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Preventing depression in pregnancy: New guidelines

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March 26, 2019

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Comments

Tim Lundeen
May 4, 2019

I’d suggest Dr Kelly Brogan’s book, A Mind of Your Own: The Truth About Depression and How Women Can Heal Their Bodies to Reclaim Their Lives

Charles Beauchamp MD, PhD
May 2, 2019

Hypothesis 1: Pregnancy is a risk factor for depression & depression is a risk factor for pregnancy outcomes with endothelial dysfunction as an intermediary as follows:

Depression endothelial dysfunction Pregnancy

Depression endothelial dysfunction poor pregnancy & perinatal outcomes.

Hypothesis 2: BioPsychoSocialInteractionalCulturalRacial HarmonyHistoricalCognitiveSpiritualMotivationalBehavioralCircadian CycleEpigeneticEnvironmenatal…etc Stressors can cause endothelial dysfunction via redox imbalance (e.g., with an induced increase in oxidative stress)

Modulators of Oxidative Stress occurrence and intensity are NF-kB, Nff2, Intracellular Thiamine Pyrophosphate & Magnesium – both cofactors of a redox regulating enzyme, Transketolase

Positive Modulators of Oxidative Stress are: downregulators of NF-kB (e.g. Pycnogenol), upregulators of Nrf2 (e.g., sulforaphane), agents that increase intracellular thiamine pyrophosphate (e.g., Benfotiamine and forms of magnesium that can effectively replete intracellular magnesium).

Unifying Hypothesis: At the correct dose and combination Pycnogenol, sulforaphane, Benfotiamine and magnesium can prevent pregnancy complications such as depression, miscarriage, premature birth, infant mortality & maternal mortality while promoting normal birth of a very well developed newborn at term AND while significantly reducing disparities in pregnancy outcomes between whites and blacks.

Charles Beauchamp MD, PhD
May 20, 2019

Expressed another way:

Possible pathway to greatly reducing racial disparities in health care outcomes:

Recognize racial disparities in the occurrence – age of onset, fastness of progression, age of untoward result – of the oxidative stress & endothelial dysfunction patholophysiologies

BioPsychoSocialInteractionalCulturalEnvironmentalExposureHistoricalEpigeneticCircadianRhythm….etc reasons exist for the disparities in oxidative stress –> endothelial dysfunction –> vascular dysregulation –> systemic & regional blood flow abnormalities –> adverse pathophysiologies –> adverse results;

There are key BIOCHEMICAL positive and negative modulators of intensity: NF-KB, Nrf2, intracellular thiamine pyrophosphate & magnesium.

There are low cost Rx agents that downregulate NF-kB (Pycnogenol), upregulate Nrf2 (sulforaphane), support intracellular Transketolase activity (magnesium, Benfotiamine) that individually and in combination can be therapeutic AT THE APPROPRIATE DOSAGE

There are also chronotherapeutic approaches (e.g., bedtime dosing of anti-hypertensive) that can make a big difference in very important clinical outcomes as stroke & heart attack

The above can apply to men as well as women – e.g., non-occurrence of the normal nocturnal systolic BP dip in African American men & Hispanic men.

There is a need for PRIMARY CARE studies that are best done as multi-state Comparative Effectiveness trials.

Linda Robbins
April 26, 2019

Hi David,  I read your article with interest  –  A lot of moms are really suffering from depression even after the first year after birth, awareness is very important.  I found this article quite useful when faced with a similar problem https://www.stuff4tots.com/transition-of-a-lifetime-the-importance-of-emotional-health-for-moms/

Best wishes.

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