Maternal Mental Health and Emergency Department Visits for Infants Born Preterm and Enrolled in a Transition Home Program Before and During the COVID-19 Pandemic.

Abstract

To determine the association between maternal mental health (MMH) disorders before and during COVID-19 and infant emergency department (ED) visits 1- and 3-months post-NICU discharge among infants in a transition home program (THP). Retrospective analysis of a publicly insured neonatal intensive care unit mother-infant dyad cohort enrolled in a THP. Groups were stratified to pre-COVID-19 pandemic (January 1, 2017-March 10, 2020) and COVID-19 pandemic (March 11, 2020-December 31, 2022). Contacts between THP families, social workers, and medical staff via phone and in-person visits were analyzed relative to ED visits and rehospitalizations. Regression models estimating effects of MMH on ED visit rates were examined. Rates of MMH disorders trended upwards between time periods but did not reach significance. Maternal characteristics were similar between time periods, yet infant birth weight was higher during COVID-19. Overall, ED visits decreased during COVID-19 for the total cohort. THP in-person visits for the total cohort decreased during COVID-19 whereas phone contacts remained unchanged. However, for infants with an ED visit during COVID-19, phone and in-person THP visits increased. In regression models, MMH disorder was associated with higher odds of ED visits ≤ 1 month of discharge (OR 2.34, 95% CI 1.11-4.91). Over the entire study period, infants of mothers with MMH disorders had more ED visits ≤ 1 month of discharge compared with infants from women without a MMH disorder. THP staff responded with increased phone and in-person contacts to support mother-infant dyads for those who had an ED visit during both time periods.