217 - Association between Elevated Maternal EPDS Scores and Developmental Delays in Children Aged 0–3 Years

Publication Number: 4214.217

Amna Haq, St. Barnabas Hospital, New Rochelle, NY, United States; Katherine Ericson, St. Barnabas Hospital, Bronx, NY, United States; Alexandra Gonzalez, SBH Health System, Bronx, NY, United States; Janine Adjo, SBH Health System, New York, NY, United States; Ilana Stein, St. Barnabas Hospital, Bronx, NY, United States; David Rubin, SBH Health System, White Plains, NY, United States

Background: Postpartum depression (PPD) affects up to 12% of mothers in the United States and is linked to adverse developmental, emotional, and behavioral outcomes in children. The Edinburgh Postnatal Depression Scale (EPDS) is well validated but how scores documented in routine pediatric visits relate to developmental outcomes in early childhood remains poorly understood. Understanding this relationship may improve early identification of at-risk children and guide timely interventions.

Objective: To determine whether elevated maternal EPDS scores correlate with developmental delays in children aged 0–3 years and to characterize the domains of delay most affected.

Design/Methods: A retrospective cohort study of 100 mother-infant dyads looking at EPDS scores at newborn, 2-, 4-, and 6-month visits was conducted. Elevated EPDS was defined as a score of ≥13 at any visit. Developmental outcomes were tracked through age 3 years, including type of delay (speech/language, motor, cognitive, social/emotional) and Early Intervention (EI) referrals. Descriptive statistics summarized maternal, infant, and demographic characteristics. Associations between elevated EPDS and child delays were examined using chi-square tests and logistic regression, adjusting for race, primary language, family history of developmental delay, maternal age, and prenatal drug use.

Results: 12.1% of mothers had an elevated EPDS at one or more visits, most often at 1-2 months postpartum. Overall, 24.2% of children had a developmental delay; of which 100% had speech/language delays, 16.7% had social/emotional delays, 8.3% had cognitive delays, and 4.2% had motor delays. Developmental delays occurred in 66.7% of children exposed to elevated maternal EPDS versus 18.4% of unexposed children (p < 0.001). 20.2% of children were referred to EI. Elevated EPDS was strongly associated with delays persisting after adjustment (adjusted OR 7, p< 0.01). Family history of developmental delay was an additional independent risk factor (adjusted OR 9, p< 0.001). Confounding factors were not significant predictors.

Conclusion(s): Elevated maternal EPDS scores in the first 6 months of postpartum were significantly associated with increased risk of developmental delays by age 3 years, particularly in speech and social-emotional domains. These findings underscore the need for early identification and treatment of maternal mental health concerns, along with timely developmental screening and support for at-risk children.