Atopic Diseases Associated with Peripartum Mental Disorders

Investigators suggested systemic mental health monitoring could be beneficial for women who have atopic disease before pregnancy.

A new investigation from Shanghai, China found that atopic dermatitis, asthma, and allergic rhinitis, before conception was associated with increased risks of peripartum mental disorders.

Additionally, they cited an increase in the prevalence of atopic diseases developed before childbearing ages. To their knowledge, the association of atopic dermatitis and allergic rhinitis with peripartum mental disorders had not been previously studied.

Though the association between asthma and postpartum depression had been studied, the findings remained inconsistent.

Jiong Li, PhD, Department of Clinical Medicine and Epidemiology, Aurhus University, and investigators intended to evaluate the associations between all 3 atopic diseases before conception as well as newly onset peripartum mental disorders in pregnant women.

The Methods

For this prospective study, Li and colleagues stifues all primiparous women who had given birth to a child in Denmark from 1978 to 2016.

Data on these women were recorded in the Danish Medical Birth Registry, which contains records on nearly all the births in Denmark.

The follow-up period was initiated on the conception date and ended on the date of a first diagnosis of any mental idosrder, death, emigration, 12 month after birth, or the end of the follow-up.

A total of 24,016 (2.6%) women were included in the study, out of the 932,422 identified.

The exposure was hospital contact and admission due to the 3 major types of atopic diseases featured in the study.

The diagnosis of mental disorders was retrieved from the Danish Psychiatric Central Research Register, which contains every psychiatric inpatients since 1970 and outpatient and emergency room contacts since 1995.

Peripartum mental disorders were defined as a newly onset mental disorder from conception date to the first‐year postpartum, with peripartum depression and anxiety representing the 2 most prevalent types of peripartum mental disorders.

The Findings

Li and investigators found that peripartum mental disorders affected 2.7% of the women exposed to asthma, atopic dermatitis, or allergic rhinitis. Only 1.2% of the unexposed were affected.

A 37% increased risk in exposed women was recorded, after adjusting for potential confounders, and a subgroup analyses revealed a more eminent risk during pregnancy than postpartum.

Investigators also found that the risk of peripartum mental disorders was slightly higher in the women with atopic multimorbidity, and frequent hospital contacts of asthma, atopic dermatitis, or allergic rhinitis were associated with higher risk.

Atopic disease such as asthma, atopic dermatitis, and allergic rhinitis was associated with increased risks of the 3 psychiatric diagnostic groups including affective disorders (HR, 1.42%; 95%, CI 1.22–1.66), neurotic and stress-related and somatoform disorders (HR, 1.31; 95% CI, 1.16–1.49) and substance abuse (HR, 1.31; 95% CI, 1.07–1.59).

Li and colleagues noted that depression had been a focus of most studies of peripartum mental disorders, though anxiety had been more prevalent. Their analyses concluded that peripartum neurotic, stress‐related and somatoform disorders were strictly associated with asthma.

“Strong associations were observed between asthma and neurotic, stress‐related and somatoform disorders, and between atopic dermatitis and substance abuse,” the team wrote. “Women who have atopic diseases before pregnancy may benefit from future systematic mental health monitoring.”

The study, “The association of asthma, atopic dermatitis, and allergic rhinitis with peripartum mental disorders,” was published online in Clinical and Translational Allergy.