid-gestation.

What is the neural tube, and when is it formed?

The neural tube is the first well-defined neural structure formed during the third week of gestation.

What is Intrauterine Growth Restriction (IUGR)?

IUGR is the failure of the fetus to reach its predetermined growth potential, typically when fetal weight is below the 10th percentile for gestational age.

What are some signs of postpartum depression?

Sluggishness, crying for no reason, feelings of worthlessness, and fear of harming oneself or the baby.

What factors increase the risk of postpartum depression in fathers?

Young age, history of depression, and financial difficulties.

What is the role of social support in managing postpartum depression?

Strong support from partners, family, and friends is crucial for recovery.

What percentage of women meet the diagnostic criteria for postpartum depression within 12 months postpartum?

10 to 15% of women.

What are some common emotional symptoms of postpartum depression?

Feelings of being a bad mother, anxiety about the baby, and difficulty bonding with the newborn.

What is the importance of screening for postpartum depression?

Screening is essential as PPD can be easily missed and has long-term consequences.

What are the three simple questions to assess postpartum depression?

1. Have you felt overwhelmed in the last week? 2. Do you have thoughts of harming yourself or your child? 3. Are you having difficulty adjusting to your new role as a mother?

What is the typical onset period for psychotic depression after childbirth?

Usually within the first 2 weeks postpartum.

What is the significance of the corpus callosum in fetal brain development?

It connects the left and right hemispheres of the brain and plays a role in developing gyri and sulci.

What are gyri and sulci, and when do they begin to appear?

Fissures that will become folds in the brain, appearing between weeks 18-24 of gestation.

What is the risk associated with untreated postpartum depression?

1/3 of women continue to be symptomatic at 12 months if untreated.

What does IUGR stand for?

Intrauterine Growth Restriction

How is IUGR measured?

As the velocity of fetal growth less than the normal growth potential for a specific newborn based on sex and ethnicity.

What is a common cause of IUGR?

Placental insufficiency, where the placenta does not provide sufficient nutrients to the fetus.

Name a factor that can contribute to IUGR.

Congenital infection, chronic diseases in the mother, abnormal chromosomes, genetic abnormalities, syndromes of unknown origin, substance abuse, or anemia.

What are some potential consequences of IUGR?

Possible mortality of the newborn, acute health problems, cognitive and medical issues, although most infants have a good long-term prognosis.

What is the Developmental Origins of Health and Disease (DOHaD) paradigm?

A framework suggesting that early-life stressors, such as IUGR, can have long-term health implications.

What is the impact of maternal prenatal depression on infant development?

It can lead to detrimental effects on the mother-child relationship and long-term developmental issues.

What are some short-term effects of postpartum depression (PPD) on infants?

Increased sad affect and distress, less eye contact and responsiveness from mothers.

What long-term outcomes are associated with maternal PPD?

Poor social and cognitive outcomes, attention-deficit/hyperactivity disorder, and lower quality of mother-infant interactions.

What role do maternal stress hormones play in fetal development?

Cortisol can affect fetal programming and lead to long-term changes in the infant's HPA axis.

What is the significance of the Dutch Famine Birth Cohort Study?

It found that adults exposed to famine during mid or late gestation had lower glucose tolerance and higher hypertension risk.

What does Barker's Hypothesis suggest?

That early life conditions can influence health outcomes in adulthood.

What is the Hertfordshire Birth Cohort Study known for?

Observing that areas with low healthy infant births in the early 1900s had higher rates of cardiovascular disease decades later.

How can paternal mental health affect infant development?

Paternal mental health disorders are associated with increased risk of emotional and behavioral disorders in offspring.

What is the role of maternal sensitivity in infant emotional development?

Maternal sensitivity serves as a model for the infant's emotional development and regulation.

What is behavioral synchrony?

The coordinated interaction between mother and infant that plays a role in forming attachment.

What is the impact of untreated maternal depression on infants' cortisol response?

Infants of untreated depressed mothers may not show the normal reduction in stress response at four months postpartum.

What are the potential effects of maternal anxiety on child outcomes?

Independent effects of anxiety can lead to emotional instability and developmental challenges in children.

What is the importance of personalized assessment in parent-child dyads?

To address the unique needs and influences on infant development related to parental mental health.

What is the relationship between maternal chronic depression and child psychiatric disorders?

Chronic maternal depression may have an additive effect on the risk of psychiatric disorders in children.

What are the implications of dysfunctional mother-infant relationships?

Over two-thirds of mother-infant relationships classified as dysfunctional can lead to long-term developmental issues.

What is the significance of cognitive behavioral therapy (CBT) during pregnancy?

CBT can benefit maternal mood and positively impact infant developmental milestones.

What is the role of the placenta in regulating maternal cortisol?

The placenta releases 11-hydroxysteroid dehydrogenase (11-OHSD-2), which transforms maternal cortisol into inactive cortisone.

What are the potential long-term effects of maternal prenatal stress on child outcomes?

Long-term problems can include cognitive delays, behavioral issues, and emotional instability.

What is the impact of maternal depression on the quality of mother-infant interactions?

Maternal depression can lead to lower quality interactions and increased infant insecurity.

What is the significance of assessing risk factors in IUGR cases?

Identifying and addressing risk factors is crucial for managing IUGR and improving outcomes.

What does the Fetal Origins Hypothesis suggest?

It suggests that fetal development and early life conditions significantly influence health and disease risks later in life.

