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Riley V, Ellis N, Mackay L, Taylor J. The impact of COVID-19 restrictions on women's pregnancy and postpartum experience in England: A qualitative exploration. Midwifery 2021; 101:103061. [PMID: 34153739 PMCID: PMC8178942 DOI: 10.1016/j.midw.2021.103061] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/27/2021] [Accepted: 05/31/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Victoria Riley
- Staffordshire University, Leek Road, Stoke-on-Trent, Staffordshire, United Kingdom, ST4 2DF.
| | - Naomi Ellis
- Staffordshire University, Leek Road, Stoke-on-Trent, Staffordshire, United Kingdom, ST4 2DF.
| | - Lorna Mackay
- Staffordshire University, Leek Road, Stoke-on-Trent, Staffordshire, United Kingdom, ST4 2DF
| | - Jennifer Taylor
- Staffordshire University, Leek Road, Stoke-on-Trent, Staffordshire, United Kingdom, ST4 2DF.
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Sakalidis VS, Rea A, Perrella SL, McEachran J, Collis G, Miraudo J, Prosser SA, Gibson LY, Silva D, Geddes DT. Wellbeing of Breastfeeding Women in Australia and New Zealand during the COVID-19 Pandemic: A Cross-Sectional Study. Nutrients 2021; 13:1831. [PMID: 34072039 PMCID: PMC8230305 DOI: 10.3390/nu13061831] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 01/17/2023] Open
Abstract
During the COVID-19 pandemic, breastfeeding women have experienced restricted access to support, placing them at increased risk of mental health concerns and limited breastfeeding assistance. This study investigated the effect of the pandemic on feeding choices and maternal wellbeing amongst breastfeeding mothers living in Australian and New Zealand. We conducted a cross-sectional online survey that examined feeding methods, maternal mental wellbeing, worries, challenges, and positive experiences during the pandemic. Most women were exclusively breastfeeding (82%). Partial breastfeeding was associated with perceived low milk supply and longer pregnancy duration during the pandemic. Reduced mental health and wellbeing was associated with lower levels of family functioning, increased perceived stress, and perinatal anxiety. Longer pregnancy duration during the pandemic was associated with lower mental health wellbeing scores, while higher perceived stress scores were reported for regions with higher COVID-19 infection rates and women with perceived low milk supply. Women reported that the pandemic resulted in less pressure and more time for family bonding, while worries about the pandemic, family health, and parenting challenges were also cited. Mental health concerns of breastfeeding women appear to be exacerbated by COVID-19, highlighting a critical need for access to mental health and broader family support during the pandemic.
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Affiliation(s)
- Vanessa S. Sakalidis
- Swiss Tropical and Public Health Institute, 4051 Basel, Switzerland;
- University of Basel, 4001 Basel, Switzerland
| | - Alethea Rea
- Mathematics and Statistics, Murdoch University, Perth, WA 6150, Australia;
| | - Sharon L. Perrella
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
- One For Women, Mt Lawley, WA 6050, Australia; (G.C.); (J.M.)
| | - Jacki McEachran
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
| | - Grace Collis
- One For Women, Mt Lawley, WA 6050, Australia; (G.C.); (J.M.)
| | | | - Stuart A. Prosser
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
- One For Women, Mt Lawley, WA 6050, Australia; (G.C.); (J.M.)
| | - Lisa Y. Gibson
- Telethon Kids Institute, Perth, WA 6009, Australia; (L.Y.G.); (D.S.)
- The University of Western Australia, Perth, WA 6009, Australia
- School of Health and Medical Sciences, Edith Cowan University, Perth, WA 6027, Australia
| | - Desiree Silva
- Telethon Kids Institute, Perth, WA 6009, Australia; (L.Y.G.); (D.S.)
- Health and Medical Sciences, The University of Western Australia, Perth, WA 6009, Australia
- Joondalup Health Campus, Perth, WA 6027, Australia
| | - Donna T. Geddes
- School of Molecular Sciences, University of Western Australia, Perth, WA 6009, Australia; (S.L.P.); (J.M.); (S.A.P.)
- Telethon Kids Institute, Perth, WA 6009, Australia; (L.Y.G.); (D.S.)
