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The Problem With Problem Pregnancies

Cites research by Sarah McCue Horwitz (Yale University) and colleagues from Yale and Johns Hopkins in 'Pediatrics,' which found women who have complications during pregnancy are more likely than other moms to suffer from postpartum depression. Why women with difficult pregnancies suffer postpartum depression; Thoughts for pediatricians.

You're seven months pregnant when you suddenly go into labor and deliver a preemie that looks more dead than alive. The nightmarish experience fades away as soon as the baby begins to thrive,but chances are you and your child will never be the same again.

Women who have complications during pregnancy are more likely than other moms to suffer from postpartum depression. What's more, they feel their child is more vulnerable to illness-a concern that may linger for years and distort the mother-child relationship.

"These mothers are filled with a pathological dread that something could still go wrong with their kids," says Yale psychologist Sarah McCue Horwitz, Ph.D. As a result they may become overprotective or have trouble separating themselves from their children--both of which can take a toll on the kids' mental well-being.

Horwitz and colleagues from Yale and Johns Hopkins surveyed mothers of 1095 children aged four to eight. They found that women who suffered from severe pregnancy complications, including diabetes and premature labor, were almost two and a half times more likely to report feeling blue within the first three months after delivery.

The women were also almost two times more likely to admit feeling that their children were likely to fall ill, and agreed with statements like: "I often have to keep [my child] indoors because of health reasons."

Women who had both problem pregnancies and postpartum depression were almost three times more likely to view their child as prone to illness or accidents, the researchers report in Pediatrics (Vol. 91, No. 3).

Why all the worry? Women who recover from a difficult delivery and subsequent depression may unwittingly internalize the intense feelings of concern they have for their child. If this concern resurfaces as, say, cloying over protectiveness, kids may suffer from their own behavioral problems, including aggression, excessive shyness, or depression during childhood and adolescence. Even worse, they may begin to perceive themselves differently, too.

Pediatricians should encourage moms to describe their pregnancy--as well as any current anxieties they may have about pregnancy complications--and then reassure them that "these things happen," advises Horwitz. "That kind of thing can go a long way."