803 - Maternal anxiety and depression relate to maternal NICU visitation, feeding, and outpatient follow-up compliance for very preterm infants

Poster Number: 803
Publication Number: 803.249

Brittney D. Dioneda, Yale-New Haven Children's Hospital, New Haven, CT, United States; Desiree Leverette, Yale-New Haven Children's Hospital, New Haven, CT, United States; Veronika Shabanova, Yale University, New Haven, CT, United States; Sarah N. Taylor, Yale University, MADISON, CT, United States; Leslie M. Harris, Yale-New Haven Children's Hospital, New Haven, CT, United States

Background: The lasting effects of maternal mental health on the health and well-being of the newborn child have been well documented and recognized as a public health priority.

Objective: We aimed to identify how maternal depression and anxiety relate to maternal NICU visitation of preterm infants, maternal milk feeding at discharge, post-discharge infant follow-up, emergency department (ED) visits, and rehospitalization.

Design/Methods: We conducted a retrospective cohort study of infants born ≤32 weeks gestation and their mothers at 2 NICUs 01/2019-03/2020; infants who survived to discharge were included. Nurse-documented maternal NICU visitation, mother and infant characteristics, and outcome-related data were abstracted from electronic health records. Depression and anxiety history were defined as an ICD-10 diagnosis in the maternal record. We used adjusted regression analyses to determine maternal NICU visitation and associations of maternal depression and anxiety with NICU visitation, maternal milk feeding, and infants’ completed subspecialty clinic appointments, ED visits, and rehospitalizations in the health system in the year after NICU discharge.

Results: Among the 156 infants and their 139 mothers (Table 1), overall maternal NICU visitation was 4.5 days/week. On average, mothers with a history of depression visited 3.8 days/week (95% CI 3.3, 4.2) while mothers without visited 4.6 days/week (95% CI 4.4, 4.8), p=0.01. Mothers with a history of anxiety visited on average 4.0 days/week (95% CI 3.6, 4.5) while mothers without visited 4.6 days/week (95% CI 4.4, 4.8), p=0.04. Table 2 shows how maternal depression and anxiety related to discharge and post-discharge outcomes. Infant feeding of any maternal milk at time of discharge was less among mothers with depression, but not among mothers with anxiety. Both maternal depression and anxiety were associated with lower percentages of completed subspecialty appointments within one year of discharge. Neither maternal depression nor anxiety were associated with the infants’ number of ED visits or rehospitalizations.

Conclusion(s): Maternal history of depression and anxiety were negatively associated with NICU visitation and infant subspecialty appointment completion after discharge. Maternal depression, but not anxiety, was associated with lower odds of maternal milk feeding at time of discharge. Given the potential impact of maternal depression and anxiety on infant health both in and beyond the NICU, further work is needed to better support the mental health needs of families during NICU admissions.