113 Advanced maternal age and its impact on the NTSV cesarean delivery rate

Abstract

OBJECTIVE:To evaluate the incidence of postpartum depression in mothers who endured maternal-neonatal separation at delivery and in the postpartum period due to their SARS-CoV-2 positive PCR status. STUDY DESIGN: We conducted a retrospective cohort study of women who delivered during the height of the COVID-19 pandemic from March 18th to May 12th 2020, when maternal-neonatal separation was recommended for SARS-CoV-2 positive mothers by the American Academy of Pediatrics. We excluded women who were less than 18 years of age at the time of delivery and those who experienced an IUFD or neonatal death. We investigated the difference in postpartum depression rates between SARS-CoV-2 positive and SARS-CoV-2 negative mothers. SARS-CoV-2 status was determined using a nasopharyngeal PCR swab upon admission to labor and delivery. We conducted analyses using Fischer Exact Tests, where a p-value of less than 0.05 was considered to be statistically significant. RESULTS: The incidence of postpartum depression was 2.4% in SARS-CoV-2 negative mothers versus 10.3% in SARS-COV-2 positive mothers with a p-value of 0.02. The relative risk of developing PPD in SARS-CoV-2 positive mothers was 3.73 with a 95% confidence interval of 1.03-13.4 with a p-value of 0.04. CONCLUSION: There was increased incidence and relative risk of postpartum depression in patients who were positive for SARS-CoV-2. Patients and providers should be made aware of this possible association. One possible contributing factor to the increased incidence of postpartum depression may have been maternal-neonatal separation. Current CDC evidence demonstrates low risk of neonatal acquisition of SARS-CoV-2 from asymptomatic positive mothers. The results of this study suggest another reason to follow the updated American Academy of Pediatrics SARS-CoV-2 recommendation, that asymptomatic mothers positive for SARS-CoV-2 should be allowed to room in with their neonate and not endure maternalneonatal separation.