Women with multiple sclerosis (MS) who experience depression onset during pregnancy had more prolonged depressive symptoms, often lasting into the postpartum period, according to an editorial published in Neurology.
The editorial authors referenced a large cohort study (N=114,629 pregnant patients) conducted by Eid et al. In total, 546 pregnant patients with MS were separated into 3 distinct categories: women with an MS diagnosis prior to pregnancy, women who were diagnosed with MS after pregnancy with MS symptoms prior to pregnancy, and women with inactive MS at the time of birth with symptom onset and diagnosis after pregnancy.
Study results found that women with an MS diagnosis preceding pregnancy had a 2-fold chance of depression in the 3rd trimester (odds ratio, 2.0; 95% CI, 1.2-3.1). Women with MS diagnosis after pregnancy with MS symptoms prior to pregnancy did not have an increased risk of perinatal depression and anxiety compared with the control group. However, for women with symptom onset in a 5-year period after pregnancy, depression and anxiety occurred at a higher frequency.
This study also showed that symptoms of depression extended longer into the postpartum period for patients with MS who experienced depression onset during pregnancy. The authors also noted the associated MS prodrome may contribute to this phenomenon.
Study investigators acknowledged that more research is necessary regarding MS and socioeconomic stressors which can influence depression. Additionally, the editorial authors noted that because an increased risk of anxiety was not observed in patients with an MS diagnosis or distinct symptoms, it is possible that pregnancy may reset a biochemical imbalance to provide protection against anxiety.
Ultimately, the study investigators concluded that their research “demonstrates the need for proactive attention around perinatal mental health in women with established and newly diagnosed MS, as well as those with neither clear symptoms nor a diagnosis of MS. Shedding light on this critical issue has the potential to lead to meaningful improvements in the diagnosis of and subsequent access to treatment for perinatal mood disorders.”
Leavitt VM, Dobson R, Svennigsson A, et al. Perinatal Depression and Anxiety in Multiple Sclerosis. Neurology. Published online April 28, 2021. doi:10.1212/WNL.0000000000012101