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Fuente-Moreno M, Garcia-Terol C, Domínguez-Salas S, Rubio-Valera M, Motrico E. Maternity care changes and postpartum mental health during the COVID-19 pandemic: a Spanish cross-sectional study. J Reprod Infant Psychol 2024; 42:753-768. [PMID: 36710435 DOI: 10.1080/02646838.2023.2171375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 01/17/2023] [Indexed: 01/31/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic led to abrupt changes in maternity care, but the impact of these changes has not yet been deeply evaluated. This study aimed to assess the impact of the unexpected changes in maternity care due to the COVID-19 pandemic on postpartum mental health (depression, anxiety and posttraumatic stress disorder). METHODS A cross-sectional, web-based study was conducted in Spain during the second half of 2020. The eligibility criteria were women≥18 years with a child≤6 months. The Edinburgh Postnatal Depression Scale (EPDS), the Generalized Anxiety Disorder-7 Screener (GAD-7) and a subset of the PTSD checklist (PCL-5) were used to assess postpartum mental health. Information regarding sociodemographic characteristics and maternity care changes was collected, and multivariate regression models were used. RESULTS Among 1781 participants, 29.3% and 33% had clinically significant depressive and anxiety symptoms, respectively. The most prevalent unexpected changes reported were related to the exclusion of supportive relatives during birth and postpartum. Changes reported during birth showed a minor association with PTSD symptomatology, and those that occurred during the postpartum period were associated with clinical depression, anxiety and PTSD symptoms. CONCLUSIONS The unexpected changes in maternity care due to the COVID-19 pandemic, especially those that occurred during the postpartum period, increased the risk of mental health problems.
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Affiliation(s)
- Marina Fuente-Moreno
- Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Madrid, Spain
| | - Clara Garcia-Terol
- Facultat de Medicina i Ciències de la Salut, Universitat de Barcelona, Barcelona, Spain
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Spain
| | | | - María Rubio-Valera
- Health Technology Assessment in Primary Care and Mental Health (PRISMA) Research Group, Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
- Parc Sanitari Sant Joan de Déu,Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucía, Seville, Spain
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Orkaby N, Kalfon-Hakhmigari M, Levy S, Krissi H, Peled Y, Handelzalts JE. COVID-19-Related worries mediate the association between attachment orientation and elevated depression levels at 21-month postpartum. J Reprod Infant Psychol 2024; 42:550-562. [PMID: 36210511 DOI: 10.1080/02646838.2022.2132382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND The study's aims were to examine whether the COVID-19 pandemic was associated with increases in depression levels of 21 months postpartum women who were initially sampled before the pandemic and whether COVID-19-related worries mediated the association between women's attachment orientations and this hypothesized increase. METHODS Participants comprised 185 postpartum women sampled in the maternity ward of a tertiary healthcare center in Israel followed from childbirth to 21 months postpartum in four-time points. . We analyzed demographic and obstetric information and the Experiences in Close Relationships (ECR) scale at T1; changes in the Edinburgh Postnatal Depression Scale (EPDS) levels at all timepoints (T1-4); and COVID-19-related worries at T4. RESULTS Results showed a significant increase in depression levels at T4 compared to T2 and T3, and an increase in the prevalence of women at the lower clinical EPDS threshold. COVID-19-related worries mediated the association between anxious attachment and depression (indirect effect: B = .21, p < .05, 95% CI = (.015, .47), R2=0.12). DISCUSSION The evident effect of COVID-19 on postpartum depression is associated with variability between people. Thus, early assessment of women's attachment orientations might provide a strategy for identifying and treating women at risk.
