Lack of Association Between Contraception Initiation at Delivery Discharge and Six-Week Postpartum Psychopathology Symptoms [ID 1168]

INTRODUCTION: Conflicting associations between delivery contraceptive choice and maternal psychological well-being in the early postpartum period are not fully understood. We examine the association between local versus systemic contraceptive options in an inner-city population. METHODS: We gathered data including background demographics, contraceptive choice at delivery, and 6-week postpartum visit Patient Health Questionnaire-9 (PHQ-9) depression scores from patients giving birth between September 1, 2020, and March 30, 2022. Depression symptomatology was compared across patients who chose local contraception (ie, intrauterine device) versus systemic hormonal contraception (ie, medroxyprogesterone acetate injection, etonogestrel implant, etonogestrel-ethinyl estradiol ring, norelgestromin/ethinyl estradiol transdermal patch, norethindrone pills), and no contraception using chi-squared and multivariable logistic regression. RESULTS: Among 3,644 patients, 57% received contraception at discharge. We did not identify an association between local, systemic, or no contraception and PHQ-9 scores at the 6-week postpartum visit in univariate or multivariable logistic regression analyses. However, odds of moderate/severe depression symptomatology scores were elevated with previous psychiatric diagnosis (odds ratio [OR] 3.58; 95% CI, 2.15–5.97), Black race (OR 2.02; 95% CI, 0.91–4.48), and being separated/divorced/widowed as compared to married/life partnership (OR 5.08; 95% CI, 1.35–19.14). CONCLUSIONS/IMPLICATIONS: We found contraceptive type initiated at delivery is not associated with elevated PHQ-9 scores at 6 weeks postpartum. However, several psychiatric and socioeconomic background factors were independently associated with 6-week postpartum PHQ-9. Therefore, addressing psychiatric and socioeconomic factors may prove more effective in reducing postpartum psychopathology symptomatology.