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

Introduction: Pregnant people carrying fetuses with congenital anomalies are at increased risk for perinatal mood and anxiety disorders (PMADs). Limited data exists 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 fetal myelomeningocele (fMMC) repair Methods: Retrospective cohort study of patients who underwent OMFS for fMMC repair 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 one day post birth. Demographics, perioperative factors, surgical and delivery outcomes, and type of psychosocial support interactions were collected. Results: 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). Conclusions: Women undergoing OMFS for fMMC repair 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.