Women with Crohn’s disease are at a higher risk for mood disorders (depression and anxiety) and substance abuse issues after giving birth than those without inflammatory bowel disease (IBD), Canadian researchers report.
Their study, “Inflammatory bowel disease and new-onset psychiatric disorders in pregnancy and post partum: a population-based cohort study,” was published in the journal Gut.
IBD is a chronic inflammatory condition affecting the gastrointestinal tract. There are two main types: Crohn’s disease and ulcerative colitis. The risk of developing mental illness is increased in patients with IBD.
Mental well-being in women during and after pregnancy is vital; immune-related disorders are associated with an increased risk for psychiatric disorders during these periods of time.
“Because of the elevated risk of mental illness in people with IBD, we felt it was important to study if women with IBD were at greater risk of developing a new mental illness during pregnancy and after giving birth compared to the overall population,” Eric Benchimol, MD, PhD, senior author of the study, a pediatric gastroenterologist at the CHEO Inflammatory Bowel Disease Centre and associate professor of pediatrics and epidemiology at the University of Ottawa, said in a press release.
Researchers analyzed the healthcare data of 3,721 women with IBD and compared it with 798,908 without IBD who gave birth between 2002 and 2014 in Ontario, Canada. They reviewed the period between conception and one year after birth to assess the mental health of the women during this period.
The study found that 22.7% of women with IBD were diagnosed with a new mental illness compared with 20.4% of women without IBD. The risk was significantly elevated for depression and anxiety (mood disorders) and alcohol or other substance abuse.
Furthermore, the risk of developing these conditions was increased post-pregnancy but not during pregnancy.
The team also found that the chances of developing these conditions appeared to be greater in women with Crohn’s disease but not ulcerative colitis.
They also noted that IBD did not increase the risk of psychotic disorders such as schizophrenia or hallucinations in these patients.
“While screening tools for anxiety and depression have been developed and validated for people with IBD and many addictions screening tools exist, none have thus far been validated in pregnant and postpartum women, so this may be an important next step in early identification and treatment that prevents significant morbidity for mothers and ensure health developmental trajectories for their children,” the authors wrote.
“Women with IBD face increased health challenges during pregnancy and after giving birth, and it’s not just physical challenges. We need to look at both the physical and mental health needs of women and ensure they are getting the best treatment and support,” said Simone Vigod, MD, lead author and chief of the department of psychiatry at Women’s College Hospital, and an adjunct scientist at The Institute for Clinical Evaluative Sciences in Canada.
“These findings are very important for both patients and healthcare providers in the IBD community,” said Mina Mawani, president and CEO of Crohn’s and Colitis Canada. “Together, women and their healthcare providers can look for opportunities to prevent mental illness during pregnancy and after birth as well as identify and treat it earlier.”