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Health Resources Hub / Neurologic Disorders / Multiple Sclerosis

New Moms with MS Face Increased Risk of Depression, Anxiety

Mental health challenges, including depression and anxiety, affect nearly half of mothers with MS in the first year postpartum, according to a new study.

By

Lana Pine

 |  Published on January 24, 2025

4 min read

New Moms with MS Face Increased Risk of Depression, Anxiety

Credit: Adobe Stock/weyo

Mothers with multiple sclerosis (MS) are more likely to experience mental health issues including depression and anxiety during pregnancy and after giving birth than mothers without MS.

“Peripartum mood and anxiety disorders constitute the most frequent form of maternal morbidity in the general population, but little is known about peripartum mental illness in mothers with MS,” wrote a team of investigators led by Ruth Ann Marrie, Ph.D., professor of medicine and community health sciences at the University of Manitoba, Canada.

MS impacts nearly 3 million people worldwide, with women being affected three times more often than men.

Researchers analyzed healthcare data from nearly 900,000 mothers in Ontario, Canada (a province that accounts for 40% of the nation’s population), comparing those with MS with those with epilepsy, inflammatory bowel disease (IBD) and diabetes, as well as healthy individuals. They estimated the incidence and prevalence of mental illness, including anxiety, depression, substance use, psychosis, bipolar disorder and suicide attempt, the year before conception, during pregnancy, and in the first, second and third years postpartum. The pregnancy period was divided into trimesters.

At the time of conception, the mean age of pregnant women was 28.6 years. Results demonstrated mental health concerns were most common in the first year after birth, with incidence rates of 14% of new mothers with MS and 8.4% of patients prenatally. Among the included mental illnesses, anxiety (3.8%) and depression (0.82%) were most common. These women had an increased incidence of all specified mental illnesses apart from suicide attempt during the prenatal period.

These results support similar studies reporting an increased incidence of mental illness among women with MS who were not pregnant. In a study published in 2015, Marrie and her team found that Canadians with MS had a 71% increased rate of depression, 42% increased rate of anxiety, 99% increased rate of bipolar and 74% increased rate of schizophrenia when compared with an age- and sex-match group of healthy individuals. These rates were higher in women than in men.

In the current study, mental illness ultimately affected 42% of mothers with MS during the prenatal period and 50.3% during the first year postpartum. Mothers with MS exhibited an increased prevalence of mental illness both prenatally and postpartum compared with other patients and healthy individuals, including anxiety (25.1%) and depression (4.6%). Six percent of women were diagnosed with substance use disorders within the first postpartum year compared with an incidence rate of 0.54%, which indicates these patients may have had a substance use disorder prior to pregnancy. Investigators noted these rates were probably underestimated, as administrative data only captures cases that lead to health care utilization.

The prevalence of mental illness within the first year after giving birth was higher among all non-MS cohorts compared with the healthy comparator group excluding one. Psychosis was more prevalent among patients except for those with IBD. However, investigators say this finding should be cautiously interpreted due to the small sample of patients.

Investigators mentioned the large sample size supported the generalizability of the findings and including a spectrum of mental illnesses along with validated case definitions further strengthened the study. However, the use of administrative case definitions introduced the possibility of misclassification. Further, the severity, clinical characteristics, treatment status and health behaviors of those with mental illness were not captured in the data.

“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,” investigators concluded. “Greater attention to preventive interventions is also needed.”