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P1129 - Peripartum depression and anxiety in women with MS. A population-based cohort study. (ID 305)
People with multiple sclerosis (MS) have increased risk of depression and anxiety. It is not known if pregnancy and birth impact the risk of psychiatric symptoms in women with MS.
To assess the occurrence, risk factors and prognosis of peripartum depression and anxiety in women with MS before and after diagnosis.
This study included women from the prospective Norwegian Mother, Father and Child Cohort study (MoBa) between 1999-2008. We used data from questionnaires at gestational weeks 18 and 30, and at 6 and 18 months postpartum. Self-reported data on depression and anxiety were recorded by Hopkins Symptom Checklist. Identification of women with MS was obtained from the Norwegian MS Registry, Norwegian Patient Registry and hospital records. The identified MS-women (n=546) were divided into 1) Pre-birth diagnosis (n=140), 2) Pre-birth onset with post-birth diagnosis (n=98) and 3) Post-birth onset (n=308). Thirty-five women were diagnosed with MS in the postpartum period. In group 2 and 3 the median follow-up time from birth until diagnosis was 7 years (range 0-17). The reference group consisted of women in MoBa without MS (n=111,267).
Depression in gestational week 30 was more common among women with pre-birth diagnosis compared to the reference group (15% vs. 9%, OR 2.0 95% CI 1.2-3.1), adjusted for age, parity, overweight, socioeconomic factors and clustering among siblings. For those depressed in this group, the symptoms more often persisted to 6 months postpartum (77% vs. 38%, p=0.004), but the prognosis 18 months postpartum was similar. Women who were diagnosed with MS in the postpartum period had higher occurrence of depression compared to the reference group both 6 months (23% vs. 10%, p=0.023) and 18 months postpartum (42% vs. 13%, p<0.001). There was no significant difference in peripartum depression in women with post-birth diagnosis (group 2 and 3) compared to the reference group. Risk factors associated with depression in women with pre-birth diagnosis were adverse socioeconomic factors, history of physical and/or sexual abuse and pre-pregnancy psychiatric disease. There was no difference in peripartum anxiety between any of the MS groups and the reference group.
Women with diagnosed MS have an increased risk of depression in the third trimester. The burden of having a MS diagnosis seems to be the determinant for depression. Clinicians should be aware of postpartum depression in women diagnosed with MS in this period.