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Affiliation(s)
- Naomi Orkaby
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yafo, Tel-Aviv, Israel
| | | | - Sigal Levy
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yafo, Tel-Aviv, Israel
| | - Haim Krissi
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yoav Peled
- The Helen Schneider Hospital for Women, Rabin Medical Center, Petach-Tikva, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Jonathan E Handelzalts
- School of Behavioral Sciences, Academic College of Tel-Aviv-Yafo, Tel-Aviv, Israel
- Department of Psychiatry, University of Michigan, Ann Arbor, Michiga, USA
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Chen C, Mochizuki Y, Okawa S, Okubo R, Nakagawa S, Tabuchi T. Postpartum loneliness predicts future depressive symptoms: a nationwide Japanese longitudinal study. Arch Womens Ment Health 2024; 27:447-457. [PMID: 38279068 DOI: 10.1007/s00737-024-01424-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/10/2024] [Indexed: 01/28/2024]
Abstract
PURPOSE The COVID-19 pandemic has intensified feelings of loneliness, especially among postpartum women. This nationwide Japanese longitudinal study assessed the impact of such feelings on depressive symptoms and mother-to-infant bonding difficulties (MIBD), two pivotal determinants of maternal and infant well-being. METHODS Starting with a baseline survey conducted between July and August 2021, we tracked 1254 postpartum Japanese women who initially reported minimal depressive symptoms (i.e., Edinburgh Postnatal Depression Scale < 9) and MIBD (i.e., Mother-to-Infant Bonding Scale < 5), over a follow-up period of approximately 6 months. Baseline loneliness was evaluated with the UCLA Loneliness Scale Short-Form (UCLA-LS3-SF3). RESULTS Forty-nine percent of the sample reported the presence of baseline feelings of loneliness. After propensity score matching on sociodemographics and various pregnancy, childbirth, and COVID-19-related aspects, baseline loneliness was associated with increased risks of later depressive symptoms but not MIBD. Using restricted cubic spline logistic regression and considering loneliness as a continuous variable, we found a positive increasing quadratic relationship with depressive symptoms. As loneliness increased, so did the risk of later depressive symptoms. However, there was no significant association between loneliness and MIBD. These results were confirmed through a sensitivity analysis using inverse probability weighting to address attrition bias. CONCLUSION Feelings of postpartum loneliness are associated with future risks of depressive symptoms. The data suggests that addressing loneliness in postpartum women early is crucial to safeguarding their well-being and that of their infants.
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Affiliation(s)
- Chong Chen
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan.
| | | | - Sumiyo Okawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryo Okubo
- Department of Psychiatry, National Hospital Organization Obihiro Hospital, Obihiro, Japan
| | - Shin Nakagawa
- Division of Neuropsychiatry, Department of Neuroscience, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
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Khoury JE, Atkinson L, Gonzalez A. A longitudinal study examining the associations between prenatal and postnatal maternal distress and toddler socioemotional developmental during the COVID-19 pandemic. INFANCY 2024; 29:412-436. [PMID: 38329905 DOI: 10.1111/infa.12584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/15/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024]
Abstract
Elevated psychological distress, experienced by pregnant women and parents, has been well-documented during the COVID-19 pandemic. Most research focuses on the first 6-months postpartum, with single or limited repeated measures of perinatal distress. The present longitudinal study examined how perinatal distress, experienced over nearly 2 years of the COVID-19 pandemic, impacted toddler socioemotional development. A sample of 304 participants participated during pregnancy, 6-weeks, 6-months, and 15-months postpartum. Mothers reported their depressive, anxiety, and stress symptoms, at each timepoint. Mother-reported toddler socioemotional functioning (using the Brief Infant-Toddler Social and Emotional Assessment) was measured at 15-months. Results of structural equation mediation models indicated that (1) higher prenatal distress was associated with elevated postpartum distress, from 6-weeks to 15-months postpartum; (2) associations between prenatal distress and toddler socioemotional problems became nonsignificant after accounting for postpartum distress; and (3) higher prenatal distress was indirectly associated with greater socioemotional problems, and specifically elevated externalizing problems, through higher maternal distress at 6 weeks and 15 months postpartum. Findings suggest that the continued experience of distress during the postpartum period plays an important role in child socioemotional development during the COVID-19 pandemic.
