Abstract
Objective To examine postpartum depression (PPD) among women with axial spondyloarthritis (axSpA), psoriatic arthritis (PsA), or rheumatoid arthritis (RA), in comparison with a matched population without rheumatic diseases (RD).
Methods A retrospective analysis using the 2013-2018 IBM® MarketScan® Commercial Claims and Encounters Database was conducted. Pregnant women with axSpA, PsA, or RA were identified, and the delivery date was used as the index date. We restricted the sample to women ≤ 55 years with continuous enrollment ≥ 6 months before date of last menstrual period and throughout pregnancy. Each patient was matched with four individuals without RD on: 1) maternal age at delivery; 2) prior history of depression; and 2) duration of depression before delivery. Cox frailty proportional hazards models estimated the crude and adjusted hazard ratios and 95% confidence interval (CI) of incident postpartum depression within one year among women with axSpA, PsA, or RA (axSpA/PsA/RA group) compared to the matched non-RD comparison group.
Results Overall, 2,667 women with axSpA, PsA, or RA and 10,668 patients without any RD were included. The median follow-up time in days was 256 (Interquartile range (IQR): 273.0) and 265 (IQR: 267.0) for the axSpA/PsA/RA and matched non- RD comparison groups. Development of PPD was more common in the axSpA/PsA/RA group relative to the matched non-RD comparison group (axSpA/PsA/RA group: 17.2%; matched non-RD comparison group: 12.8%; adjusted hazard ratio: 1.22 [95% CI, 1.09 – 1.36).
Conclusion Postpartum depression is significantly higher in women of reproductive age with axSpA/PsA/RA when compared to those without RD.
