Risk for Postpartum Depressive Symptoms Among Pregnant Women in a Tertiary Care Setting with and Without a Positive COVID-19 Test

Objective: The objective of this study was to systematically examine the risk for postpartum depressive symptoms based on COVID-19 positivity status during pregnancy.Methods: This is a retrospective matched cohort study of pregnant patients admitted to labor and delivery units from March through December 2020. Patients were administered three brief screening questions for postpartum depression followed by the Edinburgh Postnatal Depression Scale (EPDS).Results: 129 patients with positive COVID-19 tests were matched with 516 COVID-19 negative controls. Similar proportions in each group responded affirmatively to at least one screening question for postpartum depression (14/129, 10.9% vs. 72/516, 14.0%; p=.35). The proportion of EPDS scores >9 did not differ significantly between the two groups. In multivariable mixed effects logistic model, prior history of psychiatric illness was the only significant predictor of an EPDS score >9 (OR 2.57, p=.002) or a positive brief screen for postpartum depressive symptoms (OR 2.93, p<.001).Conclusions: No significant differences in the rates for postpartum depressive symptoms were observed among pregnant women with and without a positive COVID-19 test during pregnancy, suggesting that testing positive for COVID-19 during pregnancy was not associated with an increased risk for the development of depressive symptoms during the acute postpartum period.