(393) Postpartum EPDS Scores in Prenatally Suspected Placenta Accreta Spectrum

Thursday, January 30, 2025

4:00 PM – 6:00 PM

Submitting Author and Presenting Author(s)

Alesha M. White, MD (she/her/hers)

Fellow
University of Texas Southwestern Medical Center
Dallas, Texas, United States

Coauthor(s)

EC

Ellery R. Cohn, MD

University of Texas Southwestern Medical Center
Dallas, Texas, United States
MM

Mishel Malik, BA

University of Texas Southwestern Medical Center
Dallas, Texas, United States
JP

Jessica E. Pruszynski, PhD

University of Texas Southwestern
Dallas, Texas, United States
Catherine Y. Spong, MD

Professor and Chair
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Christina L. Herrera, MD

Assistant Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States

Objective: Placenta accreta spectrum (PAS) is a life-threatening condition and may impact mental health. Peripartum hysterectomy is also independently associated. This study's objective was to assess the association of prenatally suspected PAS and Edinburgh Postnatal Depression Scale (EPDS) scores.

Study Design: This was a case-control study of singleton pregnancies from 2010 to 2024. Cases with prenatal suspicion of PAS based on imaging were matched to controls by age, parity, cesarean delivery and whether the cesarean was scheduled. Those with fetal anomalies or stillbirth after 24 weeks gestation were excluded. Postpartum EPDS scores were compared with patients with prenatal suspicion of PAS by hysterectomy status using the Kruskal-Wallis test and to matched controls using the Wilcoxon signed rank test.

Results: Of 184 cases matched 101 had available EPDS scores. This was significantly different from matched controls where 150 scores were available (55% vs 82% %, p< 0.001). Sixty-two (61.4%) of cases with EPDS scores underwent hysterectomy. Median EPDS scores were not statistically higher (3 (1-7) vs 3 (1-4), p = 0.114) comparing cases to matched controls. Among cases, patients that underwent hysterectomy had significantly higher median EPDS scores (4 (2-8) vs 2 (0-5), p = 0.049). The percentage of EPDS scores that would require intervention and referral (score of ≥13) were not significantly different between cases and controls (p=0.206), however all five cases with EPDS score ≥13 had a hysterectomy compared to none in the controls (p=0.048).

Conclusion: Patients with prenatal suspicion of PAS were less likely to attend their routine postpartum visit. Compared to matched controls, these patients did not have higher postpartum EPDS scores following delivery but performance of hysterectomy increased EPDS score significantly. Providing counseling services in pregnancy and enhanced postpartum interventions may be of benefit.