539: Postpartum depression in women with pregnancies complicated by a fetal congenital cardiac anomaly

Abstract

To investigate factors contributing to postpartum depression (PPD) in pregnancies complicated by a fetal congenital cardiac anomaly. We reviewed the medical records of all pregnancies complicated by a fetal congenital cardiac anomaly who received prenatal, intrapartum and postpartum care at a single academic center between October 2016 and October 2018. Women who completed the Edinburgh Postnatal Depression scales (EPDS), a standard assessment in our center, at their routine 6-week postpartum appointment were included in the analysis. PPD was defined as an EPDS score ≥10. Maternal sociodemographic, obstetric, and neonatal data were compared between women with and without PPD. Out of 235 women referred to our center due to a fetal congenital cardiac anomaly, we identified 45 women with complete prenatal, intrapartum, and neonatal data including EPDS scores. The EPDS was completed a median of 43 days postpartum (IQR 42-49) with a median score of 4 (IQR 1-9). Eleven women (24%) were identified as having PPD. There were no differences in sociodemographic factors, or a history of depression between those with and without PPD (Table 1). Moreover, women with obstetric complications including PPROM, PTL, chorioamnionitis, fetal growth restriction, cesarean delivery or postpartum hemorrhage did not have increased rates of PPD. When analyzing the effect of neonatal factors on PPD, the rates of neonatal intubation, ECMO, or surgery in first 6 weeks were similar between women with or without PPD; however, the frequency of PPD was significantly higher among women whose infant had a plan for surgery at the time of EPDS testing (70.0 vs. 24.2%, p=0.02) (Table 2). In pregnancies complicated by fetal congenital cardiac anomaly, women with a plan for neonatal cardiac surgery at the time of their postpartum appointment are at a significantly higher risk for postpartum depression.View Large Image Figure ViewerDownload Hi-res image Download (PPT)