A5 first-onset psychiatric disorders in pregnant and post-partum women with inflammatory bowel disease in ontario, canada: a population-based study

Inflammation is associated with psychiatric illness, and patients with inflammatory bowel disease (IBD) have elevated risk of anxiety and depression. Pregnancy alters immune functioning, and inflammation may result in psychiatric disorders in pregnancy and postpartum. Determine risk and predictors of psychiatric disorders in women with IBD during pregnancy and postpartum. Among all women with a singleton live birth in Ontario 2002–2014 with no history of pre-pregnancy psychiatric disorder, we identified women with IBD using validated algorithms applied to health administrative data (Ontario Crohn’s and Colitis Cohort). The primary outcome was any psychiatric disorder during pregnancy or in the first postpartum year (outpatient, emergency or hospitalization). Cox proportionate hazard regression compared risk of psychiatric disorders in those with/without IBD, adjusting for maternal age, year, income, rurality, prenatal care, and C-section, reported as hazard ratios (aHR). In women with IBD only, logistic regression determined predictors of new-onset psychiatric disorder overall, and postpartum. Risk of new psychiatric disorder in 3721 women with IBD was 22.7% vs 20.4% in 798,908 without IBD (aHR 1.12, 95%CI 1.05–1.20). Most healthcare contacts were for depression or anxiety in outpatient primary care settings. Risk was elevated for Crohn’s disease (aHR 1.12, 95%CI 1.02–1.23), but not ulcerative colitis (aHR 1.09, 95%CI 0.98–1.21), and post-partum (aHR 1.20, 95%CI 1.09–1.31), but not during pregnancy (aHR 1.04, 95%CI 0.94–1.15). Predictors noted in Table. Women with IBD have increased risk for new-onset psychiatric disorders, especially depression and anxiety, in the peripartum period. Providers should be aware of this elevated risk to increase opportunities for prevention, early identification and treatment. Predictors of risk of psychiatric diagnosis in pregnant women with IBD aReported at specific ages since association was non-linear. NB infant characteristics not considered for pregnancy and postpartum model since intrapartum events not influenced by post-birth variables Predictors of risk of psychiatric diagnosis in pregnant women with IBD aReported at specific ages since association was non-linear. NB infant characteristics not considered for pregnancy and postpartum model since intrapartum events not influenced by post-birth variables Medical Psychiatry Alliance