— First postpartum year carried higher risks than prenatal period
by Judy George, Deputy Managing Editor, MedPageToday January 24, 2025
Mothers with multiple sclerosis (MS) had a higher risk of peripartum mental illness than comparator mothers, administrative health data from Canada showed.
Incident mental illness — most commonly, depression and anxiety — affected 8.4% of mothers with MS prenatally and 14.2% during the first postpartum year, reported Ruth Ann Marrie, MD, PhD, of Dalhousie University in Halifax, and co-authors.
The incidence of mental illness was higher among women with MS during both the prenatal period (incidence ratio [IR] 1.26, 95% CI 1.11-1.44) and the postpartum period (IR 1.33 for the first year, 95% CI 1.20-1.47) versus comparator mothers, the researchers wrote in Neurologyopens in a new tab or window.
The first postpartum year was a higher risk period than the prenatal months (IR 1.27, 95% CI 1.08-1.50), Marrie and colleagues said.
Mothers with MS had an increased risk of all specific mental illnesses except suicide attempts. Of note, substance use increased in women with MS, from 0.54% during pregnancy to 6% after giving birth.
Compared with mothers who had other chronic diseases — epilepsy, inflammatory bowel disease (IBD), or diabetes — mothers with MS had higher risks of peripartum depression, anxiety, and psychosis.
These findings have several implications, Marrie and colleagues noted. “Untreated maternal depression is associated with substance use, increased risk of future depressive episodes, and suicide,” they wrote.
Maternal mental illness also has important effects on the physical and mental health of a child, they added. “Mothers with depression breastfeed for shorter periods, and their children receive less preventive care and undergo more emergency department visits,” they pointed out. “Infants and older children may suffer from behavioral disturbances, developmental delays, and social withdrawal.”
