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From the Journals

MS Linked to Higher Peripartum Depression

Study finds mothers with MS have a higher risk of peripartum mental illness, with 50.3% affected in the first postpartum year—emphasizing the need for early intervention.

Conexiant

A population-based study in Ontario found that mothers with multiple sclerosis had a significantly higher incidence and prevalence of peripartum mental illness compared with those without chronic conditions, as well as mothers with epilepsy, inflammatory bowel disease, and diabetes.

The recent findings, published in Neurology, analyzed 894,852 mothers between 2002 and 2017, including 1,745 with multiple sclerosis (MS), 5,954 with epilepsy, 4,924 with inflammatory bowel disease (IBD), and 13,002 with diabetes. Researchers found that 8.4% of mothers with MS experienced new-onset mental illness prenatally, rising to 14.2% in the first postpartum year. Depression and anxiety were the most common incident disorders. The first postpartum year was a higher-risk period than pregnancy (IR 1.27; 95% CI 1.08–1.50), with a prevalence of 50.3% compared to 42% during pregnancy.

Compared with mothers without chronic illnesses, those with MS had a 26% higher incidence of peripartum mental illness during pregnancy (IR 1.26; 95% CI 1.11–1.44) and a 33% higher incidence in the first postpartum year (IR 1.33; 95% CI 1.20–1.47).

Mothers with MS had higher rates of depression, anxiety, psychosis, and substance use disorder compared with those with epilepsy, IBD, or diabetes. Psychosis and substance use disorder were significantly more prevalent in mothers with MS. During pregnancy, the incidence rate ratio (IRR) for psychosis in MS compared to IBD was 5.76 (95% CI 4.58–7.25), while the IRR compared to diabetes was 1.47 (95% CI 1.27–1.70). Postpartum substance use disorder increased from 0.54% prenatally to 6% in the first year after childbirth.

"Given the potential adverse consequences for maternal and child health, clinicians caring for mothers with these diseases should be aware of these risks and ensure that recommended screening occurs, followed by appropriate treatment as needed. Greater attention to preventive interventions is also needed," said Ruth Ann Marrie from the Department of Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Full authors' disclosures are available in the study.