What is the Barker Hypothesis?

It posits that the in-utero environment and early postnatal life are key determinants of chronic diseases such as cardiovascular diseases and type 2 diabetes.

What is fetal programming?

It refers to how adverse environments during fetal life and early childhood can increase the risk of diseases in adulthood.

How does maternal undernutrition affect fetal development?

It leads to intrauterine growth restriction, which can result in poor childhood growth and increased risk of diseases later in life.

What is the aim of DoHaD research?

To understand how early life environmental conditions affect health and disease risk in later life.

What has contributed to the growth of the DoHaD field?

Increased attention from health policymakers and findings from studies like the Dutch famine and Hertfordshire cohorts.

What role does epigenetics play in DoHaD?

Epigenetics may provide new mechanisms explaining how early life conditions influence health outcomes.

What are common pregnancy complications?

High blood pressure, gestational diabetes, infections, and preeclampsia.

What is gestational hypertension?

It is high blood pressure that occurs during pregnancy, which can restrict blood flow to the placenta.

What is gestational diabetes?

It is diabetes that develops during pregnancy due to hormonal changes affecting insulin production and usage.

What are some infections that can complicate pregnancy?

STIs such as HIV/AIDS, Herpes, Gonorrhea, HPV, Chlamydia, Syphilis, and Hepatitis B.

What is preeclampsia?

A pregnancy complication characterized by high blood pressure and signs of damage to the liver and kidneys.

What is preterm labor?

Labor that begins before 37 weeks of pregnancy, which can be caused by infections or previous preterm births.

What is a miscarriage?

The loss of a pregnancy from natural causes before 20 weeks; after 20 weeks, it is called a stillbirth.

What are some risk factors for preeclampsia?

First pregnancy, obesity, family history, and pre-existing medical conditions like chronic hypertension.

What is the significance of Canada in the DoHaD field?

Canada is recognized for its excellent research and robust knowledge translation in the DoHaD field.

What can untreated gonorrhea during pregnancy lead to?

Increased risk of miscarriage or preterm birth, and potential severe infections in the newborn.

What is the role of progesterone in pregnancy?

It is sometimes used to help prevent preterm birth in women at risk.

What are congenital anomalies?

Birth defects that can result from complications during pregnancy.

What is iron deficiency anemia in pregnancy?

A condition where there is a lack of iron, leading to insufficient red blood cells, which can complicate pregnancy.

What are the consequences of high blood pressure in pregnancy?

It can slow fetal growth and increase the risk of preterm labor and preeclampsia.

What is the recommended timing for gestational diabetes screening?

All pregnant women should be screened between 24-28 weeks of gestation.

How can infections during pregnancy affect the infant?

Infections can pass from mother to infant and may lead to complications such as miscarriage or preterm labor.

What is the relationship between maternal health and stillbirth?

Maternal health problems can contribute to stillbirth, alongside chromosomal abnormalities and placental issues.

What is hypoxic-ischemic encephalopathy?

A condition that can result from injuries to the brain or head.

What is an early stillbirth?

Fetal death occurring between 20-27 weeks of gestation.

What is a late stillbirth?

Fetal death occurring between 28-36 weeks of gestation.

What is preterm birth (PTB)?

Labor that starts before 37 weeks of pregnancy.

What percentage of newborns in Canada are born prematurely?

7-10%.

What are the two categories of preterm births?

Iatrogenic (due to complications) and spontaneous (body decides to deliver early).

What are common symptoms of preterm labor?

Tightening of the uterus, menstrual-type cramps, pressure in the lower abdomen, backache, diarrhea, and changes in discharge.

How is preterm labor diagnosed?

Using an electronic monitor to check contractions and fetal heart rate, along with cervix exams and tests for amniotic fluid.

What are possible complications of preterm labor?

Risk of preterm birth and complications due to underdeveloped organs.

What treatments are available for preterm birth?

Bed rest, tocolytic medicines, corticosteroids, cervical cerclage, antibiotics, and possible delivery.

What is the Canadian Preterm Birth Initiative?

A program funding research and improving perinatal health care related to preterm birth.

What is a molar pregnancy?

An abnormal pregnancy where the placenta develops into a mass of fluid-filled sacs instead of a fetus.

What are the two types of molar pregnancy?

Complete molar pregnancy (no fetus) and partial molar pregnancy (may have non-viable fetus).

What is an ectopic pregnancy?

When a fertilized egg implants outside the uterus, often in a fallopian tube.

What is recurrent spontaneous abortion?

Experiencing three or more consecutive miscarriages.

What is cervical incompetence?

The cervix opens without uterine contractions, potentially allowing a small neonate to pass through.

What is the role of corticosteroids in preterm birth treatment?

To help the lungs of the fetus grow and mature, prescribed if the fetus is viable and before 35 weeks.

What is the significance of the placenta?

It provides oxygen and nutrients to the fetus while removing waste during pregnancy.

What is implantation?

The process where a fertilized egg attaches to the walls of the uterus.

What are the risks associated with preterm birth?

Increased morbidity, financial and social impacts on infants and families.

What is the most common type of preterm birth?

Spontaneous preterm birth, making up 70% of cases.

What is the risk of pregnancy loss?

Highest at the very start of pregnancy and immediately after birth.

What is a late spontaneous abortion?

Spontaneous loss of pregnancy from the 12th through the 19th weeks.