452 - Identification of Adverse Maternal Mental Health and Social Drivers of Health through Standardized Screening in a NICU Follow-Up Clinic

Publication Number: 4443.452

April Perez-Moore, UMass Chan Medical School, Worcester, MA, United States; Ashley E. Galvin, UMass Memorial Children's Medical Center, Brighton, MA, United States; Michaela Olah, UMass Chan Medical School, Worcester, MA, United States; Margaret Parker, UMass Chan School of Medicine, Worcester, MA, United States; Arvin Garg, UMass Memorial Children's Medical Center, Worcester, MA, United States

Background: The American Academy of Pediatrics recommends screening and referral for adverse maternal mental health (MMH) and social drivers of health (SDOH) in clinical encounters. While standardized screening and referral have become more widespread in primary pediatric care, adoption in outpatient subspecialty care is less common.

Objective: Following the implementation of a standardized screening process for MMH and SDOH in a NICU follow-up (NFU) clinic, we aimed to 1) examine the rate of screening and referral; and 2) determine the prevalence of adverse MMH symptoms and SDOH.

Design/Methods: We initiated standardized screening for MMH and SDOH among children with English and Spanish-speaking mothers in the NFU clinic at a single tertiary center in 11/2024. We examined chart data from 11/2024-10/2025. Screening tools were sent to mothers via MyChart 1 week before the clinic visit. Results were reviewed and any appropriate referrals were given at the clinic visit. Mothers with infants < 12 months (n = 80) received MMH screening tools [Edinburgh Postpartum Depression Scale (EPDS) and Postpartum Bonding Questionnaire (PBQ)]. Mothers with children of any age (n = 189) received an SDOH screening tool [WE CARE]. We examined rates of depression (EPDS score ≥13), impaired postpartum bonding (PBQ score ≥26), any social risks (i.e. household insecurities) and any social needs (i.e. indicated desire for assistance).

Results: Among all eligible clinic visits, 69% completed MMH screening and 67% completed SDOH screening (Table 1). Among those who completed MMH screeners, 70% reported postpartum depression symptoms, with 14% scoring in the clinical range; 100% reported impaired bonding symptoms, with 2% scoring in the clinical range and 96% reporting infant-focused anxiety symptoms. 63% of all subclinical and clinical range scores were already in care of a mental health provider, and the remainder (37%) received a printed handout on community mental health resources. Among those who completed SDOH screeners, 20% reported ≥1 social risk (most commonly food insecurity), and 28% reported ≥1 social need (most commonly childcare and utilities). All mothers reporting a social need received support either by text message (61%) or printed handout (39%).

Conclusion(s): We achieved approximately two-thirds completion of MMH and SDOH screening and referral at a NFU clinic through automated delivery of screening tools via MyChart to mothers 1 week before a scheduled clinic visit. High rates of unmet social needs and symptoms of depression and infant-focused anxiety were reported.

Table 1. Screening Results
Results of Maternal Mental Health and Social Drivers of Health Screening