ArticleBMC medicine2023
Rheumatoid arthritis and the risk of postpartum psychiatric disorders: a Nordic population-based cohort study.
Article in BMC medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 10 citations in OpenAlex.
- Genetic architecture of postpartum psychosis: from common to rare genetic variation.Molecular psychiatry · 2026Article
- Physiological Mechanisms in Pregnancy and Their Relevance to the Clinical Management of Perinatal Mental Illness.Journal of clinical medicine · 2026Review
- Association between nocturnal ozone enhancement and daily cardiovascular mortality: A multi-city study in China.Eco-Environment & Health · 2026Article
- Identifying prenatal risk factors of postpartum depression with machine learning.Scientific reports · 2025Article
- Family Planning and Rheumatoid Arthritis.Current rheumatology reports · 2025Review
- Rheumatoid Arthritis and Pregnancy: Managing Disease Activity and Fertility Concerns.Seminars in reproductive medicine · 2024Review
- Bidirectional association between autoimmune disease and perinatal depression: a nationwide study with sibling comparison.Molecular psychiatry · 2024Article
- Postpartum depression and autoimmune disease: a bidirectional Mendelian randomization study.Frontiers in psychiatry · 2024Article
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Authors and funding
9 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostpartum psychiatric disorders (PPD) are common complications of childbirth. A common explanation for their development is that the psychological, hormonal, and immune changes associated with pregnancy and parturition may trigger psychiatric symptoms postpartum. Rheumatoid arthritis (RA) is characterized by abnormalities in the activity of the hypothalamic-pituitary-adrenal axis and of the immune system, but its association with PPD is unknown. We analyzed whether women with RA before childbirth have an increased risk of PPD.
methodsWe conducted a large population-based cohort study including mothers of singleton births in the Danish (1995-2015), Finnish (1997-2013), and Swedish Medical Birth Registers (2001-2013) (N = 3,516,849). We linked data from the Medical Birth Registers with data from several national socioeconomic and health registers. Exposure was defined as having a diagnosis of RA before childbirth, while the main outcome was a clinical diagnosis of psychiatric disorders 90 days postpartum. We analyzed the association between RA and PPD using Cox proportional hazard models, stratified by a personal history of psychiatric disorders.
resultsAmong women without a history of psychiatric disorders, the PPD incidence rate was 32.2 in the exposed and 19.5 per 1000 person-years in the unexposed group; women with RA had a higher risk of overall PPD than their unexposed counterparts [adjusted hazard ratio (HR) = 1.52, 95% confidence intervals (CI) 1.17 to 1.98]. Similar associations were also observed for postpartum depression (HR = 1.65, 95% CI 1.09 to 2.48) and other PPD (HR = 1.59, 95% CI 1.13 to 2.24). Among women with a history of psychiatric disorders, the incidence rate of overall PPD was 339.6 in the exposed and 346.6 per 1000 person-years in the unexposed group; RA was not associated with PPD. We observed similar associations between preclinical RA (RA diagnosed after childbirth) and PPD to those corresponding to clinical RA.
conclusionsRheumatoid arthritis was associated with an increased PPD risk in women without, but not in those with a psychiatric history. If our findings are confirmed in future studies, new mothers with RA may benefit from increased surveillance for new-onset psychiatric disorders postpartum.
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