(638) Anxiety and perinatal mood disorders in patients with and without a history of preterm birth

Thursday, February 9, 2023

4:00 PM – 5:30 PM

Objective: Our aim was to examine anxiety symptomatology at initiation of prenatal care and subsequent frequency of mood disorders in patients with and without a history of spontaneous preterm birth (PTB) using a validated anxiety screening tool.

Study Design: This was a prospective observational cohort study of the Generalized Anxiety Disorder 7-item screen (GAD-7) implemented at entry to prenatal care in two maternity clinics at a large, inner-city hospital. GAD-7 screening was initiated for patients with prior PTB referred for care at an MFM clinic (PTB) and those without prior PTB receiving care in a low-risk Women’s Health Center (WHC). Those with a GAD-7 score of ≥10 were offered a formal evaluation by a mental health counselor (MHC) for diagnosis and treatment. Multifetal gestations, congenital anomalies, or initiation of care after 34 weeks were excluded. Study outcomes were completion of a MHC referral and subsequent mood disorder diagnosis.

Results: Between Sept 2020 and Dec 2021, a total of 1323 patients completed the GAD-7 screen with 163 in the PTB cohort and 1160 in the WHC cohort. In all, 182 (14%) screened patients scored >10 on the GAD-7 with significantly higher positive screen rates in the PTB compared to WHC group (20% vs 13%, P = 0.01). For those with a positive screen, 153 (84%) accepted a referral to a MHC with 126 (82%) evaluated. A total of 32 (25%) patients were diagnosed with anxiety, depression, or bipolar disorder (Figure). There were no significant differences in rates of referral acceptance, completion, or mood disorder diagnosis between patients with and without a history of PTB. Demographic and perinatal outcomes were similar in those with a positive screen who accepted and completed the referral evaluation (Table).

Conclusion: One in four antepartum patients with a positive anxiety screen were diagnosed with a perinatal mood disorder. These findings highlight the importance of mood disorder screening during pregnancy.

Primary & Presenting Author(s)

Yevgenia Y. Fomina, MD
University of Texas Southwestern Medical Center
Dallas, Texas, United States

Coauthor(s)

AR
Aldeboran N. Rodriguez, MD
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Anne M. Ambia, MD
Assistant Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Denisse S. Holcomb, MD
Assistant Professor, Obstetrics
University of Texas Southwestern Medical Center
Dallas, Texas, United States
TW
Tina Wolfson, N/A
University of Texas Southwestern Medical Center
Dallas, Texas, United States
MD
Meitra Doty, MD
University of Texas Southwestern Medical Center
Dallas, Texas, United States
RC
Rebecca Corona, PhD
Parkland Health and Hospital System
Dallas, Texas, United States
JD
Jeanette Dominguez, N/A
Parkland Health and Hospital System
Dallas, Texas, United States
MP
Mark Peters, MD
University of Texas Southwestern Medical Center
Dallas, Texas, United States
DM
Donald D. McIntire, PhD
University of Texas Southwestern Medical Center
Dallas, Texas, United States
David B. Nelson, MD
Associate Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States