Women with multiple sclerosis (MS) who developed depression during pregnancy had prolonged depressive symptoms that often lasted into the postpartum period, according to an editorial published in Neurology.
The authors of the editorial referred to a large cohort study (N = 114,629 pregnant patients) carried out by Eid et al. A total of 546 pregnant patients with MS were divided into 3 different categories: women with a diagnosis of MS before pregnancy, women with a diagnosis of MS after pregnancy with symptoms of MS before pregnancy and women with inactive MS at birth with symptoms onset and Diagnosis after pregnancy.
The study results showed that women diagnosed with MS before pregnancy were 2 times more likely to develop depression in the 3rd trimester (odds ratio 2.0; 95% CI 1.2-3.1). Post-pregnancy women diagnosed with MS with symptoms of MS before pregnancy did not have an increased risk of perinatal depression and anxiety compared to controls. However, women with symptoms onset within 5 years of pregnancy were more likely to experience depression and anxiety.
This study also showed that symptoms of depression in patients with MS who experienced depression during pregnancy lengthened into the postpartum period. The authors also found that the associated MS prodrome may contribute to this phenomenon.
The study’s researchers acknowledged that more research is needed on MS and socio-economic stressors that can affect depression. Additionally, the editors’ authors noted that it is possible for pregnancy to restore a biochemical imbalance to provide protection from anxiety, as no increased risk of anxiety has been observed in patients diagnosed with MS or with pronounced symptoms.
Ultimately, the study’s investigators concluded that their research shows “the need for proactive attention for perinatal mental health in women with existing and newly diagnosed MS, and in women with no clear symptoms or diagnosis of MS. The elucidation of this critical issue has the potential to lead to significant improvements in the diagnosis and subsequent access to treatment of 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