"Nearly twice as many women (12 percent) as men (7 percent) are affected by a depressive illness each year. At some point during their lives, as many as 20 percent of women have at least one episode of depression that should  be treated. Although conventional wisdom holds that depression is most closely associated with menopause, in fact, the childbearing years are marked by the highest rates of depression, followed by the years prior to menopause." 

(Source:  "Depression Research at the National Institute of Mental Health," National Institute of Mental Health, National Institutes of Health, NIH Publication No. 00-4501, 1999, Reprinted 2000;  http://www.nimh.nih.gov/publicat/depresfact.cfm.)

"The popular antidepressant Paxil may increase the risk of birth defects if pregnant women take it during the first trimester, federal health officials announced late Tuesday.

...The study involved 3,581 pregnant women and found a 4 percent incidence of birth defects in those taking Paxil during the first trimester, versus a 2 percent incidence in those taking other antidepressants. The risk in the general  population was 3 percent, said Mary Anne Rhyne, a Glaxo spokeswoman. Among the most common malformations were ventricular septal defects: holes or other flaws in the wall between two of the heart's chambers."

(Source:  benedict Carey, "Paxil Alert for Pregnant Women," The New York Times, September 29, 2005;  http://www.nytimes.com/2005/09/29/health/womenshealth/29depress.html?ex=1128657600&en=8bd050dcbd8bb681&ei=5070&emc=eta1.)

Pediatricians may not be seeing the children of depressed single mothers much, but emergency room doctors certainly are.  According to a study recently published in Pediatrics by researchers at the Johns Hopkins School of  Medicine, depressed mothers are negligent in seeking preventive medical care for their young children and are over-reliant on emergency care.  And who are these depressed mothers?  Quite typically, they are mothers who are not  married to nor living with their children's father.

In order to better understand when and how children receive preventive and acute medical care during their first 30 months of life, the authors of the new study examined data collected for 4,874 households with a young child.  Just  as they anticipated, "a smaller percentage of children whose mothers had depressive symptoms completed each age-appropriate well-child visit or received each age-appropriate vaccination than children whose mothers did not  have symptoms."  Maternal depressive symptoms were also correlated - as was also hypothesized - with "increased odds of overall E[mergency] D[epartment] use in the first 3 years of life."  Children with depressed mothers also  "tended to have increased odds of hospitalization," though this tendency did not cross the threshold for statistical significance in multi-variable analyses.

Through further careful scrutiny of their data, the Johns Hopkins scholars establish that certain groups of mothers are far more vulnerable to depressive symptoms than others and were therefore far more likely to fall into  "unfavorable patterns of health care seeking for children."  Adverse family circumstances indeed emerge as a strong predictor of vulnerability to maternal depression.  Among the depressed mothers in the study, the researchers  conclude that mothers who are "not married or living with the biological father" are "disproportionately" represented among those manifesting depressive symptoms (p. < 0.001 at both 2-4 months and 30-33 months).

For good reason, the authors of the new study view their findings as strong evidence of "the need to incorporate a family focus in delivering care to children."