Mental illness likely to develop in women with IBD during postpartum
Women with inflammatory bowel disease (IBD), particularly Crohn’s disease, are at high risk of developing mental illness such as mood, anxiety and substance use disorders during the postpartum period, a study suggests.
Researchers used population-based health administrative data and identified 3,721 women with IBD and 798,908 controls without the disease. They calculated the incidence of new-onset mental illness from conception to 1-year postpartum and identified correlates of such illness in IBD using logistic regression.
Perinatal mental illness occurred in 22.7 percent of women in the IBD group and in 20.4 percent in the control group, corresponding to incidence rates of 150.2 and 132.8 per 1,000 patient-years (adjusted hazard ratio [aHR], 1.12; 95 percent CI, 1.05–1.20) or one additional case of new-onset mental illness per 43 pregnant women with IBD.
Of note, the risk was pronounced in the postpartum period (aHR, 1.20; 1.09–1.31) but not during pregnancy and in women with Crohn’s disease (aHR, 1.12; 1.02–1.23) but not ulcerative colitis. The risk of mental illness was specifically elevated for a new-onset mood or anxiety disorder (aHR, 1.14; 1.04–1.26) and alcohol or substance use disorders (aHR, 2.73; 1.42–5.26).
Predictors of a mental illness diagnosis included maternal age, delivery year, medical comorbidity, number of prenatal visits, family physician obstetrical care and infant mortality.
The present data show that the well-described risk of psychiatric disease in IBD patients extends to mental illness in the perinatal period. Researchers pointed out a need for validated tools to identify pregnant and postpartum women who are at risk for or suffering from perinatal mental illness in order to prevent significant morbidity for mothers and ensure health developmental trajectories for their children.