Study Finds Positive Association Between Depression During and After Pregnancy and Autoimmune Diseases

Perinatal depression refers to depression that occurs during pregnancy or postpartum. It affects about 3% to 20% of women worldwide. It is known that autoimmune diseases, including ulcerative colitis, have been associated with mental health conditions, such as anxiety and depression. However, there is limited research investigating the relationship between perinatal depression and autoimmune diseases.

In a study published earlier this month in the journal Molecular Psychiatry, lead investigator Emma Bränn and colleagues from the Karolinska Institutet in Stockholm, Sweden, examined the bidirectional association between perinatal depression and autoimmune diseases, including ulcerative colitis.

Using data from the Swedish National Medical Birth Register, Bränn and her colleagues identified all women who gave birth in Sweden between 2001 and 2013. From this group, the researchers identified all women with a first-time perinatal depression diagnosis or who had been prescribed an antidepressant from the estimated date of conception to one year postpartum.

Each participant with perinatal depression was randomly matched with 10 women without perinatal depression. A total of 55,229 women with perinatal depression and 552,990 unaffected women were included in the analysis.

Additionally, the researchers conducted a matched cohort investigating the association between perinatal depression and the risk of developing an autoimmune disease. This cohort included 50,728 women with perinatal depression and 479,669 women without perinatal depression. Neither group had a previous history of autoimmune disease. The cohort was followed from the match date until the diagnosis of an autoimmune disease, emigration, death, or December 31, 2013 (a median of 4.75 years).

To control for confounders, such as genetic and environmental factors, Bränn and her colleagues included a sibling comparison. A total of 41 types of autoimmune diseases were identified, including multiple sclerosis, ulcerative colitis, psoriasis, and myasthenia gravis.

Results showed a significant positive bidirectional association between perinatal depression and autoimmune disease for multiple sclerosis, ulcerative colitis, thyroid disease, psoriasis, and coeliac disease. Overall, women with an autoimmune disease were 30% more likely to have perinatal depression, and women with perinatal depression had a 30% higher risk of developing a subsequent autoimmune disease.

“Our findings suggest a bidirectional association between [perinatal depression] and [autoimmune disease], independent of psychiatric comorbidities. These findings have implications for research on biological mechanisms, and for healthcare professionals who need to be alert to the risk of [perinatal depression] in women with [autoimmune disease], and vice versa,” Bränn and her colleagues concluded.