(PL7) THE ASSOCIATION BETWEEN SEXUALLY TRANSMITTED INFECTIONS AND DEPRESSION IN PREGNANCY

Background:
Depression involves intertwining socio-economic, behavioral, and health factors, creating a complex landscape for providers to address during pregnancy. Its association with limited healthcare access, risky sexual behaviors, and immunologic inflammation also complicates its relationship with sexually transmitted infections (STIs). This study aimed to assess the risks of STIs and preterm birth with self-reported depression among underserved pregnant patients.

Methods:
A retrospective cohort study was conducted of pregnant patients from 2/2019 to 5/2023 among singleton pregnant patients within a public health system in Southeastern Texas. Medical records for patients undergoing routine pregnancy screening during the study period were reviewed. Demographic data, self-reported depressive symptoms during pregnancy, STI data, and obstetric outcomes were recorded. Patients with depression were identified through self-reports to providers or Edinburgh Postnatal Depression Scale scores >10. A multivariable Poisson regression model with robust error variance was used to examine the association between depression and outcomes. Adjusted relative risks (aRR) with 95% confidence intervals (CI) were calculated.

Results:
Among the 20,111 singleton pregnant patients studied, 1,054 (5.24%) reported experiencing depression during pregnancy, and 3.2% were diagnosed with any STI (including gonorrhea, chlamydia, HIV, syphilis, or viral hepatitis). After multivariable adjustment, compared to patients without depression, those with depression had an increased risk of having any STI (aRR 1.48 95% CI 1.18-1.85). Notably, patients with depression were 1.78 (95% CI 1.16-2.75) times more likely to have syphilis compared to those without. Moreover, depression during pregnancy was associated with an increased risk of preterm birth ( <37 weeks) (aRR 1.56 95% CI 1.38-1.76).

Conclusion:
Our findings exemplify an elevated risk of STI, particularly syphilis, among pregnant patients with depression. Additionally, depression is associated with an increased risk of preterm birth among underserved patients.