Maternal Postpartum Depression, Surgical Timing, and Neurodevelopment in Non-Syndromic Craniosynostosis

Objectives This study evaluated the relationship between maternal postpartum depression (PPD) and both surgical care and long-term neurodevelopment in patients with non-syndromic craniosynostosis (NSC). Design and methods Mothers of NSC patients were identified in the Epic Cosmos database and matched 1:1 to controls. PPD was identified with codes from the 10th edition of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) among mothers of NSC patients with documented surgery and maternal records. Multivariate regression was used to evaluate associations between maternal PPD and neurocognitive outcomes defined by ICD-10 codes, adjusting for surgical timing (<12 vs. ≥12 months), social vulnerability index, race, maternal age, length of follow-up, and comorbidities. Separate models assessed the association of maternal PPD and sociodemographic factors with late surgery (≥12 months). Results Mothers of NSC patients ( N = 18 450) demonstrated elevated rates of PPD (odds ratio: 1.24, 95% confidence interval [CI]: [1.17, 1.31]) and other postpartum psychiatric conditions. Among the surgical cohort with linked maternal records ( N = 2650), maternal PPD was associated with higher odds of almost all assessed neurocognitive disorders. After adjustment for comorbidities and sociodemographic confounders, late surgery was associated with increased neurocognitive problems. Maternal PPD was independently associated with late surgery (adjusted odds ratio: 1.26, 95% CI: [1.03, 1.55]), along with Black race and maternal age <25 years. Conclusions Maternal PPD is more common among mothers of children with NSC and is associated with neurodevelopmental morbidity and delayed surgery. These findings suggest the potential value of early maternal mental health support in craniofacial care.