Perinatal Mood and Anxiety in Women Undergoing Open Maternal-Fetal Surgery for Myelomeningocele Closure

Pregnant people carrying fetuses with congenital anomalies are at increased risk for perinatal mood and anxiety disorders (PMADs). Limited data exist regarding the impact of maternal-fetal surgery on maternal mental health. This study aimed to evaluate PMAD symptoms in pregnant people who opted for open maternal-fetal surgery (OMFS) for spina bifida (fMMC) closure.

This was a retrospective cohort study of patients who underwent OMFS for fMMC closure at a level III fetal center. The Postpartum Depression Screening Scale (PDSS) and Impact of Event Scale-Revised (IES-R) were administered at initial evaluation and 1 day post-birth. Demographics, perioperative factors, surgical and delivery outcomes, and type of psychosocial support interactions were collected.

Of 171 pregnant people who underwent OMFS, 91 (50.8%) screened positive for depressive symptoms and 27 (15.1%) for anxiety/traumatic stress at the initial evaluation, prior to OMFS. After delivery, 45 (25.1%) screened positive for depressive symptoms and 2 (0.01%) for anxiety/traumatic stress symptoms. There was a statistically significant decrease in positive screen rates in the postpartum period for depressive and anxiety/traumatic stress (p < 0.001).

Women undergoing OMFS for fMMC closure are at a high risk for PMAD symptoms in the perinatal period. Routine mental health screening in pregnancy and integrated psychosocial support are essential in caring for this unique population.