From the Departments of Clinical Medicine (K.E., Ø.F.T., K.-M.M., C.F.T., N.E.G., M.-H.B.) and Global Public Health and Primary Care (T.R.), University of Bergen; Neuro-SysMed (Ø.F.T., J.A., K.-M.M., T.R., S.W.), The Norwegian Multiple Sclerosis Registry and Biobank (J.A., S.W.), and The Norwegian Multiple Sclerosis Competence Centre (J.A., T.R.), Department of Neurology (K.E., S.W., N.E.G., M.-H.B.), Haukeland University Hospital, Bergen; Department of Neurology (H.Ø.F.), Telemark Hospital Trust, Skien; Department of Neurology (T.H.), Akershus University Hospital, Lørenskog; Institute of Clinical Medicine (T.H., C.S.), University of Oslo; Department of Neurology and The Norwegian National Advisory Unit on Tick-borne Diseases (Å.R.L.), Sørlandet Hospital, Kristiansand; Department of Neurology (J.S.W.), Møre og Romsdal Hospital Trust, Molde; Department of Neurology (N.Ø.), Nordland Hospital Trust, Bodø; Department of Neurology (C.S.), Vestre Viken Hospital Trust, Drammen; Department of Obstetrics and Gynecology (C.F.T.), Stavanger University Hospital; and Department of Neuromedicine and Movement Science (J.S.W.), Norwegian University of Science and Technology, Trondheim, Norway.
Neurology. 2021 Jun 8;96(23):e2789-e2800. doi: 10.1212/WNL.0000000000012062. Epub 2021 Apr 21.
To assess the occurrence of perinatal depression and anxiety in women before and after diagnosis of multiple sclerosis (MS).
A total of 114,629 pregnant women were included in the Norwegian Mother, Father and Child Cohort study (1999-2008). We assessed depression and anxiety by questionnaires during and after pregnancy. Women with MS were identified from national health registries and hospital records and grouped into (1) MS diagnosed before pregnancy (n = 140) or MS diagnosed after pregnancy with (2) symptom onset before pregnancy (n = 98) or (3) symptom onset after pregnancy (n = 308). Thirty-five women were diagnosed with MS in the postpartum period. The reference group (n = 111,627) consisted of women without MS.
Women with MS diagnosed before pregnancy had an adjusted odds ratio of 2.0 (95% confidence interval, 1.2-3.1) for depression in the third trimester. Risk factors were adverse socioeconomic factors and history of psychiatric disease and physical/sexual abuse. The risk of anxiety was not increased. Women diagnosed with MS in the postpartum period had especially high risk of postpartum depression. Women with MS symptom onset within 5 years after pregnancy had increased risk of both depression and anxiety during pregnancy, whereas women with more than 5 years until symptom onset did not.
Women diagnosed with MS have increased risk of perinatal depression. Women with MS symptom onset within 5 years after pregnancy have increased risk of both depression and anxiety during pregnancy.
评估多发性硬化症（MS）女性在诊断前后的围产期抑郁和焦虑发生情况。
共有 114629 名孕妇纳入挪威母婴儿童队列研究（1999-2008 年）。我们通过问卷在孕期和产后评估抑郁和焦虑情况。通过国家健康登记处和医院记录确定 MS 女性，并分为（1）孕前诊断的 MS（n=140）或（2）孕期诊断的 MS，且（2a）症状前发病（n=98）或（2b）症状后发病（n=308）。35 名女性在产后期间被诊断为 MS。对照组（n=111627）由无 MS 的女性组成。
孕前诊断为 MS 的女性在孕晚期患抑郁的调整比值比为 2.0（95%置信区间，1.2-3.1）。危险因素包括不利的社会经济因素、精神病史和身体/性虐待。焦虑风险没有增加。产后期间诊断为 MS 的女性尤其有患产后抑郁的高风险。产后 5 年内发病的 MS 女性在孕期有患抑郁和焦虑的风险增加，而发病时间超过 5 年的 MS 女性没有。
诊断为 MS 的女性有发生围产期抑郁的风险增加。产后 5 年内发病的 MS 女性在孕期有患抑郁和焦虑的风险增加。
