A new study reveals that people with multiple sclerosis (MS) experience significantly higher rates of mental illness during pregnancy and the first year after childbirth, compared to those without MS.
The findings suggest a critical need for targeted mental health screening and interventions for this group, with depression and anxiety being the most prevalent conditions.
MS and Mental Health During Pregnancy
People with multiple sclerosis (MS) are at a much higher risk of developing mental health issues during and after pregnancy compared to those with other chronic conditions, according to a new study that analyzed over 890,000 births in Ontario.
Published today (January 22) in Neurology, the medical journal of the American Academy of Neurology, the study highlights the unique mental health challenges faced by individuals with MS during pregnancy and the first year after giving birth. Using population-based health data from ICES, researchers found that 8% of people with MS developed a new mental illness during pregnancy, with this number increasing to 14% in the first year postpartum. The most commonly reported conditions were depression and anxiety.
The study compared mental health outcomes among females with MS (close to 1,700) to females with epilepsy, inflammatory bowel disease, diabetes, and people without these chronic conditions. The researchers analyzed mental illness before conception, during pregnancy, and up to three years after giving birth.
Postpartum Mental Health Vulnerability in MS Patients
The first year after childbirth was found to be a particularly vulnerable period, with people with MS being 33% more likely to experience a mental illness than people without MS or another of the studied chronic diseases. Overall, half of people with MS were living with a mental illness in the first year postpartum.
“Our findings highlight the heightened vulnerability of mothers with MS to mental illness, emphasizing the need for mental health screening and early intervention, including the use of preventive strategies,” says lead author Dr. Ruth Ann Marrie, a Professor of Medicine and Multiple Sclerosis Clinical Research Chair at Dalhousie University.
Key Findings:
- People with MS had a 26% higher incidence of mental illness during pregnancy and a 33% higher risk in the first year postpartum compared to pregnant people without MS, after adjusting for factors such as age, socioeconomic status, and obstetric complications.
- Mental illness affected 42% of people with MS during pregnancy and 50% in the first year after giving birth, compared to 30% of people without MS during pregnancy and 38% in the first year after birth.
- About 1% of people with MS experienced psychosis and nearly 6% developed substance use disorders within one year of giving birth.
- People with epilepsy, inflammatory bowel disease and diabetes also had increased risks of mental illness during pregnancy and in the first postpartum year compared to people without these conditions.
While people with MS consistently showed elevated risk, the findings suggest a broader need for mental health support across chronic conditions during the pregnancy and postpartum period.
One limitation of the study is that administrative data can only capture mental health issues for which health care services are sought, which means that the burden of mental illness among this population could be underestimated.
“Future studies should assess how the activity and severity of chronic diseases such as MS may affect mental health during the pregnancy and postpartum period, and how comprehensive care strategies can best support mental health during this period,” says senior author Dr. Colleen Maxwell, a Senior Adjunct Scientist at ICES and a Professor in the Schools of Pharmacy and Public Health Sciences at the University of Waterloo.
Reference: “Peripartum Mental Illness in Mothers With Multiple Sclerosis and Other Chronic Diseases in Ontario, Canada” by Ruth Ann Marrie, James Bolton, Yushu (Vicki) Ling, Charles Bernstein, Kristen M. Krysko, Ping Li, Kyla A. Mckay, Priscila Pequeno, Neda Razaz, Dalia Rotstein, Karma Deakin-Harb and Colleen J. Maxwell, 22 January 2025, Neurology.
DOI: 10.1212/WNL.0000000000210170
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