456 - The Impact of Maternal Mental Health on Infant Neurodevelopmental Outcomes during the COVID-19 Pandemic

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 456
Publication Number: 456.431

Brennan Higgins, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Rebecca Baer, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Scott P. Oltman, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Laura Jelliffe-Pawlowski, University of California, San Francisco, School of Medicine, San Francisco, CA, United States; Elizabeth E. Rogers, University of California, San Francisco, School of Medicine, San Francisco, CA, United States

Presenting Author(s)

Brennan V. Higgins, MD, MPhil (she/her/hers)

Fellow
University of California, San Francisco, School of Medicine
San Francisco, California, United States

Background:

The COVID-19 pandemic has led to increased anxiety and depression in pregnant people and has created economic hardships, food insecurity and childcare scarcities for new families.

Objective: Given the known relationship between maternal mental health and infant neurodevelopment, this study seeks to describe the impact of maternal mental health challenges during the pandemic on infant development at 6 months. This study also investigates the impact of COVID-19 exposure on neurodevelopmental outcomes.

Design/Methods: This cohort includes pregnant people enrolled in the Healthy Outcomes of Pregnancy for Everyone Study between July 2020 and May 2022. Health characteristics and neurodevelopmental outcomes were obtained from participant completed surveys at enrollment, 6 weeks and 6 months postpartum. Postpartum depression was assessed using the Edinburgh Postnatal Depression scale, postpartum anxiety using the Generalized Anxiety Disorder-7 score, and infant neurodevelopment using the 6-month Ages and Stages questionnaire. Adverse events during pregnancy included personal or family history of divorce or separation, incarceration, substance abuse, illness, domestic violence, food insecurity, or economic strain. The relative risk of medical complications and infant neurodevelopmental impairment was compared between dyads who experienced an adverse event, postpartum depression, postpartum anxiety, or COVID-19 and dyads with none of these experiences or diagnoses.

Results: Out of 214 mother-infant dyads, half of mothers experienced an adverse event, anxiety, or depression (29%, 16%, 34% respectively). Adverse events during pregnancy were associated with an increased risk of preterm birth (RR 4.0, 95% CI 1.0-14.5, p< 0.05) and prolonged maternal hospitalization (RR 2.2, 95% CI 1.1-4.4). Adverse events, anxiety and depression were not associated with increased risk of abnormal infant development at 6 months. COVID-19 infection was reported in 7% of mothers and 4% of infants and was not associated with increased risk of abnormal infant development.

Conclusion(s): The COVID-19 pandemic has been challenging for pregnant people and new families. While COVID-19 exposure has not been demonstrated to be associated with infant neurodevelopmental impairment in this study or others, the strain of the pandemic has led to increased maternal mental health challenges. Further study in this area with larger sample sizes is necessary. As we learn to live in COVID-19 pandemic, investigation of resilience factors allowing families to overcome these challenges without infant health or neurodevelopmental consequences is important.