(065) Perineal and Pelvic Pain and Maternal Mental Health

Introduction Research indicates that sexual health is an important part of wellbeing in women, yet is under-researched in the context of the peripartum period. Pelvic and perineal pain is associated with decreased sexual health (Kendall et al., 2015), which in turn, is associated with decreased quality of life and comorbid mental and physical health conditions. The majority of women with pelvic and perineal pain (which can be affected by pregnancy) experience sexual dysfunction. The biopsychosocial model is commonly used to conceptualize the etiology and management of sexual dysfunction (Parish et al., 2019). The perinatal and postpartum period often encompasses changes in several biopsychosocial facets (eg, hormones, social role changes). Yet there is little research on the association between pelvic pain and mental health specifically amongst perinatal women. A meta-analysis found increased odds of postpartum depression in women with postpartum pain (Lu & Shen, 2023). Earlier identification of such an association between mental and pelvic health may allow for earlier intervention. In addition, little research has specifically examined the role of posttraumatic stress disorder (PTSD) in perinatal pelvic health, especially in the perinatal period. Comorbidity of perinatal mental and pelvic/sexual health conditions likely worsen quality of life in the perinatal period, which can have downstream effects on relationship functioning and overall health. Additional research is needed to examine the association between pelvic pain and high-risk maternal mental health conditions. Objective The aim of this study was to examine the association between high-risk mental health conditions and perinatal and pelvic pain in women who gave birth. Methods This was a retrospective chart review study of diagnostic codes (depressive disorder noted in pregnancy; prior posttraumatic stress disorder [PTSD] diagnosis, and pelvic and perineal pain diagnosis while pregnant) and mean scores on the Edinburg Postnatal Depression Scale (EPDS) of women who gave birth at a large metropolitan hospital system in the Midwes, t between November 2020 to November 2025. Results A chi-square test of independence revealed a significant association between prenatal diagnoses of depressive disorder pelvic and perineal pain, X^2(1) = 154.26, p < .001. About 34% of women with pelvic and perineal pain, and 22% of women without pelvic and perineal pain were also diagnosed with depression. Descriptive statistics showed that highest mean scores on the EPDS in pregnancy in women with perineal and pelvic pain (M = 6) and women without perineal and pelvic pain (M = 4). A chi-square test of independence revealed a significant association between prior diagnosis of PTSD and prenatal diagnosis of pelvic and perineal pain, X^2(1) = 42.09, p < .001. About 4% of women with pelvic and perineal pain, and 2% of women without pelvic and perineal pain were diagnosed with prior PTSD. Conclusions Results provide preliminary evidence of comorbidity in prenatal perineal and pelvic pain and maternal PTSD and depression. This data can inform future research, and potentially interdisciplinary approaches to sexual health in postpartum women. The study is limited by use of retrospective chart review data collected from women in one region of the US. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: past consultant for strategic sciences, LLC, and carespace health LLC.