Those living with multiple sclerosis who are pregnant have a greater chance of experiencing mental illness during pregnancy and in the first few years following birth.
Research published in Neurology found that pregnant people with MS had a 26% increased risk of mental illness during pregnancy when compared with pregnant people without MS and a 33% increased risk of mental illness after birth.
“We found that 22 in every 100 mothers with MS developed a new mental illness during pregnancy or the first year after birth, compared to only 18 in every 100 mothers without MS, diabetes, epilepsy or inflammatory bowel disease. The risk of mental illness was higher in mothers with MS even after we accounted for age at conception, and household income in the areas where they lived,” Ruth Ann Marrie, MD, PhD, author of the study and a researcher at Dalhousie University in Halifax, Canada, and member of the American Academy of Neurology told Theravive.
“More people with MS are having children than before – as the number of people with MS grows. Although we know that people with MS are at higher risk of mental illness than people without MS, we do not know much about mental illness during pregnancy. Yet, we know that mental illness during pregnancy or post-partum can have a big impact on the health and well-being of the affected parent and the child.”
In undertaking their study, the researchers looked at data from 894, 852 pregnant people. Of these people, 1745 had MS.
The researchers examined the health records of people who had given birth across a 15 year span. The records used began two years before conceptions and ended three years following birth.
The study authors then examined how many of the pregnant people had been newly diagnosed with mental illness during pregnancy or had an existing mental illness during that period. They also examined who had a new diagnosis or existing diagnosis in the first, second and third year following birth.
The mental illnesses looked at included depression, psychosis, suicide attempts, anxiety, bipolar disorder and substance abuse.
42% of the people who had MS and were pregnant were affected by mental illness. This increased to 50% in the first year following birth.
By comparison, 30% of people with MS during pregnancy were affected by mental illness, and 38% were affected in the first year after birth.
8% of people with MS received a new diagnosis of mental illness during pregnancy, and 14% received a new diagnosis in the first year after birth.
By comparison, 7% of those without MS received a new mental health diagnosis during pregnancy and 11% received a new diagnosis in the first year following birth.
When the researchers adjusted for factors like age at conception and income in the area of residence of the person they found that pregnant people who live with MS had a 26% increased risk of mental illness during pregnancy as well as a 33% increased risk of mental illness after giving birth when compared with pregnant people who don’t have MS.
Marrie says physicians can play an important role in supporting those with MS in pregnancy planning.
“Clinicians could have conversations about the potential for mental illness as part of pregnancy planning discussions held with people with MS, and ensure this is considered in the care plan,” she said.
“Referral for counseling interventions reduces the risk of perinatal depression in the general population; so this may be useful to consider for people with MS as well. Asking about or formally screening for symptoms of mental illness during pregnancy and post-partum periods may help aid earlier detection and management.”