(715) The association with severe lacerations and increased risk of perinatal depressive symptoms

We performed a retrospective cohort study of patients who had a vaginal delivery between July 1, 2021-July 1, 2023. Perineal lacerations were classified as either severe (3^rd or 4^th degree) or non-severe (1^st, 2^nd degree or intact perineum). Positive perinatal depressive symptoms were defined as a score of ≥10 on the Edinburgh Postnatal Depression Scale (EPDS) or positive response to question 10 at the 6-week postpartum visit. Univariable analyses of demographic and clinical characteristics and positive EPDS scores at the 6-week postpartum visit were performed. Multivariable logistic regression was performed using variables determined a priori (multiparity, gestational age (GA) at delivery, mode of delivery, race/ethnicity, exclusively breastfeeding at 6-weeks postpartum) to evaluate the independent association of severe perineal laceration and positive EPDS scores at the 6-week postpartum visit.

Results: 689 patients met inclusion criteria with 661 (95.9%) with non-severe perineal lacerations and 28 (4.1%) with severe. In univariable analysis, those with severe perineal lacerations were more likely to be White non-Hispanic or of Asian race/ethnicity, be multiparous, have a lower admission body mass index, have an operative assisted delivery, be delivered at a later GA, have greater blood loss, have a shoulder dystocia or episiotomy, and require a laceration revision within 6 weeks postpartum compared to those without (Table 1). Patients with severe lacerations were less likely to have a positive EPDS at 6-weeks postpartum but these results were not significant (7.1 vs 9.9%, p = 0.66) and these findings persisted in adjusted analysis (aOR 0.62, 95%CI 0.13, 2.84).

Conclusion: Severe perineal lacerations was not associated with an increased risk of perinatal depressive symptoms at the 6-week postpartum visit.