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While PMD has been linked to perinatal depression, associations with the full spectrum of perinatal psychiatric disorders (PNPDs), including anxiety and psychosis, remain largely unexplored. This study aimed to investigate whether a history of PMD is associated with increased risk of a first-onset PNPD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Nationwide register-based cohort study from 2003 to 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Swedish national and regional population and healthcare registers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>1 052 977 women with 1\u2009799\u2009010 pregnancies recorded in the Swedish Medical Birth Register. Individuals with PMD prior to pregnancy were identified through clinical diagnoses or prescribed medications in Swedish healthcare registers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>First-onset PNPDs diagnosed from pregnancy start to 12 months postpartum were identified through Swedish healthcare registers. PNPDs were categorised into eight subgroups: depression, anxiety, stress-related disorders, bipolar disorder, psychosis, alcohol use disorder, drug use disorder and other. Multivariable logistic regression models were used to estimate ORs and 95% CIs, adjusting for demographic and clinical covariates. Sibling analyses were also conducted to address potential familial confounding.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 1 052 977 women included, 13\u2009382 women (1.3%), corresponding to 17\u2009514 (1%) pregnancies, had a diagnosis of PMD prior to pregnancy. In the type-specific analysis, an increased likelihood was found for all subtypes of disorders, except for perinatal psychosis. The strongest associations were observed for bipolar disorder (adjusted OR 3.98, 95% CI 3.15 to 5.04), followed by perinatal depression (adjusted OR 2.74, 95% CI 2.56 to 2.94). Associations were present in both antepartum and postpartum periods and were stronger among women without psychiatric history. Sibling comparisons showed attenuated but statistically significant associations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings highlight that women with a history of PMD face an increased likelihood of developing PNPDs, particularly depression and bipolar disorder, both during pregnancy and postpartum. Given frequent perinatal healthcare contact, these findings may help inform targeted risk identification and early intervention strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-116361","type":"journal-article","created":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T11:25:41Z","timestamp":1782645941000},"page":"e116361","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of perinatal psychiatric disorder among women with a history of premenstrual disorder: a nationwide register-based study from Sweden"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-7784-6289","authenticated-orcid":false,"given":"Nora Elise","family":"Verberne","sequence":"first","affiliation":[{"name":"Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands"},{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Yan","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Br\u00e4nn","sequence":"additional","affiliation":[{"name":"Unit of Integrative Epidemiology, Karolinska Institute Institute of Environmental Medicine, Stockholm, Sweden"},{"name":"Center for Epidemiology and Community Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-0657-485X","authenticated-orcid":false,"given":"Yihui","family":"Yang","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Zhou","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alkistis","family":"Skalkidou","sequence":"additional","affiliation":[{"name":"Department of Women's and Children\u2019s Health, Uppsala University, Uppsala, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth R","family":"Bertone-Johnson","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4455-6492","authenticated-orcid":false,"given":"Astrid M","family":"Kamperman","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, Epidemiological and Social Psychiatric Research Institute, Erasmus MC University Medical Center Rotterdam, Rotterdam, Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4186-8661","authenticated-orcid":false,"given":"Donghao","family":"Lu","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,6,28]]},"reference":[{"key":"2026062804250960000_16.6.e116361.1","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1016\/S0140-6736(14)61277-0","article-title":"Effects of perinatal mental disorders on the fetus and child","volume":"384","author":"Stein","year":"2014","journal-title":"The Lancet"},{"key":"2026062804250960000_16.6.e116361.2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2015.14121510"},{"key":"2026062804250960000_16.6.e116361.3","doi-asserted-by":"crossref","unstructured":"Yu H , Shen Q , Br\u00e4nn E , et al . 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