Women with a chronic physical condition more likely to experience mental illness in pregnancy or postpartum

One in five women have a chronic physical condition when they become pregnant, which puts them at an increased risk of mental illness in pregnancy or postpartum, according to a new study by researchers at ICES, a non-profit research institute that uses population-based health information to produce knowledge on a broad range of healthcare issues. 

The study published today in PLoS Medicine, looked at the data for more than 850,000 women in Ontario and found that women with a chronic physical condition were more likely (20.4 per cent) than those without a chronic physical condition (15.6 per cent) to experience mental illness in pregnancy or postpartum.

“Women with chronic physical conditions including diabetes, hypertension, and asthma, may benefit from targeted strategies to reduce their risk of mental illness in the perinatal period, including strategies to support disease management and improve coping,” says Hilary Brown, lead author of the study and an assistant professor at U of T Scarborough and adjunct scientist at ICES.

Previous research has shown that outside of pregnancy, chronic physical conditions such as diabetes, hypertension, and asthma are known to increase the risk of mental illness, but this association has rarely been studied in pregnant populations.

The researchers looked at women aged 15 to 49 with a live birth conceived from 2005 to 2015 and followed the women for one year postpartum. Perinatal mental illness was defined by a diagnosis of psychotic disorder, mood or anxiety disorder, substance use disorder or an addiction diagnosis from conception to 365 days postpartum.

“Women with a chronic physical condition are generally already connected with the healthcare system around the time of pregnancy, so there are efficient avenues for support strategies to be implemented, including through primary and obstetric care providers,” adds Brown.

The researchers add that perinatal mental illness negatively affects mothers, infants and families but only one third of women with perinatal mental illness receive mental healthcare. Early identification and treatment among high-risk women could prevent perinatal mental illness. 

Author block: Hilary K. Brown, Andrew S. Wilton, Joel G. Ray, Cindy-Lee Dennis, Astrid Guttmann and Simone N. Vigod.

The article “Chronic physical conditions and risk for perinatal mental illness: a population-based retrospective cohort study,” is published in the August 26, 2019 issue of PLoS Medicine.

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Deborah Creatura
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