PubMed · 16094740
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Nicholas Thomson, Ana Cerdeño-Tárraga, Stephen Bentley. 2005. Massive attack.. https://doi.org/10.1038/nrmicro1212
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Miscarriage occurs in 10-20% of clinically recognized pregnancies and is associated with two- to fourfold increases in depressive symptoms. No counseling programs for depressed miscarrying women have been manualized or evaluated for safety and efficacy. We investigated whether depressive symptoms decline substantially among miscarrying women receiving one to six weekly sessions of manualized, telephone-administered interpersonal counseling (IPC), a variant of interpersonal psychotherapy (IPT) in an open trial. Depressive symptom levels were measured with the Center for Epidemiologic Studies-Depression (CES-D) scale. Of 65 women evaluated, 24 were study eligible; 17 consented to participate. Change in symptom levels was evaluated by comparing baseline to postintervention CES-D scores in an intention to treat (ITT) sample (n=17) and a completer subsample (n=9). The latter sample comprised women reevaluated postintervention. In the ITT sample, the CES-D mean score declined from 25.4 to 18.8 [mean within-subject change=6.6, 95% confidence interval (CI)=1.4-11.6]; in the completer subsample, it declined from 23.6 to 11.2 (mean within-subject change=12.3, 95% CI=4.0-20.7). Findings from this small open trial suggest that IPC decreases depressive symptoms after miscarriage. A randomized, controlled trial of IPC's safety and efficacy with depressed miscarrying women is warranted.
The aim of our study was to assess the prevalence and outcome of pregnancy in idiopathic inflammatory myopathy patients who became pregnant after the onset of the disease. Female idiopathic inflammatory myopathy patients (173) were included in our study. The patients' charts and clinical data were retrospectively analyzed. One hundred and four female idiopathic inflammatory myopathy patients had 186 pregnancies, but only nine of these patients (4 polymyositis-PM, 5 dermatomyositis-DM) became pregnant after the onset of the disease. Nine patients with pregnancies after the disease onset had 14 gravidities. Six pregnancies resulted in normal deliveries, two ended in prematurity, six ended in abortions (two induced abortions). Regarding the four patients (3 PM, 1 DM) with active disease at the time of pregnancy, two pregnancies ended in prematurity, four ended in spontaneous abortion and one healthy baby delivered. The other five patients (2 PM, 3 DM) with the disease in remission had uneventful pregnancies and healthy babies were delivered. Treatment was not required during pregnancy in case of two dermatomyositis patients with long lasting remission. New onset dermatomyositis developed in one patient in her pregnancy's third trimester. The mean weight of newborns in the active myositis cases was 2,193 (1,680-2,700) g; while in patients with remission was 3,167 (2,800-3,800) g. The active maternal disease in idiopathic inflammatory myopathy (IIM) might result intrauterin retardation and death. Disease activity in active and new-onset cases could be controlled by increasing the dose of corticosteroid.
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