(288) The Association Between 1st Trimester Maternal Depression or Anxiety and Fetal Growth Restriction

Thursday, February 9, 2023

10:30 AM – 12:00 PM

Objective: Although depression & anxiety are associated with metabolic dysfunction in non-pregnant persons, it remains unclear whether these preexisting maternal mental health conditions are associated with gestational metabolic dysfunction. As such, we investigated whether 1st trimester (Tri1) depression or anxiety are associated with the development of gestational hypertension (GHTN), preeclampsia (PRE) or fetal growth restriction (FGR).

Study Design: We performed a retrospective cohort study of pregnant persons who received prenatal care in Tri1 at a diverse, urban county hospital from 2016-21. Maternal and neonatal data were abstracted from our institutional database. Rates of chronic hypertension (CHTN), GHTN, PRE and FGR were examined for those with and without depression or anxiety. Univariate analyses and logistic regression were performed. Regression models were adjusted for subject age, CHTN and body mass index (BMI).

Results: Of our cohort (N= 3,938), 4.85% (N=191) had depression or anxiety in Tri1. Concordant with non-pregnant state data, those with Tri1 depression or anxiety had higher rates of CHTN compared to those without (21.99% vs 13.93%, p=0.002). Among those with vs without Tri1 depression or anxiety, rates of GHTN (21.47% vs 20.92%, p=0.86) and PRE (4.71% vs 5.45%, p=0.901) did not differ. However, those with Tri1 depression or anxiety had an increased risk for FGR (14.66% vs 10.03%, p=0.04). Even when controlling for confounders, those with Tri1 depression or anxiety had 1.5-fold higher odds of experiencing FGR vs those without (AOR 1.5, 95% 1.04-2.4, p=0.032).

Conclusion: Our data suggests that maternal depression or anxiety in Tri1 precedes FGR independent of preexisting metabolic risks. These results suggest potential vascular disturbances driving abnormal gestational outcomes. Future studies examining pathophysiological mechanisms underlying how depression or anxiety contribute to this increased biological risk are necessary. Furthermore, identification of individuals with Tri1 depression or anxiety as a high-risk group for FGR could clinically modify antenatal surveillance.

Primary & Presenting Author(s)

Melanie Mitta, MD
Emory University
Atlanta, Georgia, United States

Coauthor(s)

VM
Vasiliki Michopoulos, MSc, PhD
Emory University
Atlanta, Georgia, United States
Suchitra Chandrasekaran, MD, MSCE
Assistant Professor
Emory University
Atlanta, Georgia, United States