522 - Maternal Mental Health Problems, Meds, and Preterm 12- and 24-month neurodevelopmental outcomes

Publication Number: 522.5726

Julia P. Mayne, Women & Infants Hospital of Rhode Island, Providence, RI, United States; Katheleen Hawes, The Warren Alpert Medical School of Brown University, Carolina, RI, United States; Elisabeth McGowan, Women & Infants Hospital of Rhode Island, Barrington, RI, United States; Richard Tucker, Women & Infants Hospital of Rhode Island, Providence, RI, United States; Betty R. Vohr, Women & Infants Hospital/ Brown Medical School, Providence, RI, United States

Background: Nearly 1 in 5 women experience a mental health (MH) problem, including anxiety or depression, during pregnancy. Public insurance, substance use, domestic violence, and involvement in Protective services are risk factors associated with adverse of child outcomes.

Objective: To assess if children of mothers with MH problems are at ↑ risk of developmental delay at 12- and 24-month follow up.

Design/Methods: A retrospective analysis of a prospectively enrolled cohort of preterm (PT) infants born Jan. 2018-Dec. 2020, cared for in the NICU, and seen in Follow-Up. Infants were stratified by the presence of a maternal MH problem at the time of birth (anxiety, depression, or both) vs. controls. Maternal social risk factors, prescribed medications, substance use, and infant medical risk factors were collected. The primary outcome was Bayley cognitive, language, and motor scores. Groups were compared using t-tests/Wilcoxon tests for continuous variables and chi-square tests for categorical variables. Regression models were run to identify predictors of Bayley scores.

Results: Mothers with MH problems at birth had ↑ rates of single status, public insurance, prescribed medication, substance use disorder, domestic violence, and involvement in protective services compared to controls (Table 1). Infants of mothers with MH problems were smaller, had ↑ BPD, home oxygen, IVH, and hospital days and ↓ breastmilk at discharge vs. controls (Table 1). 12-month cognitive scores (p=0.03), motor scores (p=0.04), and fine motor scores (p=0.02) were ↓ among PTs of mothers with a MH problem at birth compared to controls (Table 2). Similar findings were seen at 24 months (Table 2). Regression models showed that public insurance and non-English speaking independently predicted low language and cognitive scores, whereas maternal prescribed medications predicted low motor scores (Tables 3 and 4).

Conclusion(s): PTs born to mothers with MH problems had ↓ 12- and 24-month Bayley scores. Prescribed medications for maternal MH disorders predicted ↓ 12- and 24-month motor scores. Maternal MH problems are often associated with multiple disparities and comorbidities. Provider awareness of risks and needs for support and intervention are essential.

Table 1. Maternal and infant characteristics


Table 2. 12-month and 24-month Bayley Scores by maternal mental health (MH) problem at birth


Table 3. Linear Regression Models to Predict Mean Bayley Scores and Table 4. Logistic Regression Models to Predict Bayley Scores <85