In a recent publication in the journal Molecular Psychiatry, researchers have explored the intricate connection between perinatal depression (PND) and autoimmune diseases, shedding light on a previously underexplored aspect of women’s health. PND encompasses both antepartum (APD) and postpartum depression (PPD), affecting 3–20% of women globally. The study indicates that major depression outside the perinatal period is associated with endocrine-metabolic disorders and immune system dysfunctions.
The study conducted by a group of Swedish researchers highlighted a reciprocal relationship between women with autoimmune diseases and the likelihood of experiencing depression during pregnancy and postpartum. Conversely, women with a history of PND have an elevated risk of developing autoimmune diseases. The study was primarily focused on prevalent autoimmune conditions, including gluten intolerance (coeliac disease), autoimmune thyroiditis, rheumatoid arthritis, type 1 diabetes, and multiple sclerosis (MS).
Dr. Bränn and colleagues utilized data from the Swedish Medical Birth Register, employing both a nested case-control study and a matched cohort study. Among the 1,347,901 pregnancies recorded from 2001 to 2013, the researchers identified 55,299 incidents of perinatal depression (PND). They included unaffected full sisters and 10 unaffected matched women for each PND case. Analyzing 41 subtypes of affective disorder (AD) diagnoses from the registers, the study compared occurrences of PND with those in unaffected population-matched women and full sisters using multivariable regressions.
The results revealed a 30% higher risk of subsequent perinatal depression (PND) in women with autoimmune diseases. Conversely, women exposed to PND exhibited a similar 30% higher risk of subsequent autoimmune diseases. These associations persisted when comparing exposed women with their unaffected sisters, encompassing both antepartum and postpartum depression. The study also highlighted a bidirectional association between perinatal depression and autoimmune thyroiditis, psoriasis, multiple sclerosis (MS), ulcerative colitis, and coeliac disease, with an overall 30% higher likelihood in women with autoimmune diseases. The most substantial correlation was observed in cases of multiple sclerosis, where the risk was doubled in both directions. This correlation was particularly robust among women without a prior psychiatric diagnosis.
The study emphasized the necessity of investigating the lasting repercussions of depression during pregnancy and the initial postpartum period, highlighting the potentially significant implications for both mothers and infants. The researchers expect that these findings may motivate policymakers to allocate funding for maternal healthcare, to ensure timely assistance and support for the needy.
Reference
Bränn E, Chen Y, Song H, László KD, D’Onofrio BM, Hysaj E, et al. Bidirectional association between autoimmune disease and perinatal depression: a nationwide study with sibling comparison. Mol Psychiatry. 2024 Jan 9;1–9.