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Clinical Obstetrics

Poster Session 4

(972) Prolonged Antepartum Admission As An Independent Risk Factor for Perinatal Depression in Patients with PPROM

Wednesday, February 14, 2024
1:00 PM – 2:30 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

The objective is to assess antepartum length of stay (LOS) as an independent risk factor for postpartum depression (PPD). Preterm premature rupture of membranes (PPROM) is a known risk factor for PPD- little is known about the effects of prolonged hospitalization on maternal mental health, a widely practiced part of management in this population. If a relationship exists between prolonged hospitalization and PPD, providers may more easily identify patients at risk and offer interventions to improve maternal and neonatal outcomes.


Study Design:

This is a retrospective cohort study of patients admitted to a single hospital for PPROM from January 2018 to March 2023. Patients were stratified based on antepartum LOS and Edinburgh Postnatal Depression (EPDS) score in the immediate postpartum period were compared. Chart review collected data regarding comorbid maternal and neonatal complications. The following exclusion criteria were used: delivery at non-viable gestational age (less than 22 weeks 0 days for this study), beyond 34 weeks 0 days, and fetal demise. We used descriptive and inferential statistics to characterize the population and determine if a relationship exists between prolonged hospitalization and EPDS score in the postpartum period.


Results:

 168 patients were eligible for review. Average antepartum LOS was 9 days, average EPDS score was 5.1. Incidence of stay 7 days or greater was 43.4% and 21% of patients had EPDS score greater than 9, indicating moderate to severe symptoms. There was no significant difference in the incidence of EPDS greater or equal to 9 based on LOS more than 7 days. (OR 0.79,  95% CI 0.37-1.69).


Conclusion:  This study doesn't suggest a statistically significant relationship between prolonged LOS and EPDS score. Analysis shows prolonged LOS may be protective against depression, a direct opposition to the original hypothesis. Investigators reason this could be due to better neonatal outcomes associated with longer latency periods and delivery at later gestational ages. More studies reviewing larger samples are needed to fully assess this patient population.