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Poster Session 1

Category: Clinical Obstetrics

Poster Session 1

(138) Association between placenta accreta spectrum and postpartum depression: a retrospective case-control study

Wednesday, February 11, 2026

10:30 AM - 12:00 PM

Submitting Author and Presenting Author(s)

Austin Oberlin, MD

Maternal Fetal Medicine Fellow
Yale University
New Haven, Connecticut, United States

Coauthor(s)

Sara Giuliano, MD (she/her/hers)

Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine
New Haven, Connecticut, United States
LL

Lisbet S. Lundsberg, MPH, PhD

Associate Research Scientist
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine
New Haven, Connecticut, United States
JC

Jennifer F. Culhane, MPH, PhD (she/her/hers)

Associate Research Scientist
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine
New Haven, Connecticut, United States
CP

Caitlin Partridge, BA

Senior JDAT Analyst
Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine
New Haven, Connecticut, United States
Colleen Sinnott, MD (she/her/hers)

Fellow
Division of Maternal Fetal Medicine, Yale School of Medicine
New Haven, Connecticut, United States
Rachel D. Seaman, MD

MFM Fellow
Yale School of Medicine
Yale School of Medicine, Connecticut, United States
YY

Yang Yang-Hartwich, PhD

Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine
New Haven, Connecticut, United States
Sonya S. Abdel-Razeq, MD

Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University
New Haven, Connecticut, United States
Olga Grechukhina, MD

Division of Maternal Fetal Medicine, Yale School of Medicine
New Haven, Connecticut, United States

Objective:
Placenta accreta spectrum (PAS) is a known risk factor for adverse mental health outcomes, though a more robust understanding of the relationship is needed. Here we aim to assess if: 1) PAS is associated with increased risk of postpartum depression (PPD) and if 2) the timing of the diagnosis and peripartum events further affect this risk.

Study Design:
This retrospective case-control study utilized deliveries at a single hospital system between 2013 – 2025. PAS cases were identified by ICD-10 codes and verified by manual review. Controls were matched 2:1 for age, parity, and mode of delivery. Cases were manually reviewed to determine timing of PAS diagnosis (antenatal or intrapartum). The primary outcome was PPD defined as either an ICD-10 code for depression or an Edinburgh Postnatal Depression Scale (EPDS) ≥10 up to one year postpartum. Bivariate analysis was performed followed by multivariate analyses using statistically significant co-variates. A sub-analysis of PAS patients, stratified by timing of the diagnosis and hysterectomy, was performed.

Results:
A total of 232 PAS cases and 464 matched controls were included (Table 1). In addition to PAS, non-married status, public insurance, chronic hypertension, hypertensive disorder of pregnancy (HDP), NICU admission, and pre-existing depression/anxiety were associated with increased odds of PPD. PAS remained an independent risk factor for PPD (aOR 3.10, 95% CI 1.56 – 6.16) along with preexisting diagnosis of anxiety/depression, language and HDP in a multivariate analysis (Table 2). Among PAS patients, neither hysterectomy nor timing of PAS diagnosis were associated with PPD.

Conclusion:
PAS is independently associated with 3-fold higher odds of PPD, even after controlling for pre-existing mental health disorders. This seems to be unrelated to hysterectomy status or timing of PAS diagnosis. Patients treated for PAS should be offered referral to mental health services and monitored closely for development of PPD.