Patients with autoimmune disease have 30% higher risk for perinatal depression
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Key takeaways:
- Autoimmune diseases were associated with higher risk for subsequent perinatal depression.
- Meanwhile, patients with perinatal depression demonstrated a 30% higher risk for subsequent autoimmune disease.
Patients with autoimmune disease demonstrate a 30% higher risk for perinatal depression, while those with perinatal depression have a 30% higher risk for subsequent autoimmune disease, according to data published in Molecular Psychiatry.
“Not only does [perinatal depression (PND)] affect the woman herself, but the child, the partner and society,” Emma Bränn, MS, a postdoctoral researcher at the Karolinska Institute, in Stockholm, and colleagues wrote. “Consequences of PND include sustained psychological ill-health, relationship difficulties and lower quality of life. However, studies investigating somatic diseases, including autoimmune diseases, in relation to PND are scarce.”
To examine the associations between perinatal depression and autoimmune disease, Bränn and colleagues analyzed data from 1,289,638 pregnancies among 815,232 women included in the Swedish National Medical Birth Register.
The researchers conducted a nested case-control study to evaluate links between autoimmune disease and subsequent perinatal depression risk, then a matched cohort study to find associations between perinatal depression and later risk for autoimmune disease.
According to the researchers, the nested case-control study found that patients with autoimmune diseases had a 30% higher risk for perinatal depression (OR = 1.3; 95% CI, 1.25-1.35). Meanwhile, in the matched cohort study, patients exposed to perinatal depression demonstrated a 30% higher risk for subsequent autoimmune disease (HR = 1.3; 95% CI, 1.25-1.36) over a median follow-up period of 4.75 years.
Autoimmune diseases with a significant positive bidirectional association included autoimmune thyroid disease, psoriasis, multiple sclerosis, ulcerative colitis and celiac diseases. Diseases associated with the greatest risk of subsequent perinatal depression included multiple sclerosis (OR = 1.96; 95% CI, 1.64-2.34), Addison’s disease (OR = 1.93, 95% CI, 1.15-3.24) and myasthenia gravis (OR = 1.9; 95% CI, 1.02-2.54).
The researchers also compared the autoimmune disease risk of each woman with perinatal depression to a full sister who had given birth without perinatal depression. According to the researchers, the sister analysis found comparable associations in each direction (nested case-control OR = 1.3; 95% CI, 1.2-1.5; matched cohort HR = 1.3; 95% CI, 1.1-1.6).
“These findings demonstrate a bidirectional association between [autoimmune disease (AD)] and PND independent of psychiatric comorbidities, suggesting possibly shared biological mechanisms,” Bränn and colleagues wrote. “If future translational science confirms the underlying mechanisms, health care providers need to be aware of the increased risk of PND among women with AD and vice versa.”
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