[Creation of an observation scale for newborns in the maternity setting]

In clinical practice in the maternity setting, professionals are regularly confronted with situations for which a clinical observation of the newborn's condition is necessary. The Assessment for Newborn Development and Abilities (Panda) scale is a tool for evaluating the sensory-motor skills of newborns and their relationship with others, as well as raising professionals' awareness of their fine observation.

The Still-Face: A Greater Challenge for Infants of Mothers With Borderline Personality Disorder

The main aim of this study was to ascertain whether infants as young as 3 months of age, whose mothers suffer from borderline personality disorder (BPD), are already at risk of greater dysregulation than infants of mothers without BPD when faced with a minor stressful experience. Nineteen mothers diagnosed with BPD and 41 controls with no history of psychopathology and their 3-month-old infants were observed using Tronick's Face-to-Face Still-Face paradigm. The authors found that infants whose mothers have BPD express less positive vocalizations and less nonautonomic self-regulation than infants of mothers with no psychopathology. The stress of the Still-Face episode affects their gaze and self-regulation behaviors more strongly than those of infants of controls. The Reunion episode seems particularly challenging for mothers with BPD, who show fewer smiles and an increase in intrusive behavior. Because infants and their mothers with BPD are already dysregulated at 3 months postpartum, envisaging very early intervention seems warranted.

Pregnancy, somatic complaints and depression: a French population-based study

OBJECTIVE

Depression during pregnancy is today one of the greatest medical risks for expectant mothers and newborns. It is associated with numerous morbid conditions and with postnatal depression. Identifying depression during pregnancy is therefore a major public health concern, but screening for depression is not routinely carried out in somatic settings. We hypothesized that the presence of numerous somatic complaints contributes to the detection of an increased risk of depression during pregnancy.

STUDY DESIGN

A cross-sectional study was conducted on 1000 consecutive pregnant women approached during OB/GYN visits at a general maternity hospital. They were asked to fill out a questionnaire, which contained the Edinburgh Postnatal Depression Scale (EPDS) and a checklist of 18 somatic complaints.

RESULTS

The median number of somatic complaints was 5 (interquartile range 3-7). The risk of depression during the 2nd and 3rd trimesters was 18.3% (EPDS score > 10.5). Logistic regression revealed that when the somatic complaints total score moved from 3 to 7, the odds of moving from not-at-risk to at-risk for antenatal depression were multiplied by 2.91.

CONCLUSION

Our results call for further research exploring somatic complaints and their link to depression during pregnancy. Until more knowledge is available, we suggest considering that women with a high number of somatic complaints during pregnancy are at high risk for depression and should be referred for further diagnostic clinical assessment and care.

[Mental illness and pregnancy]

Pregnancy was once thought a period of bliss devoid of mental illness. We now know this is not so. It is well documented that pregnancy and the peripartum are not only a time when preexisting mental illness will persist but that it is also a high-risk period for renewed episodes of mental illness, whether de novo or relapse. In this paper, we will describe the three main axis of management of maternal mental illness during the peripartum: maternal psychiatric illness, fetal, neonatal and infant development and future mother-infant relationship. We will give an overview of how to organize care for mothers with schizophrenia and bipolar disorder. Good practice management of psychotropic medication during this period will be described. Finally the importance of networking and multidisciplinary management of these situations will be underlined.