Increased Risk of Postpartum Depression in Women With Allergic Rhinitis During Pregnancy: A Population-Based Case-Control Study

Risk factors for postpartum depression in pregnant women with allergic rhinitis: a retrospective study

OBJECTIVE

Allergic rhinitis can cause symptoms to worsen after pregnancy and may cause problems such as postpartum depression. The goal of this study was to investigate the factors that influence postpartum depression in pregnant women with allergic rhinitis (AR).

METHODS

We conducted a retrospective cohort study that included women with AR (based on self-reports) between June 2015 to June 2019 in Harvard University Partners Healthcare Systems (PARTNERS) in the USA. The study group was divided into postpartum depression and non-postpartum depression. Routine clinical and laboratory information was collected. Univariate and least absolute shrinkage and selection operator (LASSO, employed for predictor selection) regression analysis was used to study associations between AR during pollen seasons and adverse outcomes. Additionally, the receiver operating characteristic (ROC) curve evaluates discriminative ability by the area under the ROC curve (AUC). The calibration curve (DCA) was conducted to determine the clinical utility and benefit of the nomogram.

RESULTS

A total of 216 pregnant women with AR participated in this study. Univariate analysis showed that 7 indicators were significantly different (P < 0.05). LASSO and multivariable regression identified four predictors to construct a nomogram for PPD in pregnant women with AR, the four selected risk predictors are as follows: pollen season pregnancy (OR = 1.514, 95%CI: 0.771-2.973), history of preterm birth (OR = 2.723, 95%CI: 1.157-6.406), number of pregnancies (OR = 2.104, 95%CI: 1.356-3.267), anti-allergy medication during pregnancy (OR = 2.975, 95%CI: 1.521-5.819). The nomogram displayed good discrimination, with AUC of 0.732 (95% CI: 0.657-0.808). The risk of postpartum depression increased with the increasing risk score of predictive nomogram. The calibration curve and DCA present optimal predictive power.

CONCLUSIONS

We highlighted the comorbidity of AR and postpartum depression, and suggested that a multidisciplinary consideration between allergists and obstetricians or midwives is needed to ensure that pregnant women consult experts to reduce AR symptoms.

TRIAL REGISTRATION NUMBER

2018P002646.

Risk of postpartum depression in women with allergic disorders: A nationwide cohort study involving 1,017,507 women

BACKGROUND

Allergic symptoms and depression are prevalent ailments in childbearing age women. This study assessed the risk of maternal postpartum depression (PPD) associated with prenatal allergic disorders.

METHODS

From 1,017,507 eligible women of 20-49 years old with singleton live births and 20-week or more gestational age in the birth registry of Taiwan, from 2011 to 2020, we identified cohorts with and without allergic disorders matched by propensity score in the size of 457,826. Cumulative incident PPDs in one year after births were assessed from insurance claims data. Odds ratios (OR) of PPD were measured by each allergic type and multiple types, comparing with the controls.

RESULTS

With an overall cumulative PPD incidence 1.25-fold higher in the allergic cohort than in the controls (0.69 % versus 0.55 %), the rate was the highest in women with asthma: 0.94 % with an adjusted OR of 1.71 (95 % CI = 1.49-1.95), followed by those with allergic rhinitis, allergic conjunctivitis and atopic dermatitis. The rate increased from 0.65 % for those with one allergic disorder to 1.06 % for those with 4 or 5 disorders, and the corresponding adjusted OR increased from 1.17 (95 % CI = 1.10-1.24) to 1.92 (95 % CI = 1.36-2.69).

LIMITATION

The claims data lack detailed information on socio-demographic status, lifestyle, laboratory result, physical activity, and family medical history.

CONCLUSIONS

Women with prenatal allergic disorder(s) are at an increased risk of PPD in addition to the impact of pregnancy. Prompt and efficient intervention for PPD prevention is needed for women with allergic disorders, particularly for those with asthma and multiple disorders.

Relationship between allergic diseases and mental disorders in women: A systematic review and meta-analysis

BACKGROUND

The relationship between allergic diseases (AD) and mental disorders (MD) in women has not been fully systematically evaluated. We aimed at validating this correlation.

METHODS

The relevant cohort and case-control studies from the establishment of the database to February 18, 2022 in PubMed, Embase, and Cochrane library were searched by computer. The researchers conducted the quality evaluation of the included articles by reviewing and discussing with reference to relevant standards, and conducted the analysis of the correlation between female patients with AD and MD by using Review Manager 5.4.

RESULTS

Six observational studies from 2631 studies (n = 1160858 women) were assessed as medium and high-quality studies. The meta-analysis demonstrated that AD was correlated with MD in female patients (OR = 1.21, 95%CI: 1.14-1.29), including asthma (OR = 1.16, 95%CI: 1.11-1.22), allergic rhinitis (OR = 1.31, 95%CI: 1.06-1.63), and atopic dermatitis in women (OR = 1.37, 95%CI: 1.24-1.50) were associated with MD. At the same time, subgroup analysis was performed according to region, study design, criteria of AD and MD, and the results demonstrated that both AD and MD were correlated in these different conditions.

CONCLUSION

Allergic diseases in female patients do have an association with mental disorders.

SYSTEMATIC REVIEW REGISTRATION

[https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022311146].