Risk Factors for Postpartum Depression Among Women at High Risk for Pelvic Floor Symptoms [9G

Abstract

INTRODUCTION: We sought to identify risk factors associated with a positive postpartum depression screen among women at high risk for pelvic floor symptoms and referred to a specialty postpartum clinic. METHODS: We performed a retrospective chart review of women seen between March 2012 and May 2016 at the Michigan Healthy Healing After Delivery Clinic at the University of Michigan, where patients are referred for early follow-up of obstetric anal sphincter injuries or pelvic floor symptoms related to childbirth. All new patients are screened for postpartum depression using the Edinburgh Postnatal Depression Scale (EPDS). Women with an EPDS score greater than or equal to 10 (positive screen) were compared to those with a score under 10 (negative screen). Logistic regression was used to identify factors independently associated with a positive EPDS screen. RESULTS: Among 294 women, 46 (15.6%) had a positive EPDS screen. Women with a positive versus negative EPDS screen were more commonly referred for pain (30.4% vs 14.1%, P=.006), and had higher prevalences of urinary incontinence (35.6% vs 20.5%, P=0.027) and history of depression/anxiety (37.0% vs 17.7%, P=0.003). In multivariable logistic regression modeling controlling for age and race, factors that remained independently associated with a positive EPDS screen were non-white race (aOR 0.35, P=.006), referral for pain (aOR 3.03, P=.005), urinary incontinence (aOR 2.20, P=.04), and history of depression/anxiety (aOR 3.33, P=.003). CONCLUSION: Among women at high risk for postpartum pelvic floor symptoms, persistent pain and urinary incontinence may be risk factors of postpartum depression.