Perinatal And Postpartum Depression A Top Priority At Annual Conference Of Ob-Gyns

Depression during and after pregnancy is prevalent among women, and, if left untreated, can have serious health consequences for both women and their babies, according to a trio of speakers at today's opening ceremonies of The American College of Obstetricians and Gynecologists' 58th Annual Clinical Meeting (ACM). The President's Program featured two of the country's leading experts on women's mental health and a former First Lady of New Jersey, who suffered postpartum depression (PPD) with both of her pregnancies.


"As ob-gyns, if we can focus more of our attention on the emotional and psychological health of our patients during pregnancy and postpartum, I believe our specialty can have a positive and significant impact on the overall health and well-being of women everywhere," said Gerald F. Joseph, Jr, MD, president of The American College of Obstetricians and Gynecologists. "I'm so passionate about postpartum depression that I've made it the theme of my presidential initiative and a major focus of the ACM's scientific program this year.


"Our message today to ob-gyns is one of awareness," added Dr. Joseph. "In essence, we may be the first to make a diagnosis of depression or to observe depressive symptoms getting worse. It's especially important to identify depression during pregnancy so that we can help prevent the condition from worsening after delivery."


The peak prevalence of major depressive disorders is during the childbearing years, and depression is one of the most common complications of pregnancy. Between 14%-23% of women will experience depression during pregnancy, and an estimated 5%-25% of women will have postpartum depression.


"Perinatal depression causes suffering in women; it compromises a mother's ability to parent effectively; and it can have negative consequences for the child and the family over the long term," said Michael W. O'Hara, PhD, who delivered the Samuel A. Cosgrove Memorial Lecture, "Perinatal Depression: Screening, Diagnosis, and Treatment." Dr. O'Hara, a professor of psychology at the University of Iowa in Iowa City, is a widely recognized authority in the field of mood disorders and depression in women. He specializes in perinatal depression, which refers to depression that occurs at any time during pregnancy or throughout the first year after giving birth.


"Although depression is the leading cause of disability for women throughout the world, it continues to be associated with stigma in our society," according to Katherine L. Wisner, MD, MS, who also spoke at the opening session. "Stigma contributes to the perception that antidepressant drug therapy is less justifiable for pregnant women with depression than, for example, antibiotics or drugs used to treat gastric ailments." Dr. Wisner is a professor of psychiatry, obstetrics-gynecology and reproductive sciences, epidemiology and women's studies at the University of Pittsburgh School of Medicine and director of the Women's Behavioral HealthCARE program at the Western Psychiatric Institute and Clinic at the University of Pittsburgh Medical Center.















"Ob-gyns, as primary care providers for women and especially in the context of pregnancy care, are in a perfect position to identify women who are depressed and to provide or facilitate access to treatments," said Dr. O'Hara. The American College of Obstetricians and Gynecologists encourages ob-gyns to strongly consider screening for depression during and after pregnancy. "What matters is that ob-gyns initiate the discussion of depression with their pregnant patients and new mothers and this can be accomplished by asking good, sensitive questions. This step is critical-you can't tell by looking at a woman whether or not she is depressed.


"One big misconception is that there is little risk to not treating," noted Dr. O'Hara. "We know very clearly that women who are depressed are more likely to smoke and take drugs. In addition, the presence of major depression during pregnancy is associated with preeclampsia, preterm birth, and low birth weight. The implications for not treating the depression are both real and severe." Studies have shown that untreated maternal depression negatively affects an infant's cognitive, neurologic, and motor skill development, and it can also negatively impact mental health and behavior of older children.


"Evidence-based treatment for depression includes psychotherapy and antidepressant medication, and other treatments such as bright morning light therapy, acupuncture, and exercise are being studied for use in pregnancy to expand therapeutic options," said Dr. Wisner. Although non-drug treatments are preferred by many pregnant women, the fact is, "the availability of accessible, acceptable, and affordable mental health intervention of any type is limited," she added. "A comprehensive disease management strategy holds the potential to reduce maternal disability and avert a new generation at risk."


Former First Lady of New Jersey, Mary Jo Codey presented the Anna Marie D'Amico Lecture, "Recognizing Postpartum Depression: Speak Up When You're Down," named after the statewide campaign put in place during Governor Richard Codey's term in office to raise awareness about PPD and offer education and resources to women, their families, and health care professionals. Mrs. Codey, who suffered PPD with both of her pregnancies, resolved to speak out so that other struggling mothers would know that they are not alone and need not feel ashamed.


