796 - The Case for Post Partum Depression and Anxiety Screening during Ponseti casting

Publication Number: 796.6932

Melissa Bent, Children's Hospital Los Angeles, Los Angeles, CA, United States; Abigail Padilla, Children's Hospital Los Angeles, Los Angeles, CA, United States; Annika Y. Myers, CHLA, Los Angeles, CA, United States; Taylor Cosanella, Children's Hospital Los Angeles, Los Angeles, CA, United States; Rachel Goldstein, Children’s Hospital Los Angeles, Los Angeles, CA, United States

Background: Congenital clubfoot is the most common musculoskeletal birth anomaly affecting infants. It may also have a profound impact on the psychological well-being of parents. Previous studies have recognized the importance of understanding the psychosocial impact of clubfoot on families.

Objective: The purpose of this study is to determine the prevalence of a positive screening for postpartum depression and/or anxiety symptoms for mothers whose infants are undergoing Ponseti casting for clubfoot.

Design/Methods: The Edinburgh Postnatal Depression Scale (EPDS) screening tool was administered to a convenience sample of biological mothers whose children were being treated for clubfoot at a single pediatric tertiary care hospital between February 2023 and October 2024. Patients were included if they were less than 4-month-old and had no prior clubfoot treatment. Data was collected at initial visit through standardized EPDS assessment and electronic medical record. Mothers that screened positive were evaluated by the orthopedic clinical psychologist.

Results: There were 58 mothers that completed the EPDS in clubfoot clinics. The mean score was 3.98 ± 3.78 (range 0-15). The prevalence of mothers who met the clinical cutoff for postpartum depression, defined as an overall score ≥10, was 5/22 (8.6%). A majority of mothers screened positive for post-partum anxiety symptoms and endorsed difficulty coping (53.45%) and feeling anxious (53.45%). For those who screened positive for depression and/or anxiety symptoms, there was not an association with idiopathic or nonidiopathic clubfoot (p=0.33), prenatal diagnosis (p = 0.11), other medical diagnoses (p = 0.20) race/ethnicity (p = 1.00). Patients who were diagnosed with clubfoot were seen by the clinic psychologist during the initial visit if time allowed. 11 patients ( 19%) met with the clinic psychologist more than one time.

Conclusion(s): The EPDS screening tool has a role in the pediatric orthopedic subspecialty clubfoot clinic. Most mothers screened positive for post-partum anxiety and/or depression symptoms. This prevalence is similar to reported literature in the general population2. This study highlights the importance of incorporating postpartum depression screening in clubfoot clinics to address the mental health needs of families undergoing Ponseti method clubfoot care. Post-partum anxiety and depression is prevalent in mothers of infants with a clubfoot diagnosis, and post-partum anxiety and depression screening is important to address the needs of families undergoing clubfoot treatment.