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Depressions common after maternal toxicity, says Dutch study

Many women who have suffered maternal toxicity feel less healthy mentally after childbirth. This is especially true for women who suffered severe maternal toxicity. Almost half of the women indicated that they suffered from depressions. These are the conclusions made by Meeke Hoedjes in the research that she carried out at Erasmus MC and for which she will receive her PhD tomorrow. Partly as a result of these outcomes, Erasmus MC has started an outpatient clinic to provide these women with extensive aftercare.

Hoedjes, medical psychologist: “Healthcare providers should become more aware of possible poor mental health after maternal toxicity. They should refer eligible women to specialized psychosocial care, such as medical psychologists or medical social workers.”

In addition to improving the mental health, it is very important for women to adopt a healthy lifestyle after maternal toxicity as they have an increased risk of suffering from cardiovascular diseases and Type 2 diabetes later in life. Many women, however, indicated that they have difficulty in adopting a healthy lifestyle after childbirth. For example, 38% of the women do not meet the recommended exercise levels after childbirth. This again particularly applies to women with severe maternal toxicity. These women mention inadequate recovery from maternal toxicity as the main reason for not being able to live a healthier life.

These women need help to improve their lifestyle after childbirth. To this end, a lifestyle intervention should be developed specially targeting this group of women. The women themselves indicate that what they particularly need is tailored guidance. They would, for example, like to be able to decide where the guidance is given, when this is started, how long it should last and how often the guidance should be given. While this tailored intervention is being developed, women who have suffered maternal toxicity can make use of an existing lifestyle intervention developed for women after pregnancy.

Ideally, all women with severe maternal toxicity should be provided with extensive aftercare, according to Hoedjes. Erasmus MC has recently opened a consultation surgery, thereby getting more extensive aftercare for eligible women underway. Currently, these women are only being seen by a gynecologist and an internist-vascular medicine specialist, but eventually a psychologist and dietician will also be part of the team treating the women.