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Affiliation(s)
- Jennifer E Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, Nova Scotia, Canada
| | - Leslie Atkinson
- Department of Psychology, Metropolitan Toronto University, Toronto, Ontario, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada
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Goyal D, Dol J, Huynh J, Anand S, Dennis CL. Postpartum Mental Health and Perceptions of Discrimination Among Asian Fathers During the COVID-19 Pandemic. MCN Am J Matern Child Nurs 2024; 49:88-94. [PMID: 38108414 DOI: 10.1097/nmc.0000000000000984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
PURPOSE The purpose of this study was twofold: (1) to examine the prevalence of postpartum depression and anxiety symptomatology among fathers of Asian descent living in North America during the COVID-19 pandemic, and (2) to identify the occurrences of online racial discrimination. STUDY DESIGN AND METHODS Using a cross-sectional design and convenience sampling methods, we recruited fathers online via social media sites (Facebook, Instagram) between March 12 and July 31, 2022. The Edinburgh Postnatal Depression Scale, General Anxiety Scale, and the Online Victimization Scale assessed mental health well-being and discrimination outcomes. Data were analyzed using descriptive statistics, two sample t-test, chi-square test of independence, and Pearson's correlation analysis. RESULTS Our sample included 61 fathers within 6 months postpartum living in the United States and Canada. Participants were on average 34 years old, married, and represented 17 Asian ethnic groups, including Asian Indian (41%), Filipino (11.3%), and Korean (8.1%). One-third of our participants (31.1%, n = 19) were at high risk of developing postpartum depression and scores of three (4.9%) fathers indicated they had clinically significant anxiety. Overall, 26.3% reported experiencing direct online racial discrimination and 65% reported occurrences of indirect online racial discrimination. CLINICAL IMPLICATIONS There was a high rate of depressive symptoms and occurrences of online racial discrimination among fathers of Asian descent living in North America. These rates are higher than the general perinatal population and further research is warranted to examine risk factors and preventive strategies among this unique paternal ethnic group.
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Grech AM, Sharma S, Kizirian N, Gordon A. Impact of the COVID-19 pandemic on new parents enrolled in the 'BABY1000' birth cohort study in Sydney, Australia: A mixed-methods study. Aust N Z J Public Health 2024; 48:100127. [PMID: 38354625 DOI: 10.1016/j.anzjph.2024.100127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 12/12/2023] [Accepted: 12/20/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVE The COVID-19 pandemic was, and continues to be, uniquely experienced by women in the perinatal period and their families. Whilst long-term impacts of the pandemic are unknown, exposures in pregnancy and early life have impacts across the life-course and future generations. The objective of this manuscript was to explore how the pregnancy, postpartum and parenting experiences of a subset of participants from the 'BABY1000' cohort in Sydney, Australia, were affected by the COVID-19 pandemic, and explore associations between these experiences and state anxiety. METHODS Mixed methods were used. Participants were requested to complete an online survey including the State-Trait Anxiety Inventory short form (STAI-6), followed by an invitation to participate in focus group discussions (FGDs). RESULTS From September to November 2021, 88 parents completed the survey (mean age 33.5 years, 60% born in Australia, 58% primiparous). Twenty-two parents participated in FGDs. Six themes were identified regarding the experience of parents: (1) Maternal support, (2) Family relationships, (3) Stress and mental health, (4) Healthcare, (5) Family lifestyle and routine, and (6) Long-term impacts. The mean STAI-6 score was 40 (SD 12.3), representing high anxiety. High anxiety was significantly associated with concern regarding COVID-19 and feeling overburdened and lonely. CONCLUSIONS The COVID-19 pandemic and associated public health orders significantly impacted participants' pregnancy, postpartum and parenting experiences. Whilst these experiences included some unexpected positives, for many, these were outweighed by negative impacts on mental health, social support, health behaviours, and family relationships. IMPLICATIONS FOR PUBLIC HEALTH Ongoing longitudinal research is imperative to identify potential long-term effects of the pandemic across the life-course, better support families in the short and long-term, and plan for public health crises in the future.
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Affiliation(s)
- Allison Marie Grech
- The University of Sydney, Faculty of Medicine and Health, Central Clinical School, Sydney, Australia; Charles Perkins Centre, The University of Sydney, Sydney, Australia.
| | - Sweekriti Sharma
- The University of Sydney, Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, Sydney, Australia; Institute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia
| | - Nathalie Kizirian
- The University of Sydney, Faculty of Medicine and Health, Central Clinical School, Sydney, Australia; Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Adrienne Gordon
- The University of Sydney, Faculty of Medicine and Health, Central Clinical School, Sydney, Australia; Charles Perkins Centre, The University of Sydney, Sydney, Australia
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Aston M, Price S, MacLeod A, Stone K, Benoit B, Joy P, Ollivier R, Sim M, Etowa J, Jack S, Marcellus L, Iduye D. Examining How Postpartum Videoconferencing Support Sessions Can Facilitate Connections between Parents: A Poststructural and Sociomaterial Analysis. NURSING REPORTS 2024; 14:99-114. [PMID: 38251187 PMCID: PMC10801463 DOI: 10.3390/nursrep14010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/20/2023] [Accepted: 01/03/2024] [Indexed: 01/23/2024] Open
Abstract
Postpartum support for new parents can normalize experiences, increase confidence, and lead to positive health outcomes. While in-person gatherings may be the preferred choice, not all parents can or want to join parenting groups in person. Online asynchronous chat spaces for parents have increased over the past 10 years, especially during the COVID pandemic, when "online" became the norm. However, synchronous postpartum support groups have not been as accessible. The purpose of our study was to examine how parents experienced postpartum videoconferencing support sessions. Seven one-hour videoconferencing sessions were conducted with 4-8 parents in each group (n = 37). Nineteen parents from these groups then participated in semi-structured interviews. Feminist poststructuralism and sociomaterialism were used to guide the research process and analysis. Parents used their agency to actively think about and interact using visual (camera) and audio (microphone) technologies to navigate socially constructed online discourses. Although videoconferencing fostered supportive connections and parents felt less alone and more confident, the participants also expressed a lack of opportunities for individual conversations. Nurses should be aware of the emerging opportunities that connecting online may present. This study was not registered.
