Skip to main content
Top

03-02-2025 | Multiple Sclerosis | News

MS increases mental illness risk among mothers in perinatal period

Author: Dr. Jonathan Smith

print
PRINT
insite
SEARCH

medwireNews: Mothers with multiple sclerosis (MS) have a higher risk for developing perinatal mental illness than their peers without MS, particularly in the first postpartum year, suggests a study from Ontario, Canada.

According to the results, the incidence of any mental illness among mothers with MS rose from 8.4% prenatally to 14.2% in the first year postpartum, compared with incidences of 7.1% and 11.0% in the same timeframes in women without MS. Meanwhile, the prevalence of mental illness in women with MS rose from 42.0% prenatally to 50.3% in the first postpartum year compared with 30.0% to 38.0% among comparators.

When accounting for factors such as age at conception and income in the area of residence, the incidence risk for mental illness was a significant 26% and 33% higher in mothers with MS than those without in the prenatal and postnatal periods, respectively.

“Given the potential adverse consequences for maternal and child health, clinicians caring for mothers with these diseases should be aware of these risks and ensure that recommended screening occurs, followed by appropriate treatment as needed,” write Ruth Ann Marrie (Dalhousie University, Halifax, Nova Scotia, Canada) and colleagues in Neurology. “Greater attention to preventive interventions is also needed.”

After the initial increase in the first year postpartum, the researchers found that the incidence of mental illness among mothers with MS declined to 9.80% and 7.54% in the second and third year postpartum, respectively.

The investigators used population-based administrative health data to identify women in Ontario who gave birth, including an index date 1 year before conception, between 2000 and 2017. The mothers were grouped based on validated administrative case definitions of MS (n=1745), epilepsy (n=5954), inflammatory bowel disease (IBD; n=4924), and diabetes (n=13,002), along with healthy comparators without these conditions (n=869,227). Only 2.9% of participants in the disease cohorts had more than one health condition of interest.

The mothers were followed-up from the index date through 3 years postpartum. The mean maternal age at conception was 28.6 years, ranging from 31.2 years in mothers with MS to 27.4 years in those with IBD.

Relative to comparators, mothers with MS were significantly more at risk for developing all specific mental illnesses in the prenatal period, including depression, bipolar disorder, anxiety, psychosis, and substance use, with adjusted rate ratios of 2.29, 2.30, 1.79, 4.31, and 2.27. The exception was suicide attempts, with too few recorded to estimate accurately.

Anxiety and depression were the most common mental health conditions among mothers with MS, with prenatal incidence rates of 3.8% and 1.7%, respectively, and corresponding rates in the first year postpartum of 5.6% and 3.8%.

The findings were similar for prevalent mental illnesses among mothers with MS, but with the addition of substance use. The prenatal rates of prevalent anxiety, depression, and substance use were 2.1%, 0.8%, and 0.6%, respectively, increasing to a corresponding 25.1%, 11.6% and 5.9% in the first year postpartum.

The researchers found that mothers with epilepsy, IBD, and diabetes also had higher incidence rates of mental illnesses in the prenatal period compared with comparators, except for psychosis and suicide attempts in the IBD group. They also had a higher prevalence of mental illnesses in the first year postpartum, except for psychosis in the IBD cohort, although the investigators note that “this should be interpreted with caution because of small numbers.”

Overall, “mothers with MS and those with epilepsy had a generally higher incidence and prevalence of mental illness than mothers with IBD or diabetes,” says the team, suggesting that this may relate to “the direct structural, functional, neuroinflammatory, and neurochemical effects of these diseases in the [central nervous system].”

In a related commentary, Lindsay Ross, from Cleveland Clinic in Ohio, USA, recommends that “clinicians caring for [women with MS] should consider implementation of validated screening tools of peripartum mental illness and substance abuse” or “include regular discussion of mental health and substance use as part of family planning, pregnancy, and postnatal visits.”

She points out the study has limitations, such as not addressing the role of racial and ethnic background on peripartum mental illness and relying on administrative datasets, and welcomes further “research on scalable implementation for screening and treatment of peripartum mental illness and substance abuse” in women with MS.

medwireNews is an independent medical news service provided by Springer Healthcare Ltd. © 2025 Springer Healthcare Ltd, part of the Springer Nature Group

Neurology 2025; 104: e210170
Neurology 2025; 104: e213366

print
PRINT

Related topics

Keynote series | Spotlight on menopause

Menopause can have a significant impact on the body, with effects ranging beyond the endocrine and reproductive systems. Learn about the systemic effects of menopause, so you can help patients in your clinics through the transition.   

Prof. Martha Hickey
Dr. Claudia Barth
Dr. Samar El Khoudary
Developed by: Springer Medicine
Watch now

Advances in Alzheimer's

Alzheimer's research and care is changing rapidly. Keep up with the latest developments from key international conferences, together with expert insights on how to integrate these advances into practice.

This content is intended for healthcare professionals outside of the UK.

Supported by:
  • Lilly
Developed by: Springer Healthcare IME
Learn more