863 COVID-19-related perinatal stress associated with increased depression risk

Abstract

The COVID-19 pandemic has been associated with increased distress among pregnant and recently delivered parents. We examined whether COVID-19-related stress was associated with depressive risk among individuals who were pregnant or within 6 months of delivery. A web-based survey was distributed to all patients who were pregnant or within 6 months of delivery at a health system in the Chicagoland area. The survey included the Edinburgh Perinatal Depression Survey (EPDS), Likert scales 0-10 evaluating COVID-related financial, social, and general stress, and collected race/ethnicity, insurance, and pregnancy status. Participants scoring ≥10 on the EPDS were considered to have clinically significant depressive symptomology. Multivariate logistic regression examined the relationship between COVID-related stress and EPDS scores. Of the 4,160 patients receiving the survey, 372 (9%) were consented and completed the survey. 137 (37%) of respondents were pregnant, 77% were white, and 93% were privately insured (Table 1). Respondents reported moderate general distress (6.15±2.4), financial stress (5.37±2.7), and social disruption (6.13±2.7) due to the COVID-19 pandemic. Non-white (39% versus 29%, p=0.07) and Medicaid-enrolled (44% versus 30%, p=0.12) participants were more likely to report depressive symptomology. Adjusting for race, insurance, and pregnancy status, those reporting higher general COVID-related stress were 1.6 (95%CI 1.39,1.80) times more likely to score ≥10 on the EPDS. Financial (aOR=1.25, 95%CI 1.14,1.37) and social distress (aOR=1.25, 95%CI 1.13,1.37) were also significantly associated with elevated risk for depressive symptomology. COVID-related distress is associated with depressive symptomology among perinatal patients. During this time of heightened financial, social, and health stressors, patients should be screened for depression and linked to care. Future studies should examine whether COVID-related depressive symptomology is associated with adverse perinatal outcomes.