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53
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Mapping Evidence of Impacts of COVID-19 Outbreak on Sexual and Reproductive Health: A Scoping Review. Healthcare (Basel) 2021; 9:healthcare9040436. [PMID: 33917784 PMCID: PMC8068100 DOI: 10.3390/healthcare9040436] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/01/2021] [Accepted: 04/06/2021] [Indexed: 12/23/2022] Open
Abstract
Introduction: The emergence of the coronavirus disease 2019 (COVID-19) pandemic has rapidly transformed the pre-existing worldwide sexual and reproductive health environment. The provision and supply of contraceptives, and a wide variety of sexual health, new-born, and maternal health services have been seriously affected. Thus, this scoping review mapped the available evidence on the impacts of the COVID-19 outbreak on sexual and reproductive health. Methods: Arksey and O’Malley’s methodological framework guided this scoping review. A search was conducted from the following databases: Embase, PubMed, CINAHL, Scopus, WOS, and AJOL. The preferred reporting items for systematic reviews and meta-analyses (PRISMA) chart and PRISMA extension for scoping reviews (PRISMA-ScR) checklist were used to document the review process. The McMaster critical review checklist was used to determine the quality of the included studies. Thematic analyses were conducted using NVivo version 12. Results: Three studies showed evidence on the impact of COVID-19 and family planning services, six studies reported on maternal and child services and eleven studies reported on sexual health (sexual behavior). Limited access to family planning use, reduction in multiple sexual partnership, decreased transactional sex, and maternal and child services disruption were some impacts reported in the included studies. Conclusion: This study has demonstrated the impacts of COVID-19 on family planning access, multiple sexual partnership, transactional sex, and disruption of maternal and child health services. Interventions that will consider the immediate availability of and access to all sexual and reproductive health services should be prioritized.
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54
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Molteni E, Astley CM, Ma W, Sudre CH, Magee LA, Murray B, Fall T, Gomez MF, Tsereteli N, Franks PW, Brownstein JS, Davies R, Wolf J, Spector TD, Ourselin S, Steves CJ, Chan AT, Modat M. Symptoms and syndromes associated with SARS-CoV-2 infection and severity in pregnant women from two community cohorts. Sci Rep 2021; 11:6928. [PMID: 33767292 PMCID: PMC7994587 DOI: 10.1038/s41598-021-86452-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/12/2021] [Indexed: 01/10/2023] Open
Abstract
We tested whether pregnant and non-pregnant women differ in COVID-19 symptom profile and severity, and we extended previous investigations on hospitalized pregnant women to those who did not require hospitalization. Two female community-based cohorts (18-44 years) provided longitudinal (smartphone application, N = 1,170,315, n = 79 pregnant tested positive) and cross-sectional (web-based survey, N = 1,344,966, n = 134 pregnant tested positive) data, prospectively collected through self-participatory citizen surveillance in UK, Sweden and USA. Pregnant and non-pregnant were compared for frequencies of events, including SARS-CoV-2 testing, symptoms and hospitalization rates. Multivariable regression was used to investigate symptoms severity and comorbidity effects. Pregnant and non-pregnant women positive for SARS-CoV-2 infection were not different in syndromic severity, except for gastrointestinal symptoms. Pregnant were more likely to have received testing, despite reporting fewer symptoms. Pre-existing lung disease was most closely associated with syndromic severity in pregnant hospitalized. Heart and kidney diseases and diabetes increased risk. The most frequent symptoms among non-hospitalized women were anosmia [63% pregnant, 92% non-pregnant] and headache [72%, 62%]. Cardiopulmonary symptoms, including persistent cough [80%] and chest pain [73%], were more frequent among pregnant who were hospitalized. Consistent with observations in non-pregnant populations, lung disease and diabetes were associated with increased risk of more severe SARS-CoV-2 infection during pregnancy.
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Affiliation(s)
- Erika Molteni
- School of Biomedical Engineering and Imaging Sciences, King's College London, 9th floor, Becket House, 1 Lambeth Palace Road, London, SE1 7EU, UK.
