P2.B039: Maternal Postpartum Depression Screening in a Pediatric Cardiac Intensive Care Unit

Purpose/Objectives: Postpartum depression (PPD) is a significant health condition present in about 10-13% of mothers in the general population and 24% of mothers with infants in the NICU. Mothers of infants with congenital heart disease (CHD) admitted to the Cardiac Intensive Care Unit (CICU) may be at increased risk of PPD due to the stressors of hospitalization. They often do not receive routine PPD screening at their outpatient obstetrician and pediatrician visits. Therefore, the aim of this study is to determine the frequency of PPD in mothers with infants admitted to the CICU through development of a screening program.

Design/Methods: Mothers with infants ≤ 6-months with CHD admitted to the Texas Children's Hospital CICU from 11/2023 to 4/2024 were included. They were screened with the Edinburgh Postnatal Depression Scale. Mental health resources were provided to all mothers, and psychology and social work were consulted for those with concerns for PPD (score ≥10) or self-harm. Additional demographic data was collected to assess for risk factors associated with PPD. Data was analyzed using Pearson Chi-Square test for categorical variables and Mann Whitney U test for continuous variables. In this adaptation, mothers were screened throughout the hospitalization and the changes in scores over time were compared using the Wilcoxon Signed Rank Test.

Results: Of 62 mothers screened, 27% initially screened positive for PPD. Of the 28 mothers still admitted to the CICU or the general cardiac floor at the 2-week follow up, 14% had a positive PPD re-screen, and the scores for all mothers had significantly decreased (median 4 vs 5, Z=-3.021, p=0.003). Of the 7 mothers still admitted 1 month later, 14% screened positive. Hospital length of stay (LOS), demographics, prior mental health concerns, and patient diagnosis were not significantly associated with increased PPD.

Conclusion/Discussion: We found the rate of PPD in mothers with infants admitted to the CICU to be higher than in the general population and in the NICU. PPD scores decreased over hospital LOS. Potential mechanisms for this include the use of the mental health resources provided at the initial screen and clinical improvement in their children over time. However, the rate of PPD appears to plateau at 1 month. Our study reveals the need to incorporate screening and resources as a part of family-centered care in a CICU, especially at admission. Larger studies are needed to further investigate the burden of PPD in this population and identify other associated risk factors.