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Affiliation(s)
- Megan Aston
- Faculty of Health, School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada; (S.P.); (D.I.)
| | - Sheri Price
- Faculty of Health, School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada; (S.P.); (D.I.)
| | - Anna MacLeod
- Faculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, Canada;
| | - Kathryn Stone
- Department of Human and Social Development, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Britney Benoit
- Faculty of Science, Rankin School of Nursing, St. Francis Xavier University, Antigonish, NS B2G 2W5, Canada;
| | - Phillip Joy
- Department of Applied Human Nutrition, Mount Saint Vincent University, Halifax, NS B3M 2J6, Canada;
| | - Rachel Ollivier
- BC Women’s Hospital & Health Centre, Vancouver, BC V6H 3N1, Canada;
| | - Meaghan Sim
- Research, Innovation and Discovery, Nova Scotia Health, Halifax, NS B3J 0E8, Canada;
| | - Josephine Etowa
- Faculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, ON K1H 8M5, Canada;
| | - Susan Jack
- School of Nursing, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Lenora Marcellus
- Department of Human and Social Development, School of Nursing, University of Victoria, Victoria, BC V8P 5C2, Canada;
| | - Damilola Iduye
- Faculty of Health, School of Nursing, Dalhousie University, Halifax, NS B3H 4R2, Canada; (S.P.); (D.I.)
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Blendermann M, Ebalu TI, Obisie-Orlu IC, Fried EI, Hallion LS. A narrative systematic review of changes in mental health symptoms from before to during the COVID-19 pandemic. Psychol Med 2024; 54:43-66. [PMID: 37615061 DOI: 10.1017/s0033291723002295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
The onset of the COVID-19 pandemic raised concerns regarding population-wide impacts on mental health. Existing work on the psychological impacts of disaster has identified the potential for multiple response trajectories, with resilience as likely as the development of chronic psychopathology. Early reviews of mental health during the pandemic suggested elevated prevalence rates of multiple forms of psychopathology, but were limited by largely cross-sectional approaches. We conducted a systematic review of studies that prospectively assessed pre- to peri-pandemic changes in symptoms of psychopathology to investigate potential mental health changes associated with the onset of the pandemic (PROSPERO #CRD42021255042). A total of 97 studies were included, covering symptom clusters including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), fear, anxiety, depression, and general distress. Changes in psychopathology symptoms varied by symptom dimension and sample characteristics. OCD, anxiety, depression, and general distress symptoms tended to increase from pre- to peri-pandemic. An increase in fear was limited to medically vulnerable participants, and findings for PTSD were mixed. Pre-existing mental health diagnoses unexpectedly were not associated with symptom exacerbation, except in the case of OCD. Young people generally showed the most marked symptom increases, although this pattern was reversed in some samples. Women in middle adulthood in particular demonstrated a considerable increase in anxiety and depression. We conclude that mental health responding during the pandemic varied as a function of both symptom cluster and sample characteristics. Variability in responding should therefore be a key consideration guiding future research and intervention.
