Association of the previous history of maternal depression with post-partum depression, anxiety, and stress in the neonatal intensive care unit

Background: A history of depression in post-partum women who have infants admitted to the neonatal intensive care unit (NICU), is associated with higher risk for anxiety and stress. These conditions, which can be harmful to neonates, may be missed if maternal mental health screening is confined to depression. Objective: To determine if the history of a previously diagnosed depression would be associated with an increased risk of both postpartum depression and other stress-related disorders (i.e. anxiety and stress) among mothers with infants in the NICU. Design: Prospective survey questionnaire-based study conducted over a period of 9 months. Setting: Urban inpatient hospital-based setting, serving mainly low-income population. Participants: A total of 118 mothers of newborns who had been in the NICU for 7-29 days were approached for enrollment. Out of 118, 96 mothers consented to be screened and were asked to fill out the 21-item Depression Anxiety and Stress Scale-21 (DASS-21) questionnaire. Outcome: Primary outcome was to determine whether the history of a previously diagnosed depression is associated with an increased risk of both postpartum depression and other stress-related disorders (i.e. anxiety and stress). Results: Out of the 96 subjects, 36 (37.5%) had a previous history of depression before delivery (Group A) while 60/96 (62.5%) did not (Group B) and 46/96 (48%) of the mothers were positive for either depression, anxiety, or stress. This included 22/96 (22.9%) mothers who screened positive for depression; 37/96 (38.5%) who screened positive for anxiety; and 32/96 (33.3%) who screened positive for stress. After adjusting for maternal drug abuse, birth weight and maternal gravidity, the association between a previous history of depression and current depression scores were statistically significant (p = .04), as were the associations between previous depression and current anxiety and stress scores (p = .02 and p = .003, respectively). Conclusions and relevance: A history of depression, documented in the antepartum medical record, identifies post-partum women who are at higher risk for anxiety and stress. Screening for depression alone may lead to missing these mental health issues.