Autoimmune conditions and comorbid depression in pregnancy: examining the risk of preterm birth and preeclampsia

• Published in: Journal of perinatology 2017-10, Vol.37 (10), p.1082-1087
• Main Authors: Bandoli, G, Chambers, C D
• Format: Article
• Language: English
• Subjects: 692/308/174; 692/499; Adult; Arthritis; Arthritis, Rheumatoid - epidemiology; Autoimmune diseases; Birth; Care and treatment; Case-Control Studies; Childbirth & labor; Comorbidity; Complications and side effects; Confidence intervals; Crohn Disease - epidemiology; Crohn's disease; Demographic aspects; Depression - epidemiology; Depression, Mental; Diagnosis; Disease control; Female; Gestational Age; Health aspects; Health risk assessment; Health risks; Humans; Logistic Models; Medicine; Medicine & Public Health; Mental depression; original-article; Pediatric Surgery; Pediatrics; Pre-eclampsia; Pre-Eclampsia - epidemiology; Pre-Eclampsia - etiology; Preeclampsia; Pregnancy; Pregnancy Complications - epidemiology; Pregnancy Outcome; Pregnant women; Premature birth; Premature Birth - epidemiology; Premature Birth - etiology; Prenatal depression; Prevention; Prospective Studies; Psoriasis; Psoriasis - epidemiology; Psychological aspects; Rheumatoid arthritis; Risk; Risk Factors; Self Report; Skin diseases; Synergism
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/jp.2017.109

Objective: The objective of this study was to determine whether prenatal depression interacts with autoimmune conditions to further increase the risk of preterm birth or preeclampsia. Study Design: Our sample included 3034 pregnant women with rheumatoid arthritis (RA), Crohn’s disease (CD) or psoriasis, or controls that were prospectively enrolled into MothertoBaby pregnancy studies. We estimated the independent and joint effects of the three autoimmune conditions and depression on the select outcomes. Results: We found an increased risk of preterm birth among women with RA (2.10; 95% confidence interval (CI) 1.54, 2.87), CD (1.87; 95% CI 1.25, 2.81) or psoriasis (1.88; 95% CI 1.27, 2.79) independent of depression status. RA was also independently associated with preeclampsia. Prenatal depression was not independently associated with preterm birth or preeclampsia, nor was there any synergism with autoimmune conditions. Conclusion: If these findings are confirmed, the absence of synergism should be encouraging news to the many women with select autoimmune conditions and depression in pregnancy.