(752) Comparison of ACE Scores and EPDS Scores in Early Pregnancy in an Inner-City Obstetric Population

Limited data suggests a possible correlation between higher Adverse Childhood Experiences (ACEs) scores and perinatal depression.  This study aims to compare early pregnancy ACE scores to the initial prenatal visit Edinburgh Postnatal Depression Scale (EPDS) scores and post-partum ACE scores to postpartum EPDS scores in an inner-city obstetric population.

Study Design:

Pregnant patients  < 20 weeks gestation were prospectively recruited from an inner city obstetrics department from June-August 2021. Patients were administered the ACE questionnaire and chart reviewed for demographics and initial visit EPDS score. ACE scores were classified as low (0), intermediate (1-3), or high risk (>4). Subjects were grouped according to ACE score risk groups to analyze differences between mean ACE and EPDS scores.

Results:

88 pregnant patients were recruited.  25 patients had post-partum ACE and EPDS scores. Means between early pregnancy ACE risk stratification and EPDS (p < 0.001) were statistically significant. There was not a statistically significant difference in mean between post-partum ACE and EPDS scores based on ACE score risk groups (p=0.131) (Table 1).

Conclusion: There is a strong correlation between ACE scores and EPDS scores in early pregnancy. In early pregnancy, patients with high-risk ACE scores have a statistically significant difference in EPDS score in comparison with low and intermediate risk groups. The insignificant post-partum findings may be a result of reduced sample size compared to early pregnancy scores, or changes in both ACE and EPDS scores. Further investigation is needed to determine if there is truly no correlation. As EPDS scores rose in both low and high-risk ACE groups, ACE scores may be a good predictor of pre-pregnancy depression, but may not be a good predictor of post-partum depression. These patients should be followed throughout their pregnancy and post-partum periods to assess for associations with adverse maternal or perinatal outcomes.