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Inflammatory bowel disease and new-onset psychiatric disorders in pregnancy and post partum: a population-based cohort study


Objective — Patients with inflammatory bowel disease (IBD) have elevated risk of mental illness.We determined the incidence and correlates of new-onset mental illness associated with IBD during pregnancy and postpartum.

Design — This cohort study using population-based health administrative data included all women with a singleton live birth in Ontario, Canada (2002-2014). Incidence of new-onset mental illness from conception to 1 year postpartum was compared between 3721 women with and 798908 without IBD, generating adjusted hazard ratios (aHR). Logistic regression was used to identify correlates of new-onset mental illness in the IBD group.

Results — About 22.7% of women with IBD had new-onset mental illness vs. 20.4% without, corresponding to incidence rates of 150.2 and 132. 8 per 1,000 patient-years (aHR 1.12, 95%CI1.05-1.20), or one extra case of new-onset mental illness per 43 pregnant women with IBD. Risk was elevated in the postpartum (aHR 1.20, 95%CI 1.09-1.31), but not during pregnancy, and for Crohn’s disease (aHR 1.12, 95%CI 1.02-1.23), but not ulcerative colitis. Risk was specifically elevated for a new-onset mood or anxiety disorder (aHR 1.14, 95%CI 1.04-1.26) and alcohol or substance use disorders (aHR 2.73, 95%CI 1.42-5.26). Predictors of a mental illness diagnosis were maternal age, delivery year, medical comorbidity, number of prenatal visits, family physician obstetrical care, and infant mortality.

Conclusion — Women with IBD were at increased risk of new-onset psychiatric diagnosis in the postpartum period, but not during pregnancy. Providers should look to increase opportunities for prevention, early identification and treatment accordingly.



Vigood SN, Kurdyak P, Brown HK, Nguyen GC, Targownik LE, Seow CH, Kuenzig ME, Benchimol EI. Gut. 2019; 68(9):1597-605. Epub 2019 Jan 9.

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