| | | | - Wenjie Ma
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Carole H Sudre
- School of Biomedical Engineering and Imaging Sciences, King's College London, 9th floor, Becket House, 1 Lambeth Palace Road, London, SE1 7EU, UK
| | - Laura A Magee
- Department of Women and Children's Health, School of Life Course Sciences and the Institute of Women and Children's Health, King's College London, London, UK
| | - Benjamin Murray
- School of Biomedical Engineering and Imaging Sciences, King's College London, 9th floor, Becket House, 1 Lambeth Palace Road, London, SE1 7EU, UK
| | - Tove Fall
- Department of Medical Sciences and Science for Life Laboratory, Uppsala University, Uppsala, Sweden
| | - Maria F Gomez
- Department of Clinical Sciences, Lund University Diabetes Centre, Jan Waldenströms gata 35, 21428, Malmö, Sweden
| | - Neli Tsereteli
- Department of Clinical Sciences, Lund University Diabetes Centre, Jan Waldenströms gata 35, 21428, Malmö, Sweden
| | - Paul W Franks
- Department of Clinical Sciences, Lund University Diabetes Centre, Jan Waldenströms gata 35, 21428, Malmö, Sweden
| | - John S Brownstein
- Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | | | | | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, 9th floor, Becket House, 1 Lambeth Palace Road, London, SE1 7EU, UK
| | - Claire J Steves
- Department of Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Andrew T Chan
- Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Marc Modat
- School of Biomedical Engineering and Imaging Sciences, King's College London, 9th floor, Becket House, 1 Lambeth Palace Road, London, SE1 7EU, UK
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Ceulemans M, Foulon V, Panchaud A, Winterfeld U, Pomar L, Lambelet V, Cleary B, O’Shaughnessy F, Passier A, Richardson JL, Allegaert K, Nordeng H. Vaccine Willingness and Impact of the COVID-19 Pandemic on Women's Perinatal Experiences and Practices-A Multinational, Cross-Sectional Study Covering the First Wave of the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073367. [PMID: 33805097 PMCID: PMC8038007 DOI: 10.3390/ijerph18073367] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 03/11/2021] [Accepted: 03/22/2021] [Indexed: 12/13/2022]
Abstract
The COVID-19 pandemic may be of particular concern for pregnant and breastfeeding women. We aimed to explore their beliefs about the coronavirus and COVID-19 vaccine willingness and to assess the impact of the pandemic on perinatal experiences and practices. A multinational, cross-sectional, web-based study was performed in six European countries between April and July 2020. The anonymous survey was promoted via social media. In total, 16,063 women participated (including 6661 pregnant and 9402 breastfeeding women). Most responses were collected from Belgium (44%), Norway (18%) and the Netherlands (16%), followed by Switzerland (11%), Ireland (10%) and the UK (3%). Despite differences between countries, COVID-19 vaccine hesitancy was identified among 40–50% of the respondents at the end of the first wave of the pandemic and was higher among pregnant women. Education level and employment status were associated with vaccine hesitancy. The first wave had an adverse impact on pregnancy experiences and disrupted access to health services and breastfeeding support for many women. In the future, access to health care and support should be maintained at all times. Evidence-based and tailored information on COVID-19 vaccines should also be provided to pregnant and breastfeeding women to avoid unfounded concerns about the vaccines and to support shared decision making in this population.
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Affiliation(s)
- Michael Ceulemans
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (V.F.); (K.A.)
- Teratology Information Service, Pharmacovigilance Centre Lareb, 5237 MH ‘s Hertogenbosch, The Netherlands;
- Correspondence: ; Tel.: +32-1637-7227
| | - Veerle Foulon
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (V.F.); (K.A.)
| | - Alice Panchaud
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
| | - Ursula Winterfeld
- Swiss Teratogen Information Service, Service de Pharmacologie Clinique, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland;
| | - Léo Pomar
- Materno-Fetal and Obstetrics Research Unit, Lausanne University Hospital, 1011 Lausanne, Switzerland; (L.P.); (V.L.)
| | - Valentine Lambelet
- Materno-Fetal and Obstetrics Research Unit, Lausanne University Hospital, 1011 Lausanne, Switzerland; (L.P.); (V.L.)
| | - Brian Cleary
- Rotunda Hospital, D01 P5W9 Dublin, Ireland; (B.C.); (F.O.)
- School of Pharmacy, Royal College of Surgeons Ireland, D02 VN51 Dublin, Ireland
| | - Fergal O’Shaughnessy
- Rotunda Hospital, D01 P5W9 Dublin, Ireland; (B.C.); (F.O.)
