January 10, 2019
2 min read

Women with IBD at higher risk for postpartum, new-onset psychiatric disorders

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Eric Benchimol, MD, PhD, FRCPC
Eric I. Benchimol

Women with inflammatory bowel disease are at higher risk for developing new-onset psychiatric disorders during the postpartum period, particularly mood and anxiety disorders and substance abuse disorders, according to research published in Gut.

Eric I. Benchimol, MD, pediatric gastroenterologist at the Children’s Hospital of Eastern Ontario Inflammatory Bowel Disease Center in Ottawa, and colleagues wrote that the risk is highest in the first 90 days after giving birth.

“There’s increasing awareness about mental illness in women during pregnancy and postpartum,” Benchimol said in a press release. “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.”

Researchers analyzed data taken from all women who gave birth in Ontario, Canada, between 2002 and 2014 to determine the incidence of new-onset mental illness from conception to one year postpartum. They compared data between 3,721 women with IBD and 798,908 women without IBD.

Investigators found that a higher percentage of women with IBD developed new-onset psychiatric disorders compared with women without IBD (22.7% vs. 20.4%), and they also had higher incidence rates (150.2 vs. 132.8 per 1,000 patient years; adjusted HR = 1.12; 95% CI, 1.05–1.2).

The risk was higher in the postpartum period (aHR = 1.2; 95% CI, 1.09–1.26) but not during pregnancy. The risk was also higher among patients with Crohn’s disease (aHR = 1.12; 95% CI, 1.02–1.23) but not ulcerative colitis. Women with IBD had an elevated risk for anxiety disorder (aHR = 1.14, 95% CI, 1.04–1.26) and alcohol or substance abuse disorder (aHR = 2.73, 95% CI, 1.42–5.26).

Researchers also determined that maternal age, delivery year, medical comorbidity, number of perinatal visits, family physician obstetrical care and infant mortality were all predictors of new-onset psychiatric diagnosis.

“This is a small but significantly increased risk of new-onset mental illness in women with IBD,” lead author of the study Simone N. Vigod, MD, MSc, FRCPC, of the Women’s College Hospital Research Institute in Toronto, said in the press release. “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.” – by Alex Young

Disclosures: Benchimol reports no relevant financial disclosures. Vigod reports receiving royalties from UpToDate Inc. Please see the full study for all other authors’ relevant financial disclosures.