TOPLINE:
Multiple sclerosis (MS) is associated with a 26% higher risk for mental illness during pregnancy and a 33% higher risk in the first postpartum year than not having MS, new research suggests.
METHODOLOGY:
- Researchers conducted a population-based, retrospective cohort study using data from almost 895,000 mothers in Canada. Participants included those with MS (n = 1745), epilepsy (n = 5954), inflammatory bowel disease (n = 4924), and diabetes (n = 13,002), as well as more than 869,000 comparators without these chronic conditions.
- Validated case definitions were used to identify depression, anxiety, bipolar disorder, psychosis, substance use disorder, suicide attempts, and any mental illness during prenatal and postpartum periods.
- Participants were followed from 1 year before conception through 3 years after delivery, with index dates between 2000 and 2017.
- The analysis was adjusted for age at conception, delivery year, income, and the obstetric comorbidity index to compare incidence rates between periods and groups.
TAKEAWAY:
- Among women with MS, incident mental illness was reported in 8% during pregnancy and in 14% during the first postpartum year. The most common incident disorders were anxiety and depression.
- In the MS cohort, prevalence of any mental illness was 42% during pregnancy and 50% during the first postpartum year.
- Mothers with MS also had an increased incidence of any mental illness during the prenatal period (adjusted incidence ratio [aIR], 1.3; 95% CI, 1.1-1.4) and the first postpartum year (aIR, 1.3; 95% CI, 1.2-1.5) compared with mothers without chronic conditions.
- The first postpartum year was a higher risk period for incident mental illness (IR, 1.3; 95% CI, 1.1-1.5) than the prenatal period.
IN PRACTICE:
“These findings emphasize the need for preventive interventions and early treatment of mental illness,” lead author Ruth Ann Marrie, MD, PhD, Dalhousie University in Halifax, Nova Scotia, Canada, said in a press release.
“Clinicians need to acknowledge that peripartum mental illness is common in [women with MS] and should be accounted for as part of their routine in family planning, pregnancy, and postpartum encounters,” Lindsay A. Ross, Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic, Cleveland, Ohio, wrote in an accompanying editorial.
SOURCE:
The study and editorial were published online on January 22 in Neurology.
LIMITATIONS:
Residual confounding could not be excluded from the findings. Mental illness severity, treatment status, or clinical characteristics and health behaviors of the participants could not be assessed. In addition, administrative data only captured conditions for which care was sought, potentially underestimating the burden of mental illness.
DISCLOSURES:
The study was funded by MS Canada and ICES. Several investigators disclosed having various funding sources and ties, including receiving support from national and international health organizations, pharmaceutical companies, and research foundations. Details are fully listed in the original article. The editorialist reported no targeted funding or conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Source link : https://www.medscape.com/viewarticle/women-ms-risk-peripartum-mental-illness-2025a10002cq?src=rss
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Publish date : 2025-01-30 09:54:01
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