Depression, Substance Abuse Linger After Pregnancy

Study: Problems continue for months after baby is born

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HealthDay Reporter

MONDAY, Aug. 16, 2004 (HealthDayNews) -- Women who binge drink, get depressed or smoke during their pregnancy boost their risk for depression and alcohol use after they give birth as well, a new study shows.

"Binge drinking, tobacco use and depression symptoms at any point during pregnancy predicted problems later," said Gregory Homish, a research associate at the Research Institute on Addictions at the University at Buffalo and first author of the study, published in the August issue of Alcoholism: Clinical & Experimental Research.

What's novel about the study, he said, is that his team was looking at the conditions as a whole, and during pregnancy. Alcohol abuse and depression are known to occur together, but often are not studied together, especially in women and pregnant women, according to Homish. "Most studies have looked at the conditions separately," he said. "But it's very common that depression and alcohol abuse go together. Depression may lead to alcohol use or vice versa."

Homish's team evaluated data from an ongoing longitudinal study of pregnancy outcomes called the Maternal Health Practices and Child Development Project. They evaluated 595 women through their eighth month after delivery.

They interviewed and assessed the women at four and seven months of pregnancy, at delivery, and again eight months after delivery. "We looked at factors that could predict postpartum [mental health status]," Homish said. Included were depressive symptoms (but not necessarily a diagnosis of clinical depression), anxiety, the use of alcohol and tobacco, social support and other factors.

At each trimester, they found that higher rates of depressive symptoms and binge drinking (four or more drinks at a sitting or occasion) and tobacco use were associated with a higher risk of being depressed and having an alcohol problem eight months after delivery.

For instance, women who smoked during the first trimester were about twice as likely to have depression and alcohol problems after delivery as those who didn't smoke during the first trimester. Women who engaged in binge drinking during the first trimester were nearly five times as likely as those who didn't to have alcohol and depression problems later.

Third-trimester anxiety was also associated with having alcohol and depression problems later. Social support, or the lack of it, wasn't related to the risk for depression and alcohol problems later.

"The idea that alcohol [problems] and depression are associated is not new," said another expert, Rina Das Eiden, a senior research associate at the University at Buffalo. "But no one has really looked at it during pregnancy and whether they predict [later problems]. If women report high levels of depressive symptoms and binge drinking, they are likely to have both problems postpartum."

The message for both health-care providers and women, said Homish, is to realize that both depression and alcohol problems can and do exist during pregnancy. He said the current assessment of alcohol problems and depression during pregnancy may be done too quickly, and health-care providers may have to ask the questions in a way that would make it easier for a pregnant woman to respond honestly.

In another study in the same issue of the journal, Norman Spear, a professor of psychology at Binghamton University, found other clues about alcohol problems. He found that infant rats eagerly accept alcohol on first exposure, perhaps boosting their risk of having alcohol problems later in life.

"Infant rats drink enormous amounts of alcohol in a short amount of time. Rats as young as three hours old have a surprising affinity for alcohol. It's about as rewarding as they find milk. As they get older, the affinity declines," Spear said.

The study is part of Spear's ongoing research to determine under what circumstances does early exposure increase acceptance of alcohol and the potential for problems later.

"What is it about brain changes that change the affinity for alcohol?" Spear asks in his research. While he said there is no direct application of his latest study to humans, early exposure may predict later problems in people. "Within the last three or four years, it has been found and documented that young adults exposed to alcohol as fetuses are more susceptible to alcohol abuse."

More information

Learn about postpartum depression at the National Women's Health Information Center.

SOURCES: Gregory Homish, Ph.D., research associate, Research Institute on Addictions at the University at Buffalo, Buffalo, N.Y.; Rina Das Eiden, Ph.D., senior research scientist, Research Institute on Addictions, University at Buffalo; Norman Spear, Ph.D., professor, psychology, Binghamton University, Binghamton, N.Y. ; August 2004 Alcoholism: Clinical & Experimental Research

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