Postpartum Depression Risk Following Prenatal Diagnosis of Major Fetal Anomalies [29E

Abstract

INTRODUCTION: To evaluate how the diagnosis of major fetal anomalies and resulting pregnancy outcomes affected the risk of postpartum depression, as assessed by the Edinburgh Postnatal Depression Scale (EPDS). METHODS: Singleton pregnancies with prenatal diagnosis of major fetal anomalies were ascertained from prospectively-maintained databases that included perinatal outcomes and subsequent EPDS responses from 1/2010 to 5/2018. EPDS scores ≥13 were considered positive and prompted referral for mental health follow-up, which was verified by electronic chart review. Statistical analyses were performed using odds ratios and χ2 with P<.05 considered significant. IRB approval was obtained. RESULTS: 912 women had a prenatal diagnosis of an anomalous fetus and postpartum EPDS screening, and 82 (9%) screened positive. Positive screening was more common with multiple fetal anomalies (15.3% vs 8.0%, P=.004) or aneuploidy (17.1% vs 8.6%, P=.02). Pregnancies complicated by fetal death (N=79, 8.6%), neonatal death (N=52, 5.7%), and termination for anomaly (N=69, 7.6%) were significantly more likely to screen positive than those with neonatal survival to discharge (all OR >2, P<.001). 34 (40%) screen-positive women attended their follow-up appointment with a mental health provider, and 18 (53%) were diagnosed with a depressive disorder. CONCLUSION: Women with prenatal diagnosis of major fetal anomalies and perinatal loss had a two-fold increased likelihood for positive depression screening using EPDS. More than half of screen positive women who seek mental health follow-up were diagnosed with a depressive disorder. Effective screening with intervention is warranted in this vulnerable population.