(701) Antenatal Anxiety as a Predictor for Postpartum Depression

Friday, February 10, 2023

10:30 AM – 12:00 PM

Objective: Postpartum depression affects 30-37% of new mothers in the United States. Psychiatric illness is a leading cause of maternal morbidity and mortality, and maternal distress in the postpartum period is associated with long-term developmental and behavioral effects in infants. Our objective was to evaluate the correlation between the Generalized Anxiety Disorder 7-Item Scale (GAD-7) taken in the 1st trimester and the Edinburgh Postnatal Depression Scale (EPDS).

Study Design: We conducted a prospective observational study of pregnant women. Women were enrolled between 11-14 weeks and completed the GAD-7 questionnaire in addition to their routine prenatal care. Women who experienced pregnancy loss or were lost to follow-up were excluded. A EPDS score of ≥10 in the postpartum period was considered to be a positive screen. Chi-square, t-tests, and non-parametric tests, and logistic regression were used where appropriate.

Results: 100 women were enrolled in the study, with 94 being included in the final analysis. The average EPDS and GAD-7 scores in the first trimester were 4.4±4.5 and 4.5±4.3. Thirteen women (13.4%) had a positive postpartum EPDS. The 1st trimester EPDS and GAD-7 were both significantly correlated with a positive postpartum EPDS (p=0.006 and < 0.001). An optimal cut-off of 5 was found for both tools using logistic regression and ROC curves. Logistic regression with these cut-offs found that the GAD-7 had an odds ratio of 18.4 (95%CI 3.2-107.2), and the 1st trimester EPDS was found to be non-significant. Using a GAD-7 cut-off of 5 had a NPV of 97% and a PPV of 40.4%. No other patient data was found to be significantly associated with a positive postpartum screen.

Conclusion: Peripartum mood disorders are a major cause of maternal morbidity and our work has shown that the GAD-7 may be useful as a screening tool. Future studies will determine whether interventions designed for these women can decrease their risk of postpartum depression.

Primary & Presenting Author(s)

Christy Chan, BS
Renaissance School of Medicine at Stony Brook University
Stony Brook, New York, United States

Coauthor(s)
BF
Brynn Franz, BS
Stony Brook University Hospital
Stony Brook, New York, United States

MT
Mahesh Tiwari, BS
Medical Student
Renaissance School of Medicine at Stony Brook University
Stony Brook, New York, United States

JC
Joseph Chappelle, MD
Chief - General Obstetrics & Gynecology
Renaissance School of Medicine at Stony Brook University
Stony Brook, New York, United States