Identification of women at high risk of postpartum psychiatric episodes: A population-based study quantifying relative and absolute risks following exposure to selected risk factors and genetic liability

Benedicte M. W. Johannsen, Janne Tidselbak Larsen, Xiaoqin Liu, Kathrine Bang Madsen, Merete Lund Mægbæk, Clara Albiñana, Veerle Bergink, Thomas M. Laursen, Bodil H. Bech, Preben Bo Mortensen, Merete Nordentoft, Anders D. Børglum, Thomas Werge, David M. Hougaard, Esben Agerbo, Liselotte Vogdrup Petersen, Trine Munk-Olsen*

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

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Abstract

Background: We quantified relative and absolute risks of postpartum psychiatric episodes (PPE) following risk factors: Young age, past personal or family history of psychiatric disorders, and genetic liability. Methods: We conducted a register-based study using the iPSYCH2012 case-cohort sample. Exposures were personal history of psychiatric episodes prior to childbirth, being a young mother (giving birth before the age of 21.5 years), having a family history of psychiatric disorders, and a high (highest quartile) polygenic score (PGS) for major depression. PPE was defined within 12 months postpartum by prescription of psychotropic medication or in- and outpatient contact to a psychiatric facility. We included primiparous women born 1981–1999, giving birth before January 1st, 2016. We conducted Cox regression to calculate hazard ratios (HRs) of PPE, absolute risks were calculated using cumulative incidence functions. Results: We included 8174 primiparous women, and the estimated baseline PPE risk was 6.9% (95% CI 6.0%–7.8%, number of PPE cases: 2169). For young mothers with a personal and family history of psychiatric disorders, the absolute risk of PPE was 21.6% (95% CI 15.9%–27.8%). Adding information on high genetic liability to depression, the risk increased to 29.2% (95% CI 21.3%–38.4%) for PPE. Conclusions: Information on prior personal and family psychiatric episodes as well as age may assist in estimating a personalized risk of PPE. Furthermore, additional information on genetic liability could add even further to this risk assessment.

OriginalsprogEngelsk
TidsskriftActa Psychiatrica Scandinavica
Vol/bind150
Udgave nummer5
Sider (fra-til)385-394
Antal sider10
ISSN0001-690X
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
This study was supported by a research training supplement from the School of Health at Aarhus University and Fabrikant Vilhelm Pedersen og Hustrus Mindelegat. For work done on the present manuscript, Trine Munk‐Olsen has received funding from PSYCH (The Lundbeck Foundation Initiative for Integrative Psychiatric Research), The Lunbeck Foundation (grant number R313‐2019‐567), and AUFF Nova (Aarhus University Research Foundation). Xiaoqin Liu is supported by the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska‐Curie grant agreement No. 891079. Liselotte Vogdrup Petersen receives funding from PSYCH (The Lundbeck Foundation Initiative for Integrative Psychiatric Research). The iPSYCH team was supported by grants from the Lundbeck Foundation (R102‐A9118, R155‐2014‐1724, and R248‐2017‐2003), NIMH (1R01MH124851‐01 to Anders D. Børglum) and the Universities and University Hospitals of Aarhus and Copenhagen. The Danish National Biobank resource was supported by the Novo Nordisk Foundation. High‐performance computer capacity for handling and statistical analysis of iPSYCH data on the GenomeDK HPC facility was provided by the Center for Genomics and Personalized Medicine and the Centre for Integrative Sequencing, iSEQ, Aarhus University, Denmark (grant to Anders D. Børglum). Parts of this study was presented at the 2022 Biennial Conference of the International Marce Society, London, September 2022. None of the funders had any role in the planning, design, analysis, interpretation of the results or publication of this study. i i

Publisher Copyright:
© 2023 The Authors. Acta Psychiatrica Scandinavica published by John Wiley & Sons Ltd.

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