Oral Concurrent Session 1 – Medical and Surgical Complications of Pregnancy

Objective: To compare the effect of two enhanced prenatal care models on perinatal depression and anxiety.Study Design: Engaging Mothers and Babies -Reimagining Antenatal Care for Everyone (EMBRACE) is a pragmatic, randomized comparative-effectiveness trial evaluating the effect of enhanced group prenatal care (eGPC) vs enhanced individual prenatal care (eIPC) on mental health (primary aim), care experiences (secondary aim), and preterm birth (exploratory aim) among Medicaid-eligible people in California's San Joaquin Valley.In this analysis, we focused on changes in depression symptom severity (primary outcome, Patient Health Questionnaire-9, scores range from 0-27) and anxiety symptom severity (secondary outcome, Generalized Anxiety Disorder-7 scale, scores range from 0-21) from baseline (≤24 weeks gestation) to 3 months postpartum.We conducted primary analyses by intention-to-treat and subgroup analyses by prenatal care visit attendance (≥1 visit, ≥4 visits) and self-reported race and ethnicity (Latine, Black).To estimate the intervention effect, we used linear mixed models that adjusted for baseline value of the outcome, self-reported history of a mental health condition, and language of interview, with random intercepts for provider.Results: 652 participants (n = 281 eGPC, n = 371 eIPC), enrolled in the study, of whom 72.2% identified as Latine and 7.4% identified as Black.Participants in both randomization groups experienced statistically significant small-to-moderate reductions in depression symptoms from baseline to three months postpartum.There were no significant differences in depression or anxiety symptom severity between the two enhanced prenatal care models, either in the full sample (intention-to-treat), by number of visits attended, or within the Latine or Black subgroups.Conclusion: This study adds to the growing evidence that enhanced prenatal care, whether delivered in group or individual formats, can support meaningful improvements in perinatal mental health among low-income populations.