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Poster Session 3

(677) Antenatal mood disorders in placenta accreta spectrum

Friday, January 31, 2025
10:30 AM – 12:30 PM  
Objective: Placenta Accreta Spectrum (PAS) is a disorder of abnormal invasion of the placenta into or through the myometrium typically treated by cesarean hysterectomy and is associated with increased morbidity and mortality. PAS is associated with increased risks of postpartum mood disorders, but no studies have directly explored antenatal mood disorders in patients with PAS. We aimed to assess antenatal rates of depression and anxiety in those with PAS compared to those with a diagnosis of placenta previa and all pregnancies without these placental diagnoses.

Study Design: We performed a retrospective cohort study using data from the EpicCosmos dataset which combines information from >1500 hospitals and >260 million patients. We queried all pregnancies between 7/1/2015-7/1/2024. We identified those with a diagnosis of placenta accreta, increta, percreta, or placenta previa during pregnancy as well as new diagnoses of depression or anxiety during pregnancy using ICD-10 codes. Demographic and mood disorder data was compared between groups using chi-square for categorical variables and ANOVA for continuous variables.

Results: In our cohort, we identified 13,944 patients with PAS, 315,756 patients with placenta previa, and 8,153,662 other pregnancies. Mean maternal age was older in those with PAS (37 +/-6years). Placenta previa had a significantly higher association with antenatal diagnosis of depression (12.1%) and anxiety (18.2%) compared to both PAS (9.9% and 14.5%) and all other pregnancies (9.5% and 13.6%). PAS had non-significantly increased rates of depression, but significantly increased rates of anxiety compared to all other pregnancies (14.5% vs 13.6%). There were no differences between the subgroups of PAS.

Conclusion: In our large cohort, placenta previa was associated with higher rates of depression and anxiety. PAS was associated with higher rates of anxiety compared to all other pregnancies. Given these findings, further investigations focused on how to best screen for perinatal mood disorders and support those affected by placental conditions requiring surgical delivery is needed.