Journal
MULTIPLE SCLEROSIS JOURNAL
Volume 28, Issue 6, Pages 970-979Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/13524585211041108
Keywords
Multiple sclerosis; pregnancy; postpartum; peripartum; depression; mood
Categories
Funding
- National Multiple Sclerosis Society Harry Weaver Award
- Sylvia Lawry Physician Fellowship from the National Multiple Sclerosis Society [FP-1605-08753]
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The prevalence of peripartum depression in women with multiple sclerosis appears to be similar to the general population, with factors such as older age, primiparity, pre-pregnancy depression, sleep disturbance, and breastfeeding difficulty associated with higher risk. Prospective studies are needed to further explore the impact of peripartum depression on self-management in multiple sclerosis and offspring development.
Background: Peripartum depression (PPD) is underexplored in multiple sclerosis (MS). Objective: To evaluate prevalence of and risk factors for PPD in women with MS. Methods: Retrospective single-center analysis of women with MS with a live birth. Prevalence of PPD was estimated with logistic regression with generalized estimating equations (GEE). GEE evaluated predictors of PPD (e.g. age, marital status, parity, pre-pregnancy depression/anxiety, antidepressant discontinuation, sleep disturbance, breastfeeding, relapses, gadolinium-enhancing lesions, and disability). Factors significant in univariable analyses were included in multivariable analysis. Results: We identified 143 live births in 111 women (mean age 33.1 +/- 4.7 years). PPD was found in 18/143 pregnancies (12.6%, 95% CI = 7.3-17.8). Factors associated with PPD included older age (OR 1.16, 95% CI = 1.03-1.32 for 1-year increase), primiparity (OR 4.02, CI = 1.14-14.23), pre-pregnancy depression (OR 3.70, CI = 1.27-10.01), sleep disturbance (OR 3.23, CI = 1.17-8.91), and breastfeeding difficulty (OR 3.58, CI = 1.27-10.08). Maternal age (OR 1.17, CI = 1.02-1.34), primiparity (OR 8.10, CI = 1.38-47.40), and pre-pregnancy depression (OR 3.89, CI = 1.04-14.60) remained significant in multivariable analyses. Relapses, MRI activity, and disability were not associated with PPD. Conclusion: The prevalence of PPD in MS appeared similar to the general population, but was likely underestimated due to lack of screening. PPD can affect MS self-management and offspring development, and prospective studies are needed.
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