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Affiliation(s)
- Mary Blendermann
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tracie I Ebalu
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Eiko I Fried
- Department of Psychology, Leiden University, Leiden, The Netherlands
| | - Lauren S Hallion
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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Hennessey EMP, Swales DA, Markant J, Hoffman MC, Hankin BL, Davis EP. Maternal anxiety during pregnancy predicts infant attention to affective faces. J Affect Disord 2024; 344:104-114. [PMID: 37802320 PMCID: PMC10841611 DOI: 10.1016/j.jad.2023.09.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/24/2023] [Accepted: 09/24/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Prenatal maternal anxiety is a known influence on offspring development. General anxiety and pregnancy-related anxiety (a distinct type of anxiety encompassing fears associated with pregnancy) are associated with offspring socioemotional development, with potential consequences for later emotional and behavioral problems. This study examines whether maternal pregnancy-related and general anxiety relate to infant attention to affective faces, a process which plays an integral role in early socioemotional development. METHODS Participants included 86 mothers and their 6-month-old infants (56.3 % female). Mothers completed measures of pregnancy-related and general anxiety three times through gestation. Infants' attention to affective faces was assessed with an eye-tracking task during which a series of face pairs were presented (happy, angry, or sad face paired with a neutral face). Overall attention measures included attention-holding (total looking time) and attention-orienting (latency to faces); affect-biased attention measures included proportion of total looking time to emotional faces and latency difference score. RESULTS Higher maternal pregnancy-related anxiety across gestation predicted decreased infant attention-holding to affective faces [F(1,80) = 7.232, p = .009, partial η2 = 0.083]. No differences were found in infant attention-orienting or affect-biased attention. LIMITATIONS Reliance on a correlational study design precludes the ability to make causal inferences. CONCLUSIONS Maternal pregnancy-related anxiety is an important predictor of child outcomes. We provide novel evidence that pregnancy-related anxiety predicts infant attention to emotional faces, behaviors which have important implications for socioemotional development. Providers may consider pregnancy-related anxiety as a target for screening and treatment that may benefit both pregnant individual and offspring.
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Affiliation(s)
| | - Danielle A Swales
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Julie Markant
- Department of Psychology & Tulane Brain Institute, Tulane University, New Orleans, LA, USA
| | - M Camille Hoffman
- Department of Obstetrics and Gynecology, Division of Maternal and Fetal Medicine, University of Colorado Denver School of Medicine, Aurora, CO, USA
| | - Benjamin L Hankin
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, CO, USA; Department of Pediatrics, University of California, Irvine, CA, USA
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Getahun D, Peltier MR, Lurvey LD, Shi JM, Braun D, Sacks DA, Burgos AE, Fong A, Trivedi N, Yasumura L, Reynolds K, Nguyen M, Volodarskiy M, Chiu VY, Lopez AH, Fassett MJ. Association between SARS-CoV-2 Infection and Adverse Perinatal Outcomes in a Large Health Maintenance Organization. Am J Perinatol 2024; 41:199-207. [PMID: 35738286 DOI: 10.1055/s-0042-1749666] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE This study aimed to examine whether severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection during pregnancy is associated with increased odds of perinatal complications and viral transmission to the infant. STUDY DESIGN A retrospective cohort study of women who delivered at Kaiser Permanente Southern California hospitals (April 6, 2020-February 28, 2021) was performed using data extracted from electronic health records (EHRs). During this time polymerize chain reaction (PCR)-based tests for SARS-CoV-2 was universally offered to all pregnant women at labor and delivery admission, as well as earlier in the pregnancy, if they were displaying symptoms consistent with SARS-CoV-2 infection or a possible exposure to the virus. Adjusted odds ratio (aOR) was used to estimate the strength of associations between positive test results and adverse perinatal outcomes. RESULTS Of 35,123 women with a singleton pregnancy, 2,203 (6%) tested positive for SARS-CoV-2 infection with 596 (27%) testing positive during the first or second trimester and 1,607 (73%) during the third trimester. Women testing positive were younger than those who tested negative (29.7 [5.4] vs. 31.1 [5.3] years; mean [standard deviation (SD)]; p < .001). The SARS-CoV-2 infection tended to increase the odds of an abnormal fetal heart rate pattern (aOR: 1.10; 95% confidence interval [CI]: 1.00, 1.21; p = 0.058), spontaneous preterm birth (aOR: 1.28; 95% CI: 1.03, 1.58; p = 0.024), congenital anomalies (aOR: 1.69; 95% CI: 1.15, 2.50; p = 0.008), and maternal intensive care unit admission at delivery (aOR: 7.44; 95% CI: 4.06, 13.62; p < 0.001) but not preeclampsia/eclampsia (aOR: 1.14; 95% CI: 0.98, 1.33; p = 0.080). Eighteen (0.8%) neonates of mothers who tested positive also had a positive SARS-CoV-2 test after 24 hours of birth, but all were asymptomatic during the neonatal period. CONCLUSION These findings suggest that prenatal SARS-CoV-2 infection increases the odds of some adverse perinatal outcomes. The likelihood of vertical transmission from the mother to the fetus was low (0.3%), suggesting that pregnancy complications resulting from SARS-CoV-2 infection pose more risk to the baby than transplacental viral transmission. KEY POINTS · SARS-CoV-2 infection is associated with increased odds of adverse perinatal outcomes.. · The odds of specific adverse outcomes were greater when a mother was infected earlier in pregnancy.. · The proportion of vertical transmission from mother to fetus was 0.3%.
