WCH CONNECTJanuary 10, 2019

Women with inflammatory bowel disease at greater risk of mental illness postpartum

  • January 10, 2019

January 14, 2019

By Sarah Warr

A new study published in Gut shows that women with inflammatory bowel disease (IBD) are at greater risk of developing a mental illness after giving birth compared to the overall population. Study authors from Women’s College Hospital (WCH) and the Children’s Hospital of Eastern Ontario (CHEO) found that more than one-fifth of pregnant women with IBD had a new-onset mental health diagnosis. The study used healthcare data on women who gave birth between 2002 and 2014 in Ontario, Canada to analyze the frequency of a new mental illness diagnosis in these women during and up to one year after a pregnancy.

IBD is a group of chronic gastrointestinal disorders in which people have ulceration, inflammation, and bleeding of their gastrointestinal tract, and are at risk for complications in other parts of the body. The two main subtypes are Crohn’s disease and ulcerative colitis. People with IBD have an elevated risk of mental illness, especially anxiety and depression, potentially related to the inflammation in the gut affecting their brain.

In the study population, pregnant women with IBD had an elevated risk of developing a new-onset mental illness postpartum when compared to women without IBD – 22.7 per cent compared to 20.4 per cent. The women with IBD were at increased risk of two out of the four mental illness diagnostic categories: mood disorders (such as anxiety and depression) and substance use disorders (such as opioid dependency). These women were primarily treated by doctors in the outpatient setting and did not need to be hospitalized. There was no evidence of increased risk for psychotic disorders (such as schizophrenia or hallucinations). This risk appeared to be elevated in women with Crohn’s disease, but not ulcerative colitis.

“This is a small but significantly increased risk of new-onset mental illness in women with IBD,” says Dr. Simone Vigod, lead author of the study, scientist at the Women’s College Hospital Research Institute, chief, department of psychiatry, Women’s College Hospital and adjunct scientist at ICES. “Women with IBD face increased health challenges during pregnancy and after giving birth, and it’s not just physical challenges. We need to look at both the physical and mental health needs of women and ensure they are getting the best treatment and support.”

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