(902) The relationship between household income and maternal psychosocial outcomes following prenatal myelomeningocele repair

To evaluate the relationship between household income and maternal psychosocial outcomes at 12 and 30 months following delivery in patients who underwent prenatal myelomeningocele (MMC) repair.

Study Design:

This was an unplanned secondary analysis of individuals undergoing prenatal MMC repair in the Management of Myelomeningocele Study (MOMS) who completed maternal psychosocial surveys by 30 months after delivery. Bivariate analyses were performed comparing families with household income above versus below $50,000 at the time of randomization, which corresponded to the median U.S. household income during the study period. Outcomes included scores from the Family Resource Scale (FRS), Family Support Scale (FSS), Impact on Family Scale, Parenting Stress Index, and Beck Depression Inventory. Wilcoxon rank-sum tests were used for continuous variables and Fisher’s exact or chi-squared tests for categorical variables. A p-value < 0.05 indicated statistical significance.

Results:

A total 83 individuals were assessed at 12 months, and 86 at 30 months. Of these, 64% and 70%, respectively, reported a household income above $50,000. While significant sociodemographic differences were noted between groups, there was no difference in lesion level, lateral ventricular size, clubfoot, operative duration, and gestational age at delivery (Table 1). Participants with lower household income had significantly lower FRS scores at 12 (133.5 v. 120, p = 0.002) and 30 months (133.1 v. 121.6, p = 0.02), as well as lower FSS scores at 12 months (49.8 v. 42.8, p = 0.009) indicating more challenges. Participants with lower income reported greater personal and financial strain at 12 months; personal strain persisted at 30 months. No statistically significant differences were observed in other outcomes.

Conclusion:

Lower household income at the time of prenatal intervention is associated with persistent disparities in maternal psychosocial and financial well-being. These findings highlight the importance of assessing maternal psychosocial well-being and addressing socioeconomic factors during counseling and post-operative care.