(245) The relationship between agentry during antepartum hospitalization and postpartum depression or anxiety symptoms

Psychological well-being during pregnancy predicts postpartum mental health, yet few tools exist to identify modifiable factors in high-risk populations. The Antepartum Agentry Scale (AAS), adapted from the Labor Agentry Scale, measures perceived control among individuals hospitalized during pregnancy. We aimed to evaluate whether AAS scores during antepartum hospitalization are associated with symptoms of depression and anxiety at six weeks postpartum.

Study Design:
In this prospective cohort study, the AAS, Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder (GAD-7) were administered to individuals hospitalized due to pregnancy complications. Follow-up PHQ-9 and GAD-7 surveys were emailed six weeks postpartum. Participants were categorized by AAS scores as “Low” (< 1 standard deviation [SD] below mean) “Average” (± 1 SD) or “High” ( >1 SD above mean). Cuzick’s test for trend evaluated associations between AAS category and postpartum mental health symptoms. Mediation analyses examined the extent to which the relationship between antepartum and postpartum mental health symptoms was partially explained by the AAS.

Results:
Of the 60 enrolled participants, 43 (72%) completed the postpartum survey. Characteristics of the analyzable sample are shown in Table 1. Higher AAS categories were associated with significantly lower PHQ-9 and GAD-7 scores (Table 2). Mediation analysis indicated that AAS score mediated 26% (95% CI –23% to 76%) of the relationship between antepartum and postpartum PHQ-9 scores, and 21% (95% CI –33% to 75%) of the relationship between antepartum and postpartum GAD-7 scores, although these did not reach statistical significance.

Conclusion:

Higher perceived control during antenatal hospitalization was associated with lower symptoms of postpartum depression and anxiety. Although mediation results were nonsignificant, these findings suggest that antepartum agentry is a potential target for intervention to improve postpartum mental health outcomes in high-risk populations.