- School of Pharmacy, Royal College of Surgeons Ireland, D02 VN51 Dublin, Ireland
| | - Anneke Passier
- Teratology Information Service, Pharmacovigilance Centre Lareb, 5237 MH ‘s Hertogenbosch, The Netherlands;
| | - Jonathan Luke Richardson
- UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 4AB, UK;
| | - Karel Allegaert
- Clinical Pharmacology and Pharmacotherapy, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, 3000 Leuven, Belgium; (V.F.); (K.A.)
- Woman and Child, Department of Development and Regeneration, KU Leuven, 3000 Leuven, Belgium
- Department of Clinical Pharmacy, Erasmus MC Sophia Children’s Hospital, 3000 CA Rotterdam, The Netherlands
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, 0316 Oslo, Norway;
- Department of Child Health and Development, Norwegian Institute of Public Health, 0213 Oslo, Norway
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Cimolai N. A Comprehensive Analysis of Maternal and Newborn Disease and Related Control for COVID-19. SN COMPREHENSIVE CLINICAL MEDICINE 2021; 3:1272-1294. [PMID: 33754135 PMCID: PMC7968576 DOI: 10.1007/s42399-021-00836-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 02/22/2021] [Indexed: 02/07/2023]
Abstract
The maternal-fetal/newborn unit is established at risk for COVID-19 infection. This narrative review summarizes the contemporary and cumulative publications which detail maternal infection, antenatal and newborn infections, and maternal/fetal/newborn management and prevention. There is a wide spectrum of maternal disease, but the potential for severe disease albeit in a minority is confirmed. COVID-19 carries risk for preterm delivery. Pregnant females can suffer multisystem disease, and co-morbidities play a significant role in risk. Congenital infection has been supported by several anecdotal reports, but strong confirmatory data are few. No typical congenital dysmorphisms are evident. Nevertheless, placental vascular compromise must be considered a risk for the fetus during advanced maternal infections. Clinical manifestations of newborn infection have been mild to moderate and relatively uncommon. Proven antiviral therapy is of yet lacking. The mode of delivery is a medical decision that must include patient risk assessment and patient directives. Both presymptomatic and asymptomatic mothers and offspring can complicate infection control management with the potential for spread to others in several regards. In the interim, infections of the maternal-fetal-newborn unit must be taken seriously both for the disease so caused and the potential for further dissemination of disease.
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Affiliation(s)
- Nevio Cimolai
- Faculty of Medicine, The University of British Columbia, Vancouver, Canada
- Children’s and Women’s Health Centre of British Columbia, 4480 Oak Street, Vancouver, B.C. V6H3V4 Canada
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57
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Pacheco F, Sobral M, Guiomar R, de la Torre-Luque A, Caparros-Gonzalez RA, Ganho-Ávila A. Breastfeeding during COVID-19: A Narrative Review of the Psychological Impact on Mothers. Behav Sci (Basel) 2021; 11:34. [PMID: 33799384 PMCID: PMC7999784 DOI: 10.3390/bs11030034] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 03/09/2021] [Accepted: 03/10/2021] [Indexed: 12/11/2022] Open
Abstract
The COVID-19 pandemic has altered the normal course of life, with measures to reduce the virus spread impacting motherhood expectations and, in particular, breastfeeding practices. This study aimed to review evidence regarding the impact of COVID-19 on breastfeeding plans and how these relate to women's psychological outcomes. Searches were conducted on PubMed and Web of Science for studies in English, Spanish, and Portuguese between January 2020 and January 2021. All study designs and pre-prints were considered. Twelve studies were included. Reports suggest that COVID-19 impacts differently on breastfeeding plans, which in turn leads to distinctive mental health outcomes. Positive breastfeeding experiences have been observed when mothers perceive that they have more time for motherhood, which may be associated with better mental health outcomes. Negative breastfeeding experiences have been observed when mothers are separated from their newborns, when mothers struggle with breastfeeding, or when mothers perceive decreased family and professional support, which seems to be associated with worse mental health outcomes. These preliminary results highlight the need for further research into the association between COVID-19, breastfeeding expectations, and maternal mental health. Filling this gap will foster the development of guidelines and interventions to better support mothers experiencing the obstacles of COVID-19 pandemic.
