589 - Social Needs as a Risk Factor for Positive Postpartum Depression Screens in Pediatric Primary Care

Postpartum depression (PPD) is a common condition that affects up to 20% of women within a year of giving birth, but lower socioeconomic status is associated with greater risk of PPD. A growing number of pediatric primary care settings are universally screening for both family-reported social needs and PPD at infant well-checks, providing an opportunity to study the relationship between social needs and PPD and inform possible targets for intervention.

Objective:

The goal of this study was to examine the association between self-reported social needs and PPD symptoms of mothers screened in pediatric primary care clinics.

Design/Methods:

This retrospective study used electronic health record data from pediatric patients (aged 0 to 6 months), whose mothers completed the Edinburg Postpartum Depression Scale (EPDS) screen and a standardized social needs screening during infant well-checks in a large pediatric primary care network between April 2021 and February 2022. Mothers were assessed for four self-reported social needs (food, housing, transportation, and utilities). Logistic regression was used to evaluate the association between reported social needs and a positive EPDS screen (score ≥10), adjusting for demographic and clinical characteristics and neighborhood-level poverty.

Results:

The study sample included 3,616 pediatric patients. The average age of the infants at the time of EPDS screening was 2 weeks, 49.5% were Non-Hispanic Black, 19.3% were Non-Hispanic White, 15.4% were Hispanic, and 15.8% were other racial or ethnic groups. The majority of the mothers of these infants spoke English (76.7%) and most infants were covered by public insurance (76.7%). Overall, 8.6% of mothers screened positive for PPD and 10.0% reported one or more social needs.  The adjusted odds of a positive depression screen were significantly higher among mothers who reported social needs compared to those who reported no needs (OR 4.18, 95% CI 3.11-5.61). The prevalence of all symptoms on the EPDS was significantly higher among those who reported social needs, relative to those reporting no needs. Mothers reporting social needs were 4.5 times as likely to report thoughts of self-harm.

Conclusion(s):

Self-report of social needs was significantly associated with positive PPD screens during infant well-checks. Social needs may be a target of future interventions addressing PPD in pediatric settings. Future research could evaluate whether improving care for social needs has added benefit for alleviating risk of PPD and its consequences, such as self-harm.