Pregnancy is hard enough.
Factor in a chronic medical condition like diabetes or hypertension, and the challenges can multiply. What’s more, these types of chronic conditions may also be connected to mental health issues.
“In the general population, research has shown that individuals with chronic conditions tend to have poorer mental health, and those with poorer mental health have more chronic condition complications,” says Hilary Brown, an assistant professor of health studies. “Surprisingly, though, these associations have been nearly ignored in perinatal populations.”
It’s surprising, she says, because pregnancy brings a battery of changes and risks – physical, hormonal, social and financial – that can also be risk factors for depression, anxiety and other mental health issues.
Now Brown has received major funding to study the mental health risks for pregnant women and new mothers who are also managing chronic medical problems. A $153,000 grant from the Canadian Institutes of Health Research will allow her to study a wide range of conditions, and help identify groups of women who should be monitored closely during and after pregnancy for poor mental health.
“This will be one of the largest studies on this topic to date worldwide, which means that we can do more complex and comprehensive analyses than has previously been possible,” she says.
The research will be aimed at providing clinicians with information that they can use to design better interventions to prevent and treat perinatal mental illness.
“Ultimately, I hope that this research will benefit the women themselves as well as their infants and families,” Brown says.
Her team will be looking at a wide range of conditions that are common among women of childbearing age, including diabetes, hypertension, asthma, and a number of autoimmune conditions. They will analyze medical records from across Ontario, including data from women’s visits to the doctor, trips to the ER, and hospitalizations. While she has deep access to demographic and clinical information, the study is designed to preserve the privacy of individual women.
Her team will track both medical and socioeconomic data, which helps further refine understanding about the groups of women at greatest risk. They will assess issues ranging from poverty, to poorly managed health conditions, to the impact of specific medications.
“I expect we will find that there are clusters of women who have particularly high risk for poor mental health during this period because of increased challenges of disease management,” she says. “This will enable us to identify groups of women who should be monitored closely during and after pregnancy and who may benefit from interventions related to their mental health.”