Postpartum Depression in Mothers of Infants With Cleft Lip and/or Palate

This study describes postpartum depression rates and risk factors for mothers with infants with cleft lip and/or palate as postpartum depression has been associated with a range of negative maternal and child outcomes. A retrospective chart review from August 2009 to May 2015 included medical diagnoses, demographics, receipt of prenatal diagnosis, and the Edinburgh Postnatal Depression Scale (EPDS). Mothers (N = 206) had infants (59.2% male; mean age in weeks 5.1 ± 6.9) with isolated cleft lip (18%), cleft palate (22.8%), or cleft lip and palate (59.2%). Mothers ranged from 16 to 45 years old (mean age 29 ± 6.2) and half had received a prenatal diagnosis. Patients mostly had public insurance (57.8%) and represented diverse ethnicities. Based on the EPDS, 11.7% of mothers met the depression cutoff of 10 or higher. The majority endorsed self-blame (68.9%), difficulty coping (59.2%), and feeling anxious (57.3%). Mothers of infants with cleft lip or cleft lip and palate who did not receive a prenatal diagnosis had higher total EPDS scores, anxiety, and incidence of feeling scared. Higher EPDS scores were predicted by not having a prenatal diagnosis and by older maternal age. Mothers of infants with a cleft had similar rates of postpartum depression as the general population; however, those who were older and who did not receive a prenatal diagnosis endorsed more symptoms. Prenatal diagnosis may contribute to positive maternal postpartum adjustment. Providers should incorporate screening for risk factors into their evaluation and treatment planning. Address correspondence and reprint requests to Alexis L. Johns, PhD, ABPP, Children's Hospital Los Angeles, 4650 Sunset Boulevard, Mailstop 96, Los Angeles, CA 90027; E-mail: ajohns@chla.usc.edu Received 12 September, 2017 Accepted 13 November, 2017 Portions of this article were presented at: 73rd Annual American Cleft Palate-Craniofacial Association Conference in April 2016 in Atlanta, GA; 74th Annual American Cleft Palate-Craniofacial Association Conference in March 2017 in Colorado Springs, CO. The authors report no conflicts of interest. © 2018 by Mutaz B. Habal, MD.

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