"Too many women with depression are slipping through the cracks and going untreated," Mrs. Codey said. "This is deeply concerning to me because the health and well-being of women are at risk. We owe it to women and their families to provide more education, screening, treatment, and support." She was active in helping to secure passage of the Melanie Blocker-Stokes MOTHERS Act, which will increase funding for research, education, and awareness of postpartum mood disorders. The provisions were included in the final federal health care reform legislation.


Source

American College of Obstetricians and Gynecologists

Some Conservatives Criticize Giuliani Judicial Appointments

Some prominent conservatives have criticized former New York City Mayor Rudolph Giuliani's (R) judicial appointments and have said his record undermines his promise that he would appoint "strict constructionists" to the Supreme Court if elected president, the Los Angeles Times reports (Hamburger/Schreck, Los Angeles Times, 3/12). Giuliani, who has formed a presidential exploratory committee, supports abortion rights. Giuliani in recent talks with conservative media outlets and voters in South Carolina said he would appoint "strict constructionist" judges to the Supreme Court. In a recent interview with Sean Hannity of Fox News, he also said that a law (S 3) being reviewed by the Supreme Court that bans so-called "partial-birth abortion" should be upheld and that he supports parental notification requirements with a judicial bypass provision for minors seeking abortions (Kaiser Daily Women's Health Policy Report, 3/5). In his eight years as mayor, Giuliani appointed or reappointed 127 municipal judges -- who preside over family courts, criminal misdemeanor cases and civil claims of less than $25,000 -- the Times reports. Connie Mackey, vice president of the Family Research Council's political and legislative division FRC action, said Giuliani's appointments "were mostly liberal," adding, "Any pro-lifer who believes they are going to get the kind of judge out of Rudy Giuliani that we see in either [Supreme Court Chief Justice John] Roberts or [Supreme Court Justice Samuel] Alito is probably going to be disappointed." Some constitutional law experts disagree with Mackey's conclusion, the Times reports. Stephen Gillers, a law professor at New York University, called it "nonsense" to cite municipal judges as an indication of how a candidate might appoint Supreme Court justices. He added that Giuliani as mayor was "guided by concerns of competence" when making judicial appointments (Los Angeles Times, 3/12).

New York Times Examines Romney Contributions to Conservative Groups
Contributions made by Massachusetts Gov. Mitt Romney (R) to several "conservative groups" in the months preceding his announcement that he is running for the Republican presidential nomination might "create the appearance of a conflict of interest for groups often asked to evaluate him," the New York Times reports. According to the New York Times, a foundation controlled by Romney in December 2006 made contributions of $10,000 to $15,000 to organizations associated with major national conservative groups, including Massachusetts Citizens for Life, Massachusetts Citizens for Limited Taxation and the Massachusetts Family Institute. Romney has contributed $35,000 in the last two years to the Federalist Society, a conservative legal group, and he contributed $25,000 to the conservative Heritage Foundation in December 2005. He and a group of his supporters also contributed about $10,000 to a not-for-profit group affiliated with National Review. All the groups have said Romney had never contributed before, and his public tax filings show no previous gifts to similar groups. According to the New York Times, the support of leading conservative organizations in Massachusetts has become important to Romney's campaign due to doubts from some conservatives over his past support for abortion rights. Romney's contributions demonstrate his convictions, his spokesperson, Kevin Madden, said, adding, "He has donated his time and his effort and whatever resources he can to help advance their causes" (Kirkpatrick, New York Times, 3/11). According to the Los Angeles Times, Romney has spent more "time and energy" addressing his position on abortion rights than any other presidential candidate (Hook, Los Angeles Times, 3/11). Romney's foundation's 2006 contributions will become public with its tax filings later this year (New York Times, 3/11).














"Reprinted with permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Chlamydia Vaccine A Step Closer To Reality

Scientists at Queensland University of Technology are one step closer to developing a world-first vaccine to protect women against contracting the most common sexually-transmitted disease, Chlamydia.


International vaccine company Sanofi-Pasteur has awarded QUT a funding boost of more than $300,000 to continue its research into Chlamydia and work towards developing a vaccine specifically targeting adolescent women.


Professor Peter Timms, from QUT's Institute of Health and Biomedical Innovation (IHBI), said a team of researchers had already identified certain proteins that were able to protect against Chlamydia infection.


