Amira M Aker1,2, Simone N Vigod2,3,4, Cindy-Lee Dennis4,5,6, Tyler Kaster2,7, Hilary K Brown1,2,3,4,8. 1. Department of Health & Society, University of Toronto Scarborough, Toronto, Canada. 2. ICES, Toronto, Canada. 3. Women's College Research Institute, Women's College Hospital, Toronto, Canada. 4. Department of Psychiatry, University of Toronto, Toronto, Canada. 5. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada. 6. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada. 7. Centre for Addiction & Mental Health, Toronto, Canada. 8. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Abstract
BACKGROUND: Asthma is a risk factor for mental illness, but few studies have explored this association around the time of pregnancy. We studied the association between asthma and perinatal mental illness and explored the modifying effects of social and medical complexities. METHODS: In a population-based cohort of 846 155 women in Ontario, Canada, with a singleton live birth in 2005-2015 and no recent history of mental illness, modified Poisson regression models were constructed to examine the association between asthma diagnosed before pregnancy and perinatal mental illness, controlling for socio-demographics and medical history. We explored the modifying effects of social and medical complexities using relative excess risk due to interaction. Additional analyses examined the association between asthma and perinatal mental illness by timing and type of mental illness. RESULTS: Women with asthma were more likely than those without asthma to have perinatal mental illness [adjusted relative risk (aRR) 1.14; 95% (confidence interval) CI: 1.13, 1.16]. Asthma was associated with increased risk of diagnosis of mental illness prenatally (aRR 1.11; 95% CI: 1.08, 1.13) and post-partum (aRR 1.17; 95% CI: 1.15, 1.19) and specifically diagnoses of mood and anxiety disorders (aRR 1.14; 95% CI: 1.13, 1.16), psychotic disorders (aRR 1.20; 95% CI: 1.10, 1.31) and substance- or alcohol-use disorders (aRR 1.24; 95% CI: 1.14, 1.36). There was no effect modification related to social or medical complexity for these outcomes. CONCLUSIONS: Women with asthma predating pregnancy are at slightly increased risk of mental illness in pregnancy and post-partum. A multidisciplinary management strategy may be required to ensure timely identification and treatment.
BACKGROUND: Asthma is a risk factor for mental illness, but few studies have explored this association around the time of pregnancy. We studied the association between asthma and perinatal mental illness and explored the modifying effects of social and medical complexities. METHODS: In a population-based cohort of 846 155 women in Ontario, Canada, with a singleton live birth in 2005-2015 and no recent history of mental illness, modified Poisson regression models were constructed to examine the association between asthma diagnosed before pregnancy and perinatal mental illness, controlling for socio-demographics and medical history. We explored the modifying effects of social and medical complexities using relative excess risk due to interaction. Additional analyses examined the association between asthma and perinatal mental illness by timing and type of mental illness. RESULTS: Women with asthma were more likely than those without asthma to have perinatal mental illness [adjusted relative risk (aRR) 1.14; 95% (confidence interval) CI: 1.13, 1.16]. Asthma was associated with increased risk of diagnosis of mental illness prenatally (aRR 1.11; 95% CI: 1.08, 1.13) and post-partum (aRR 1.17; 95% CI: 1.15, 1.19) and specifically diagnoses of mood and anxiety disorders (aRR 1.14; 95% CI: 1.13, 1.16), psychotic disorders (aRR 1.20; 95% CI: 1.10, 1.31) and substance- or alcohol-use disorders (aRR 1.24; 95% CI: 1.14, 1.36). There was no effect modification related to social or medical complexity for these outcomes. CONCLUSIONS: Women with asthma predating pregnancy are at slightly increased risk of mental illness in pregnancy and post-partum. A multidisciplinary management strategy may be required to ensure timely identification and treatment.
Authors: Milton Kotelchuck; Erika R Cheng; Candice Belanoff; Howard J Cabral; Hermik Babakhanlou-Chase; Taletha M Derrington; Hafsatou Diop; Stephen R Evans; Judith Bernstein Journal: Matern Child Health J Date: 2017-04
Authors: Brendon Stubbs; Ai Koyanagi; Nicola Veronese; Davy Vancampfort; Marco Solmi; Fiona Gaughran; André F Carvalho; John Lally; Alex J Mitchell; James Mugisha; Christoph U Correll Journal: BMC Med Date: 2016-11-22 Impact factor: 8.775