Mothers who had juvenile arthritis were more often diagnosed with post-partum depression

WASHINGTON — Mothers with a history of juvenile arthritis were more often diagnosed with post-partum depression, according to data presented at the American College of Rheumatology Annual Meeting.

Debbie Ehrmann Feldman, PhD, at the University of Montreal School of Rehabilitation, and colleagues identified all mothers with a history of juvenile arthritis who had their first child between 1983 and 2010 (n = 1,681; mean age = 24.7 years) and identified a cohort of first-time mothers without juvenile arthritis during this same period (n = 6,724; mean age = 25 years). The comparison cohort was matched 4:1 to those with the disease by using date of first birth, maternal age and location of residence. Between the two groups, the researchers compared post-partum complications, including the following:

major puerperal infection;
thromboembolic events;
anesthetic complications;
post-partum hemorrhage;
obstetrical trauma;
obstetrical surgical wound complications; and
depression.

After adjusting for maternal age, education, cesarean delivery, hypertension, diabetes, birthweight and adverse birth outcome, researchers performed a multivariate analysis between juvenile arthritis and each complication.

Researchers found mothers with a history of juvenile arthritis — compared to those without the disease — had a higher rate of depression in their first year post-partum (29.8% vs. 6.7%) and a higher rate of post-partum hemorrhage (10% vs. 6.1%), but a lower rate of puerperal infections (1.6% vs. 2.5%) and obstetrical trauma (4.3% vs. 7.2%). In the multivariate analysis, juvenile arthritis was associated with an increased risk for post-partum depression (risk ratio = 4.25) and post-partum hemorrhage (risk ratio = 1.65), but a decreased risk for thromboembolic events (risk ratio = 0.79) or obstetrical trauma (risk ratio = 0.6).

The researchers wrote that higher rates of pre-existing depression in women with a history of juvenile arthritis or more frequent post-partum follow-up could explain their results.

“Prevention strategies, especially for post-partum hemorrhage and thromboembolism, may be important,” Feldman said in her presentation. “And physicians need to be aware of the high risk for these complications.” – by Will Offit

Reference:

Feldman DE, et al. Abstract #3050. Presented at: American College of Rheumatology Annual Meeting; Nov. 11-16, 2016; Washington.

Disclosure: The researchers report no relevant financial disclosures.