P1.239: Exploring the Maternal Impact of NICU Experiences: A Retrospective Analysis of Edinburgh Postnatal Depression Scale (EPDS) Scores and Neonatal Intensive Care Units (NICU) Factors

Purpose/Objectives: Postpartum depression (PPD) is the only maternal condition screened for by pediatricians; but a common childhood adverse experience. PPD impacts maternal health, infant’s brain development, and parent-child bonding. Current recommendations are screening at well-child appointments in the first 6 months, allowing for intervention during a crucial bonding period. Studies have shown that mothers of NICU infants are at a higher risk of PPD. NICU graduates are already at increased risk for developmental delay, and untreated PPD only increases the risk.

At the CHKD NICU, screening for PPD is not part of routine care. In this study, we aim to identify those that would benefit most from maternal PPD support prior to discharge from the NICU, which would help optimize the use of limited resources and allow for more targeted screening in the future.

Design/Methods: We collected EMR data from 2020-2021 for patients discharged from the CHKD level IV NICU prior to 6 months of age. We compared the amount of screening performed in the NICU versus outpatient pediatric clinics. We looked at EPDS scores, as well as gestational age, birth weight, acuity factors (such as surgical interventions, need for subspecialty involvement etc.), number of follow-ups at discharge, and the admission duration. We compared the NICU factors to highest EPDS and performed a t-test (two-tailed, P< 0.05) to determine if there was a significant difference between those who screened positive on EPDS and those who did not.

Results: Of the 182 mothers, 25% (46) screened positive for PPD. 76% of those that screened positive were not screened at all during their NICU stay and were only screened in the outpatient setting. Five percent (9) of mothers screened positive for suicidal ideation, with 56% of those with SI not having been screened in the NICU. On average, the first EPDS screen was at 13.7 weeks of age.

The number of acuity factors (p=0.009), and number of follow-ups (p=0.008) both showed a significant difference between those with positive screens and those without. Gestational age, birth weight, and length of stay showed no significant difference (p= 0.82, 0.53, 0.30 respectively).

Conclusion/Discussion: Our results underscore the need for routine screening for PPD while in the NICU so that maternal support is established prior to discharge. They also show that higher acuity NICU stays and higher number of follow-up appointments at discharge are associated with a greater risk of screening positive for PPD. Interestingly, the difference in gestational age, birth weight, and length of stay were not statistically significant, though length of stay may become more significant with additional data. This suggests that families with higher acuity admissions should at minimum be routinely screened for PPD while in the NICU or have maternal support established prior to discharge.