"We've been testing these proteins as part of animal trials...and we think we've got the answer. It is possible that within three to five years we'll be finished the animal trials and be looking at clinical trials in humans."


Professor Timms said Sanofi-Pasteur's funding would allow QUT to evaluate the effectiveness of Chlamydia prevention methods developed at the university, as well as compare and test possible prevention methods being developed by Sanofi-Pasteur.


He said once a vaccine had been developed it could be administered via a patch, similar to ones used by smokers for nicotine.


"Patches are a good way to deliver proteins to a part of the body's immune system and they are also easy and user-friendly."


He said with rates of Chlamydia infection in some Australian communities as high as 12 per cent of the female population, there was a "real need" to develop a vaccine.


"Chlamydia is the most common infectious disease in the world and results in infertility in women and long-term chronic pelvic pain," he said.


"There are antibiotics to treat Chlamydia, but there's no vaccine to prevent it. In many cases women don't know they are infected because there are not really any physical signs or symptoms, so by and large they don't get treatment."


Professor Timms said Sanofi-Pasteur was one of the world's largest companies devoted to the development of human vaccines.


"The fact that such a large vaccine company as Sanofi-Pasteur has selected QUT to help develop Chlamydia vaccines points to the value of the work being done here," he said.
"Despite this current injection of funds, further work and funding is still needed to take this current research through to a vaccine product."


QUT researchers working on the project are part of IHBI's Cells and Tissue Domain and include Professors Peter Timms, Ken Beagley, Associate Professor Louise Hafner, Celia Berry and Chris Barker.


qut.edu.au

Clinton Replacement In Senate Must Uphold Her Legacy As 'Champion For Women,' Opinion Piece Says

Although President-elect Barack Obama's nomination of Sen. HilLary Clinton (D-N.Y.) for secretary of state is an "unprecedented opportunity to bring her unique leadership, advocacy and diplomacy skills to the world's stage," it is important to "make sure that our gain is not simultaneously our loss," Kelli Conlin, president of NARAL Pro-Choice New York, writes in a Albany Times Union opinion piece. Clinton as a senator has been a "singular champion for all the women of the United States," Conlin writes, adding, "Clinton led the way for progressive, pro-choice legislation in the Senate and, because she represents New York, our state's priorities helped push the rest of the nation forward."

Conlin continues, "So when we think about appointing her replacement, we must ask what it truly means to replace" a senator "who nearly single-handedly ended [FDA's] foot-dragging on approving emergency contraception for over-the-counter access" and worked with Sen. Charles Schumer (D-N.Y.) "to oppose the [Bush] administration's plan to reduce federal reimbursement to health clinics (including family planning clinics, substance abuse counseling and mental health clinics)." Since July, Clinton and Sen. Patty Murray (D-Wash.) "have been leading the opposition" to the "misguided" proposed HHS conscience rule that would allow many health care workers to decline to participate in care because of their moral or religious beliefs, Conlin writes. She also notes that Clinton sponsored the Lily Ledbetter Fair Pay Act, which would have "helped close the pay gap and end the inequities that have shortchanged women and families for far too long." In addition, Clinton cosponsored legislation to repeal the "Mexico City" policy -- also known as the "global gag rule" -- as well as bills to fund comprehensive sex education, to expand access to contraception and to codify Roe v. Wade, Conlin writes.

"Simply put, there is no other senator who has shown such commitment, dedication and leadership when it has come to standing up for women's health and rights," Conlin says. She adds that although "[s]ome may argue that, with the election of a pro-choice president and additional pro-choice senators and Congress members, we no longer need an advocate like Clinton," the truth is "that we need someone like her even more. Not just to defend against regressive legislation, but to push forward a proactive, pro-choice agenda." Conlin continues, "We need someone who not only represents New York's pro-choice values, but has the political acumen and ability to confront the entrenched power structures in the Senate. We need someone who has the same willingness to be an ally and advocate for New York and women across the country." She concludes, "We hope that as Gov. David Paterson (D) considers the appointment of Clinton's successor, he will choose someone who will commit to upholding this legacy" (Conlin, Albany Times Union, 12/2).


Reprinted with kind permission from nationalpartnership. You can view the entire Daily Women's Health Policy Report, search the archives, or sign up for email delivery here. The Daily Women's Health Policy Report is a free service of the National Partnership for Women & Families, published by The Advisory Board Company.


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