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Affiliation(s)
- Francisca Pacheco
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (F.P.); (M.S.); (R.G.)
| | - Mónica Sobral
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (F.P.); (M.S.); (R.G.)
| | - Raquel Guiomar
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (F.P.); (M.S.); (R.G.)
| | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Centre for Biomedical Research in Mental Health (CIBERSAM), 28040 Madrid, Spain;
| | - Rafael A. Caparros-Gonzalez
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18071 Granada, Spain;
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, 18011 Granada, Spain
| | - Ana Ganho-Ávila
- Center for Research in Neuropsychology and Cognitive Behavioral Intervention, Faculty of Psychology and Educational Sciences, University of Coimbra, 3000-115 Coimbra, Portugal; (F.P.); (M.S.); (R.G.)
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58
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Ceulemans M, Foulon V, Ngo E, Panchaud A, Winterfeld U, Pomar L, Lambelet V, Cleary B, O'Shaughnessy F, Passier A, Richardson JL, Hompes T, Nordeng H. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic-A multinational cross-sectional study. Acta Obstet Gynecol Scand 2021; 100:1219-1229. [PMID: 33475148 PMCID: PMC8014496 DOI: 10.1111/aogs.14092] [Citation(s) in RCA: 120] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/11/2021] [Accepted: 01/16/2021] [Indexed: 12/21/2022]
Abstract
Introduction Evidence on perinatal mental health during the coronavirus disease 2019 (COVID‐19) pandemic and its potential determinants is limited. Therefore, this multinational study aimed to assess the mental health status of pregnant and breastfeeding women during the pandemic, and to explore potential associations between depressive symptoms, anxiety, and stress and women's sociodemographic, health, and reproductive characteristics. Material and methods A cross‐sectional, web‐based study was performed in Ireland, Norway, Switzerland, the Netherlands, and the UK between 16 June and 14 July 2020. Pregnant and breastfeeding women up to 3 months postpartum who were older than 18 years of age were eligible. The online, anonymous survey was promoted through social media and hospital websites. The Edinburgh Depression Scale (EDS), the Generalized Anxiety Disorder seven‐item scale (GAD‐7), and the Perceived Stress Scale (PSS) were used to assess mental health status. Regression model analysis was used to identify factors associated with poor mental health status. Results In total, 9041 women participated (including 3907 pregnant and 5134 breastfeeding women). The prevalence of major depressive symptoms (EDS ≥ 13) was 15% in the pregnancy cohort and and 13% the breastfeeding cohort. Moderate to severe generalized anxiety symptoms (GAD ≥ 10) were found among 11% and 10% of the pregnant and breastfeeding women. The mean (±SD) PSS scores for pregnant and breastfeeding women were 14.1 ± 6.6 and 13.7 ± 6.6, respectively. Risk factors associated with poor mental health included having a chronic mental illness, a chronic somatic illness in the postpartum period, smoking, having an unplanned pregnancy, professional status, and living in the UK or Ireland. Conclusions This multinational study found high levels of depressive symptoms and generalized anxiety among pregnant and breastfeeding women during the COVID‐19 outbreak. The study findings underline the importance of monitoring perinatal mental health during pandemics and other societal crises to safeguard maternal and infant mental health.
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Affiliation(s)
- Michael Ceulemans
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.,Teratology Information Service, Pharmacovigilance center Lareb, 's-Hertogenbosch, the Netherlands
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium
| | - Elin Ngo
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway
| | - Alice Panchaud
- Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - Ursula Winterfeld
- Swiss Teratogen Information Service, Service de Pharmacologie Clinique, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Léo Pomar
- Materno-Fetal and Obstetrics Research Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Valentine Lambelet
- Materno-Fetal and Obstetrics Research Unit, Lausanne University Hospital, Lausanne, Switzerland
| | - Brian Cleary
- Rotunda Hospital, Dublin, Ireland.,School of Pharmacy, Royal College of Surgeons Ireland, Dublin, Ireland
| | - Fergal O'Shaughnessy
- Rotunda Hospital, Dublin, Ireland.,School of Pharmacy, Royal College of Surgeons Ireland, Dublin, Ireland
| | - Anneke Passier
- Teratology Information Service, Pharmacovigilance center Lareb, 's-Hertogenbosch, the Netherlands
| | - Jonathan L Richardson
- UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust and Public Health England, Newcastle upon Tyne, UK
| | - Titia Hompes
- Department of Neurosciences, KU Leuven, Leuven, Belgium.,Adult Psychiatry, UPC KU Leuven, Leuven, Belgium
| | - Hedvig Nordeng
- Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, PharmaTox Strategic Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.,Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway
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