Treatment-requiring postpartum depression in mothers with multiple sclerosis: A nationwide cohort study

BACKGROUND: Postpartum depression (PPD) is a common mental health concern, but its occurrence among mothers with multiple sclerosis (MS) is not well established. Understanding this risk is important for guiding perinatal care. OBJECTIVES: To investigate the risk of treatment-requiring PPD among mothers with MS compared to mothers without MS. METHODS: We conducted a nationwide cohort study including all live births in Denmark from 1997 to 2023, using Danish national health registers. Treatment-requiring PPD was defined as redeemed prescriptions for antidepressants within 12 months postpartum, identified in the Danish National Prescription Register. Logistic regression models estimated crude and adjusted odds ratios (aORs), adjusting for maternal age, parity, preterm birth, multifetal gestation, and antidepressant use within 6 months before conception. Analyses were clustered by mother. RESULTS: Within 12 months postpartum, 236 of 2850 deliveries in women with MS (8.3%) and 58,778 of 1,532,959 deliveries of women without MS (3.8%) redeemed antidepressant prescriptions. Mothers with MS had higher odds of antidepressant use with aOR 1.9 (95% confidence interval (CI): 1.6-2.3). CONCLUSIONS: Mothers with MS have an elevated risk of treatment-requiring PPD. Enhanced monitoring and tailored mental health support during the perinatal period may be warranted.