Atopic diseases before pregnancy increase the risk of peripartum mental disorders

05 January 2022

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Women with a history of asthma, atopic dermatitis and allergic rhinitis before conception were at increased risk of peripartum mental disorders, according to a study published in Clinical and translational allergy.

Tai Ren, MARYLAND, a postdoctoral student at Shanghai Jiao Tong University School of Medicine, and colleagues also found that women with atopic diseases before pregnancy can benefit from systematic monitoring of their mental health.

Data were derived from Ren T, et al. Clin Transl Allergy. 2021; doi: 10.1002 / clt2.12082.

The researchers studied 937,422 first-time women who had given birth to a singleton living between 1978 and 2016 in Denmark. Before conception, 24,016 (2.6%) of them had been diagnosed with at least one of the three atopic diseases studied, including asthma (1.7%), atopic dermatitis (0.6% ) or allergic rhinitis (0.8%). In addition, 4,461 of those diagnosed (18.6%) presented with atopic multimorbidity.

The researchers were particularly interested in affective disorders such as peripartum depression and peripartum anxiety – which are the two most common types of peripartum mental disorders – and they also analyzed substance abuse.

Overall, 1.2% of women without asthma, atopic dermatitis or allergic rhinitis were affected by peripartum mental disorders, compared to 2.7% of women who had been exposed to these atopic diseases. After adjusting for potential confounding factors, the researchers found a 37% increased risk of mental disorders in exposed women (HR = 1.37; 95% CI, 1.27-1.49).

Women with atopic multimorbidity had a slightly higher risk of peripartum mental disorder (HR = 1.48; 95% CI: 1.23-1.77).

There was also a more pronounced association in women who gave birth in the spring (HR = 1.49; 95% CI, 1.27-1.75) and an attenuated association in women who gave birth in the summer (HR = 1.29; 95% CI 1.1 to 1.51).

Specifically, asthma, atopic dermatitis and allergic rhinitis were associated with an increased risk of affective disorders (HR = 1.42; 95% CI: 1.22-1.66); neurotic, stress-related and somatoform disorders (HR = 1.31; 95% CI, 1.16-1.49); and substance abuse (HR = 1.31; 95% CI: 1.07 to 1.59).

The researchers found similar association levels for affective disorders when they looked at asthma, atopic dermatitis, and allergic rhinitis separately. Specifically, asthma increased the risk of neurotic, stress-related, and somatoform disorders (HR = 1.4; 95% CI: 1.21-1.62), and atopic dermatitis was associated with substance abuse (HR = 1.62; 95% CI 1.12 to 2.34).

Researchers have noted that poor control of atopic disease during the peripartum period worsens symptoms and can influence mental disorders through various causal pathways. For example, worsened atopic symptoms can contribute to mental stress via severe pruritus or dyspnea-induced sleep disorder. Allergic reactions can also deregulate the autoimmune system and trigger mental disorders, and peripheral inflammation can affect the brain.

Additionally, the researchers wrote that there are genetic overlaps between asthma and Attention Deficit Hyperactivity Disorder, Anxiety, and Major Depressive Disorder, indicating that shared genetic susceptibility may also make a difference. part of these underlying causes.

Early detection is necessary for effective management of peripartum mental disorders, the researchers wrote, so women with poor control of atopic disease during pregnancy may benefit from systematic mental health monitoring and treatment. consultation with a specialist.

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