224 The association between perinatal depressive symptoms and child neurodevelopment

Abstract

Prior studies suggest that maternal depression adversely impacts child development. Our objective is to determine the association between perinatal depressive symptoms and child neurodevelopment. Secondary analysis of a RCT of thyroxine therapy for low risk pregnant women with subclinical hypothyroidism. Patients without a clinical diagnosis of depression were assessed for depressive symptoms using the Center for Epidemiological Studies-Depression (CESD) scale at 11-20 and 34-38 weeks, and 1-year postpartum. The CESD was not scored until completion of the trial. A CESD score ≥16 is considered screen positive for depression. In the primary trial, thyroxine therapy did not improve child cognitive outcomes or maternal depressive symptoms, thus all patients with available CESD scores were included in this analysis. Our primary outcome was child IQ score <85 at 5 years of age using the WPPSI-III Full Scale test. Associations between a positive depression screen and neurodevelopmental outcomes were determined with multivariable logistic regressions. 209 maternal/child dyads were analyzed. 24% of patients screened positive for depression at baseline and 15% at 1-year postpartum. Compared to patients with a CESD <16, those who screened positive had a higher BMI, were more likely to smoke, and less likely to have higher education. Children born to patients with a positive depression screen, either antenatally or at 1-year postpartum, had a higher rate of IQ <85 at 5 years of age (35% vs. 18 % and 47% vs. 21%) compared with children born to patients with a CES-D <16. Additionally, they had higher rates of other adverse neurodevelopmental outcomes. However, these associations did not persist on multivariable analysis (Tables). Findings were similar for patients with a positive antepartum screen that persisted to 1 year postpartum. In this cohort of pregnant women with subclinical hypothyroidism, having a positive perinatal depression screen was not associated with child neurodevelopmental outcomes after controlling for covariates including social determinants of health.View Large Image Figure ViewerDownload Hi-res image Download (PPT)