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Affiliation(s)
- Darios Getahun
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Morgan R Peltier
- Department of Psychiatry, Jersey Shore University Medical Center, Neptune, New Jersey
| | - Lawrence D Lurvey
- Department of Obstetrics and Gynecology, Southern California Permanente Medical Group, Pasadena, California
| | - Jiaxiao M Shi
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - David Braun
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
- Department of Obstetrics and Gynecology, Southern California Permanente Medical Group, Pasadena, California
| | - David A Sacks
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Anthony E Burgos
- Department of Pediatrics, Kaiser Permanente Downey Medical Center, Downey, California
- Department of Clinical Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Alex Fong
- Department of Obstetrics and Gynecology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Neha Trivedi
- Department of Obstetrics and Gynecology, Kaiser Permanente San Diego Medical Center, San Diego, California
| | - Lyn Yasumura
- Department of Obstetrics and Gynecology, Kaiser Permanente Baldwin Park Medical Center, Baldwin Park, California
| | - Kristi Reynolds
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Marielle Nguyen
- Department of Neonatal Medicine, Kaiser Permanente Orange County Medical Center, Anaheim, California
| | | | - Vicki Y Chiu
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Adrian H Lopez
- Department of Obstetrics and Gynecology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - Michael J Fassett
- Department of Obstetrics and Gynecology, Kaiser Permanente West Los Angeles Medical Center, Los Angeles, California
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Dumitriu D, Lavallée A, Riggs JL, Frosch CA, Barker TV, Best DL, Blasingame B, Bushar J, Charlot-Swilley D, Erickson E, Finkel MA, Fortune B, Gillen L, Martinez M, Ramachandran U, Sanders LM, Willis DW, Shearman N. Advancing early relational health: a collaborative exploration of a research agenda. Front Pediatr 2023; 11:1259022. [PMID: 38143537 PMCID: PMC10748603 DOI: 10.3389/fped.2023.1259022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/07/2023] [Indexed: 12/26/2023] Open
Abstract
Here, we introduce the Early Relational Health (ERH) Learning Community's bold, large-scale, collaborative, data-driven and practice-informed research agenda focused on furthering our mechanistic understanding of ERH and identifying feasible and effective practices for making ERH promotion a routine and integrated component of pediatric primary care. The ERH Learning Community, formed by a team of parent/caregiver leaders, pediatric care clinicians, researchers, and early childhood development specialists, is a workgroup of Nurture Connection-a hub geared toward promoting ERH, i.e., the positive and nurturing relationship between young children and their parent(s)/caregiver(s), in families and communities nationwide. In response to the current child mental health crisis and the American Academy of Pediatrics (AAP) policy statement promoting ERH, the ERH Learning Community held an in-person meeting at the AAP national headquarters in December 2022 where members collaboratively designed an integrated research agenda to advance ERH. This agenda weaves together community partners, clinicians, and academics, melding the principles of participatory engagement and human-centered design, such as early engagement, co-design, iterative feedback, and cultural humility. Here, we present gaps in the ERH literature that prompted this initiative and the co-design activity that led to this novel and iterative community-focused research agenda, with parents/caregivers at the core, and in close collaboration with pediatric clinicians for real-world promotion of ERH in the pediatric primary care setting.
