486: Is maternal non-disclosure of HIV serostatus to her family associated with postpartum depression?

Abstract

ObjectiveTo determine whether maternal disclosure of her positive HIV serostatus to family members prior to delivery is associated with postpartum depression.Study DesignIn this retrospective cohort study, women who received obstetric care in a specialty perinatal HIV clinic (2007-2014) were dichotomized by whether they had disclosed their HIV status to at least one family member aside from sexual partner(s) prior to delivery. Postpartum depression was identified initially by a positive result on a validated depression screening tool (PHQ9 or EPDS) at the six-week postpartum visit and then confirmed by interview with a mental health professional. Postpartum depression rates in women who had disclosed were compared to those in women who had not disclosed. Multivariable logistic regression was performed to identify whether disclosure remained an independent risk factor for postpartum depression after controlling for potential confounders, including antenatal mental health disorders.ResultsOf the 215 women who received care in this time period, 83% (N=179) had a documented family disclosure status and constituted the analyzable sample. In this cohort, 42% (N=76) had disclosed their HIV status to at least one family member prior to delivery. Women who disclosed to their family were younger and had a longer-standing HIV diagnosis. They were also less likely to be a foreign-born or to have been diagnosed with HIV in the index pregnancy. There were no differences in race/ethnicity, marital status, employment status, insurance status, antenatal mental health disorders or substance abuse history between disclosers and non-disclosers. Disclosure to family was associated with lower rates of postpartum depression (11.4% vs 24.7%, p=0.033), which persisted after controlling for potential confounders (Table).Conclusion ObjectiveTo determine whether maternal disclosure of her positive HIV serostatus to family members prior to delivery is associated with postpartum depression. To determine whether maternal disclosure of her positive HIV serostatus to family members prior to delivery is associated with postpartum depression. Study DesignIn this retrospective cohort study, women who received obstetric care in a specialty perinatal HIV clinic (2007-2014) were dichotomized by whether they had disclosed their HIV status to at least one family member aside from sexual partner(s) prior to delivery. Postpartum depression was identified initially by a positive result on a validated depression screening tool (PHQ9 or EPDS) at the six-week postpartum visit and then confirmed by interview with a mental health professional. Postpartum depression rates in women who had disclosed were compared to those in women who had not disclosed. Multivariable logistic regression was performed to identify whether disclosure remained an independent risk factor for postpartum depression after controlling for potential confounders, including antenatal mental health disorders. In this retrospective cohort study, women who received obstetric care in a specialty perinatal HIV clinic (2007-2014) were dichotomized by whether they had disclosed their HIV status to at least one family member aside from sexual partner(s) prior to delivery. Postpartum depression was identified initially by a positive result on a validated depression screening tool (PHQ9 or EPDS) at the six-week postpartum visit and then confirmed by interview with a mental health professional. Postpartum depression rates in women who had disclosed were compared to those in women who had not disclosed. Multivariable logistic regression was performed to identify whether disclosure remained an independent risk factor for postpartum depression after controlling for potential confounders, including antenatal mental health disorders. ResultsOf the 215 women who received care in this time period, 83% (N=179) had a documented family disclosure status and constituted the analyzable sample. In this cohort, 42% (N=76) had disclosed their HIV status to at least one family member prior to delivery. Women who disclosed to their family were younger and had a longer-standing HIV diagnosis. They were also less likely to be a foreign-born or to have been diagnosed with HIV in the index pregnancy. There were no differences in race/ethnicity, marital status, employment status, insurance status, antenatal mental health disorders or substance abuse history between disclosers and non-disclosers. Disclosure to family was associated with lower rates of postpartum depression (11.4% vs 24.7%, p=0.033), which persisted after controlling for potential confounders (Table). Of the 215 women who received care in this time period, 83% (N=179) had a documented family disclosure status and constituted the analyzable sample. In this cohort, 42% (N=76) had disclosed their HIV status to at least one family member prior to delivery. Women who disclosed to their family were younger and had a longer-standing HIV diagnosis. They were also less likely to be a foreign-born or to have been diagnosed with HIV in the index pregnancy. There were no differences in race/ethnicity, marital status, employment status, insurance status, antenatal mental health disorders or substance abuse history between disclosers and non-disclosers. Disclosure to family was associated with lower rates of postpartum depression (11.4% vs 24.7%, p=0.033), which persisted after controlling for potential confounders (Table). Conclusion