(748) Maternal Depression and its Effect on Spontaneous and Indicated Preterm Births within the nuMoM2b Cohort

Friday, February 10, 2023

10:30 AM – 12:00 PM

Objective: To evaluate the role of depression in spontaneous and indicated preterm birth (PTB) within the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b) cohort and maternal comorbidities.

Study Design: Utilizing the nuMoM2b database, we divided the prospective, observational cohort based on maternal depression (EPDS >12). Outcome data of a live birth was required for inclusion. PTB was defined as delivery < 37 weeks and was further divided into spontaneous and indicated PTB. Maternal demographics and medical histories, and pregnancy outcomes were extracted. Statistical analysis included Chi square, student t tests, and logistic regression with significance levels of < 0.05.

Results: 8702 nulliparous women were included in analysis with 1283 (14.7%) with depression and 7462 (85.7%) without depression. The depression group had younger patients (24.8+5.8 v 27.3+5.5; p< 0.001), less college education (39.7% v 64.5%; p< 0.001), more psychiatric medication use (17.5% v 7.2%; p< 0.001), more tobacco use (18.2% v 6.4%; p< 0.001), lower income (31.0% v 13.7%; p< 0.001), more obesity (33.0% v 26.1%; p< 0.001), higher asthma rate (18.4% v 13.3%: p< 0.001), greater spontaneous PTB rate (9.5% v 7.4%; p=0.04), and greater indicated PTB rate (12.6% v 9.2%: p=0.02). Groups were similar for preexisting DM, HTN, and gravidity. On logistic regression modeling, maternal depression did not remain an independent predictor of spontaneous or indicated PTB. (Table 1)

Conclusion:

Maternal depression by itself was not an independent predictor of spontaneous or indicated preterm birth. Maternal obesity and preexisting diabetes were independent predictors of both spontaneous and indicated PTB. Advanced maternal age and prior cervical surgery predicted spontaneous PTB, whereas hypertensive disorders predicted an indicated PTB. Education had a protective effect with spontaneous PTB.

Primary & Presenting Author(s)

Gloria Singleton (she/her/hers)
Medical Student
Stony Brook Medicine
Stony Brook, New York, United States

Coauthor(s)

Bijal Parikh, MD (she/her/hers)
Stony Brook Medicine
Stony Brook, New York, United States
Cassandra Heiselman, DO, MPH
Clinical Assistant Professor
Renaissance School of Medicine at Stony Brook University
Stony Brook, New York, United States
DG
David Garry, DO
Stony Brook Medicine
Stony Brook, New York, United States