(115) Factors associated with postpartum depression symptoms following antepartum hospitalization

Hospitalized antepartum patients are at increased risk for postpartum depression (PPD), which can contribute to adverse maternal and infant health outcomes. Developing approaches to identify those at highest risk of PPD would enable timely and targeted intervention. We aimed to identify factors associated with PPD symptoms in hospitalized antepartum patients and to assess their predictive utility.  

Study Design:

This retrospective cohort study included pregnant individuals hospitalized due to medical or obstetric complications in a referral center, 2012–2025. Data were extracted from the electronic health record, including demographics, medical history, and postpartum Edinburgh Postnatal Depression Scale (EPDS) score collected within 8 weeks of delivery. Primary outcome was EPDS score ≥ 10, indicating PPD symptoms. We performed bivariate analyses and multivariate logistic regression modeling. Potential predictors were identified based on a priori clinical relevance; the least absolute shrinkage and selection operator (LASSO) was used for final variable selection. Receiver operating characteristic (ROC) curve analyses assessed model discriminatory ability. 

Results:

Among 4161 included individuals, 1291 (31%) reported PPD symptoms. Cohort characteristics stratified by PPD symptoms are presented in Table 1. Multivariate logistic regression modeling showed that certain demographic and clinical factors were associated with PPD symptoms (Figure 1). Discriminatory ability of the multivariate model was modest, with area under the curve (AUC) of 0.70 (95% CI 0.68 – 0.71). 

Conclusion:

One in three individuals hospitalized during pregnancy reported PPD symptoms. While certain demographic and clinical factors are associated with PPD symptoms, their overall ability to accurately identify those at increased risk is limited, reducing their utility in guiding targeted interventions. These findings support that postpartum mental health services are needed for individuals who experience antenatal hospitalization and highlight the need for universal mental health service provision for this high-risk population.