64 - Transitioning from NICU to Home: Understanding the Evolution of Postpartum Depression in Birthing Parents of Preterm Infants

Publication Number: 4063.64

RACHAEL E. VILLARI, New York Medical College, Mamaroneck, NY, United States; Marjorie Y. Leon, Boston Children's Health Physicians, Westchester Medical Center, Valhalla, NY, United States; Srinidhi Gadula, New York Medical College, Valhalla, NY, United States; Jordan S. Kase, New York Medical College, Valhalla, NY, United States

Background: Postpartum Depression (PPD) is one of the most common conditions affecting birthing parents (BPa) in the U.S., with higher rates reported among those whose preterm infants are admitted to the Neonatal Intensive Care Unit (NICU). Little is known about how PPD symptoms evolve in BPa of preterm infants as families transition from the NICU setting to home. The Edinburgh Postnatal Depression Scale (EPDS) is a validated PPD screening tool, with scores ≥10 or endorsement of item #10 (self harm and/or suicidal ideation) indicating a positive screen.

Objective: To understand how pre- and post- discharge (DC) PPD rates evolve for BPa of very preterm infants (VPT: ≤32 weeks gestational age [GA] at birth) during the transitional period from NICU to home.

Design/Methods: In this ongoing prospective cohort study, BPa of VPT infants admitted to the NICU and DC’d to home completed the EPDS at two time points: a) during infant hospitalization (day 14-35 of life); b) within two weeks post infant NICU DC. Demographic, antenatal, and neonatal health conditions were compared by EPDS screening status (positive vs. negative). Chi-square tests were used to examine associations between categorical variables and EPDS results, and independent-samples t-tests were used for continuous variables. A p-value of < 0.05 was considered statistically significant.

Results: During infant NICU hospitalization, 25% of BPa screened positive for PPD compared to 4% post-NICU DC. No BPa with negative PPD screens during infant NICU hospitalization transitioned to positive PPD screens post-NICU DC. 17% of BPa with positive PPD screens during infant NICU hospitalization transitioned to negative PPD screens post-NICU DC. A personal or family history of mental illness and the presence of chronic medical conditions were significantly associated with positive PPD screens during infant NICU hospitalization. Additional associations between positive screens for both inpatient and outpatient settings are summarized in tables 1-3.

Conclusion(s): Rates of positive PPD screening among BPa of VPT infants exceeded those reported in the general population (12-16%), highlighting a heightened mental health burden within this group. Notably, many parents experience symptom improvement after infant NICU DC, suggesting a potential alleviation of stressors once home. These findings underscore the need for ongoing PPD surveillance and targeted mental health resources for BPa of VPT infants, particularly those with preexisting or familial health conditions, to support continuity of care through the critical transition from NICU to home.

Table 1: Birthing Parent Sociodemographic Medical History
BPaSociodemographicsTable.pdfAssociations between birthing parent sociodemographic medical history and EPDS results.

Table 2: Birthing Parent Antenatal Conditions
AntenatalConditions.pdfAssociations between birthing parent antenatal conditions and EPDS results.

Table 3: Neonatal Health Conditions
NeonatalConditionsTable.pdfAssociations between neonatal health conditions and birthing parent EPDS results.