(449) Is severity of congenital cardiac disease associated with increased perinatal mood symptoms

To assess whether fetal cardiovascular disease severity is associated with perinatal mood symptoms in mothers with prenatal diagnosis of congenital heart disease (CHD). 

Study Design:

Expectant mothers completed validated screens for depressive, anxiety and traumatic symptoms following diagnosis of CHD (Time 1) and immediately postpartum (Time 2). Postpartum Depression Screening Scale (PDSS) was used to identify symptoms of depressive risk (≥ 60 and ≥ 21) and Impact of Events Scale (IES-R) was administered to determine traumatic risk (≥ 33) in a cohort of patients at a single fetal therapy center from December 1, 2012 through July 1, 2017. A fetal cardiologist reviewed echocardiographic imaging blinded to clinical course and assigned a Fetal Cardiovascular Disease Severity Score (FCDSS score severity range:1, lowest thru 7, highest) based on previously validated scale (Davey et al., 2014). Demographics were collected including mental health history confirmed by a licensed perinatal psychologist. Statistical analysis was performed using Fisher’s exact test and chi squared test for categorical variables and Mann-Whitney U test for continuous variables.

Results:

Depressive risk was 47% (n=177/380) during pregnancy and 34% (n=129/380) postpartum. Anxiety and traumatic stress risk was 14% (n=52/380) during pregnancy and 4.7% (n=18/380) postpartum. Increasing FCDSS did not corelate with clinical depressive, anxiety or traumatic stress risk during pregnancy or postpartum (Table 1). While FCDSS was not associated with increased risk for mood symptoms, patients with a FCDSS ≥ 5 (n= 197), received more psychosocial support during pregnancy (Table 2). History of maternal mental health diagnosis strongly correlated with increased depressive risk in pregnancy (67% vs 43%, p=0.001) and postpartum (50% vs 31%, p=0.009).

Conclusion:

Severity of fetal cardiovascular disease is not associated with additional depressive, anxiety and traumatic risk. Pre-existing maternal mental health diagnosis is strongly associated with perinatal mood symptoms emphasizing the importance of perinatal psychosocial support.