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. 2025 Jun;31(7):846-855.
doi: 10.1177/13524585251330109. Epub 2025 Apr 18.

Risk factors for incident peripartum mental illness in multiple sclerosis

Ruth Ann Marrie  1 , James M Bolton  2 , Vicki Ling  3 , Charles N Bernstein  4 , Kristen M Krysko  5 , Ping Li  3 , Kyla A McKay  6 , Neda Razaz  7 , Dalia L Rotstein  5 , Karma Deakin-Harb  8 , Colleen Maxwell  3   9   10
Affiliations

Risk factors for incident peripartum mental illness in multiple sclerosis

Ruth Ann Marrie et al. Mult Scler. 2025 Jun.

Abstract

Background: Mothers with MS face an increased incidence and prevalence of peripartum mental illness as compared to mothers without MS.

Objective: To determine the factors associated with the risk of peripartum mental illness among mothers with MS.

Methods: We identified mothers with MS with live births between 2002 and 2019 using linked population-based administrative data from Ontario, Canada. Using validated definitions, we estimated the incidence of mental illness (depression, anxiety, bipolar disorder) from conception through the first post-partum year (peripartum period). We used multivariable Poisson regression to assess the association between age, delivery year, area-level deprivation (Ontario Marginalization Index), disease duration, disability, and comorbidity and incidence of peripartum mental illness.

Results: Among 1745 mothers with MS, the mean (SD) age at conception was 31.2 (4.8) years. Mothers living in communities that lacked cohesion had increased rates of peripartum depression (incidence rate ratio [IRR] 1.25; 1.11-1.42) and anxiety (IRR 1.20; 1.07-1.33). Elevated MS disability level was associated with elevated peripartum depression rates (IRR 1.51; 1.12-2.04).

Conclusion: Higher area-level deprivation and disability levels are associated with an increased incidence of peripartum mental illness. These findings may assist clinicians in identifying women with MS who may benefit from peripartum mental health support.

Keywords: Multiple sclerosis; cohort; epidemiology; mental illness; women’s health.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: R.A. Marrie receives research funding from: CIHR, MS Canada, Crohn’s and Colitis Canada, National Multiple Sclerosis Society, CMSC, the Arthritis Society, Pfizer Foundation, Public Health Agency of Canada and the US Department of Defense and is a co-investigator on studies receiving funding from Biogen Idec, Roche Canada. She holds the Multiple Sclerosis Clinical Research Chair (Dalhousie University). J.M. Bolton receives research funding from MS Canada, and the Ruth Hurd Professorship. V. Ling reports no disclosures relevant to the manuscript. C. Bernstein is supported by the Bingham Chair in Gastroenterology. CB has served on advisory Boards for AbbVie Canada, Amgen Canada, Bristol Myers Squibb Canada, Eli Lilly Canada, Ferring Canada, Innomar Pharmacy, JAMP Pharmaceuticals, Janssen Canada, Pendopharm Canada, Sandoz Canada, Takeda Canada, and Pfizer Canada; Educational grants from Abbvie Canada, Boston Scientific, Eli Lilly Canada, Fresenius Kabi Canada, Ferring Canada, Organon Canada, Pfizer Canada, Takeda Canada, and Janssen Canada. Speaker’s panel for Abbvie Canada, Janssen Canada, Pfizer Canada, and Takeda Canada. Received research funding from Abbvie Canada, Takeda Canada and Pfizer Canada. K.M. Krysko has received grants from MS Canada and the University of Toronto Division of Neurology; a contract for a study site from Roche; speaking or consulting fees from Biogen, EMD Serono, Novartis, Roche; advisory board member for Biogen, EMD Serono, Novartis, Roche; scientific advisory committee member for Bristol-Myers Squibb. K.A. McKay receives research funding from the Karolinska Institutet, the Swedish Research Council, and Bjarne Ahlström’s Foundation and has received speaker honoraria from Biogen Inc and Sanofi. N. Razaz receives funding from the Swedish Research Council. D. Rotstein receives research funding from MS Canada, the National MS Society, the Consortium of Multiple Sclerosis Centers, the University of Toronto Division of Neurology and Roche Canada. She has received consulting or speaker fees from Alexion, Amgen, Biogen, EMD Serono, Novartis, Roche, Sanofi Aventis and Touch International Medical Education. K. Deakin-Harb reports no disclosures relevant to the manuscript. C. J. Maxwell receives funding from CIHR, MS Canada, National Multiple Sclerosis Society, the Public Health Agency of Canada, and the Alzheimer Society of Canada.

References

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