Depression in pregnancy linked to autoimmune disease, especially MS

History of depression can increase risk of autoimmune disease, and vice versa

Lindsey Shapiro, PhD avatar

by Lindsey Shapiro, PhD |

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Women with a history of depression around the time they get pregnant are at increased risk of developing autoimmune diseases such as multiple sclerosis (MS), according to recent research.

Likewise, women who have an autoimmune disease are more likely to get depressed during pregnancy and in the year after childbirth, called the perinatal period.

These observed relationships were strongest among women with MS, where the disease raised the likelihood of depression by 96%, and depression increased the odds of MS by 79%.

“Our study suggests that there’s an immunological mechanism behind perinatal depression and that autoimmune diseases should be seen as a risk factor for this kind of depression,” Emma Bränn, PhD, researcher at Karolinska Institutet, in Sweden, and the study’s first author, said in a university press release.

The study, “Bidirectional association between autoimmune disease and perinatal depression: a nationwide study with sibling comparison,” was published in Molecular Psychiatry.

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Research has linked immune dysregulation to perinatal depression

Broadly, autoimmune diseases are characterized by the immune system’s mistaken attack on the body’s own tissues. In MS, these attacks target otherwise healthy cells in the brain and spinal cord.

The perinatal period is a particularly sensitive time, where hormonal, physical, and psychological changes can contribute to depression. Accumulating evidence has linked immune dysregulation to perinatal development of the mood disorder.

However, while some studies suggest a relationship between autoimmune diseases, including MS, and perinatal depression, the findings have overall been conflicting, according to the researchers.

In the study, the scientists examined the possible relationship between autoimmunity and perinatal depression by looking at data housed in Swedish national registries. There, they identified more than 815,000 women who had given birth in the country from 2001 to 2013, amounting to nearly 1.3 million pregnancies.

A little more than 55,000 of these women had been diagnosed with perinatal depression. Of 1,109 women with MS in the registry, 200 developed perinatal depression and showed several demographic and pregnancy characteristics that differed from those who did not develop the mental disorder.

Our study suggests that there’s an immunological mechanism behind perinatal depression and that autoimmune diseases should be seen as a risk factor for this kind of depression.

Scientists looked at incidence of 41 autoimmune diseases

The scientists then looked at the incidence of 41 different autoimmune diseases, including MS, among these women compared with women without perinatal depression.

After adjusting for demographics and pregnancy characteristics, the analysis revealed a bidirectional relationship between perinatal depression and autoimmunity, where women with autoimmune diseases were about 30% more likely to suffer from depression, and vice versa.

The researchers also directly compared women to their sisters with or without perinatal depression to control for familial factors such as genetics or childhood environment. Findings were similar to the earlier analyses, indicating the link between depression and autoimmunity was not significantly affected by familial factors.

This bidirectional association was stronger among women who did not have other co-existing psychiatric disorders compared with women who had a prior history.

About 56% of individual autoimmune diseases were associated with perinatal depression in either direction, with MS, thyroid disease, psoriasis, ulcerative colitis, and celiac disease having a significant, bidirectional association with perinatal depression.

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The relationship was strongest for MS, where the autoimmune condition was associated with about a 96% increased risk of developing perinatal depression compared to those without autoimmune conditions. Likewise, perinatal depression increased the odds of later developing MS by 79%.

“These findings have implications for research on biological mechanisms, and for healthcare professionals who need to be alert to the risk of PND [perinatal depression] in women with [autoimmune disease], and vice versa,” the researchers wrote.

Still, the scientists emphasized the nature of the study is observational, so it is not possible to conclude from the results that perinatal depression definitively causes autoimmune diseases, or vice versa.

The team now plans to continue researching the long-term effects of perinatal depression.

“Depression during this sensitive period can have serious consequences for both the mother and the baby,” Bränn said. “We hope that our results will help decision-makers to steer funding towards maternal healthcare so that more women can get help and support in time.”