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Affiliation(s)
- Dani Dumitriu
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, United States
- Division of Developmental Neuroscience, Department of Psychiatry, Columbia Vagelos College of Physicians and Surgeons, New York, NY, United States
| | - Andréane Lavallée
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, United States
| | - Jessica L. Riggs
- Department of Psychiatry, The University of Michigan, Ann Arbor, MI, United States
| | - Cynthia A. Frosch
- Department of Human Development and Family Science, Auburn University, Auburn, AL, United States
| | - Tyson V. Barker
- Science and Innovation Strategy, Institute for Child Success, Greenville, SC, United States
| | - Debra L. Best
- Department of Pediatrics, Division of General Pediatrics and Adolescent Health, Duke University School of Medicine, Durham, NC, United States
| | | | - Jessica Bushar
- HealthySteps, ZERO TO THREE, Washington, DC, United States
| | | | - Elizabeth Erickson
- Department of Pediatrics, Division of General Pediatrics and Adolescent Health, Duke University School of Medicine, Durham, NC, United States
| | - Morgan A. Finkel
- Division of Child and Adolescent Health, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian Morgan Stanley Children’s Hospital, New York, NY, United States
| | - Bryn Fortune
- Fortune Consulting, Early Relational Health-Family Network Collaborative, Royal Oak, MI, United States
| | - Leah Gillen
- Department of Research and Innovation, Reach out and Read, Boston, MA, United States
| | - Marty Martinez
- Chief Executive Officer, Reach Out and Read, Boston, MA, United States
| | - Usha Ramachandran
- Department of Pediatrics, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, United States
| | - Lee M. Sanders
- Department of Pediatrics, Division of General Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| | - David W. Willis
- Center for the Study of Social Policy, Washington, DC, United States
| | - Nikki Shearman
- Department of Research and Innovation, Reach out and Read, Boston, MA, United States
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12
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Sayahi M, Nikbina M, Jahangirimehr A, Barati B. Mental health status of pregnant women during COVID-19 in healthcare centers of Iran: A cross-sectional study. PLoS One 2023; 18:e0294850. [PMID: 38015922 PMCID: PMC10683986 DOI: 10.1371/journal.pone.0294850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 11/08/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND AND OBJECTIVE The COVID-19 pandemic impacted every single aspect of life. In addition to being a public health emergency, the COVID-19 outbreak impacted the mental health of individuals, especially pregnant women. This study aimed to examine the mental health status of pregnant women and also the effect of sociodemographic factors on their mental health status during COVID-19 in healthcare centers of Iran. METHODS This cross-sectional, analytical-descriptive study was conducted among pregnant women referring to healthcare centers in Shoushtar, Iran, in 2021. Multistage cluster sampling was used to select participants. Data were collected using the General Health Questionnaire-28 (GHQ-28). Data were analyzed using SPSS software version 22. The Pearson correlation coefficient was used to examine the association between quantitative variables. A generalized linear model (GLM) was applied to estimate the effect of independent variables on the dependent variable (mental health). RESULTS A total of 197 participants with a mean ± SD age of 27.85 ± 6.37 years took part in this study. The total mean score of mental health was estimated at 17.47±8.20. The highest mean ± SD score was, respectively, related to social dysfunction (6.63 ± 2.86), anxiety and insomnia (5.28 ± 3.53), and somatic symptoms (4.17 ± 3.27). Mental health disorder was significantly correlated with participants' age (R = .223, P = .00), number of pregnancy (gravida) (R = .272, P = .00), number of births (para) (R = 0.272, P = .00), and number of abortions (R = .172, P = .015). About 80% of pregnant women did not reveal impaired mental health conditions or psychological distress, while 19.3% showed scores that indicate probable mental health conditions. CONCLUSION Social dysfunction was the most common mental health problem among pregnant women. It is necessary to pay more attention to the mental health status of pregnant women during a pandemic. Interventions such as practical strategies to promote social support and improve pregnant women's mental health during pregnancy are highly important.
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Affiliation(s)
- Masoumeh Sayahi
- Department of Midwifery, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Maryam Nikbina
- Department of Midwifery, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Azam Jahangirimehr
- Department of Public Health, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Barat Barati
- Department of Radiologic Technology, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
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13
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D'Anna-Hernandez K, Lara-Cinisomo S, Non A. Changes in mental health symptoms and sociocultural factors across the COVID-19 pandemic in mothers of Mexican descent. Arch Womens Ment Health 2023; 26:625-637. [PMID: 37535116 DOI: 10.1007/s00737-023-01345-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 07/01/2023] [Indexed: 08/04/2023]
Abstract
Latinos have been disproportionately affected by the COVID-19 pandemic in the US. Little is known about the lasting effects on mental health, particularly among mothers of young children, who historically report high levels of depression and anxiety. We examined if anxiety and depression symptoms worsened for mothers of Mexican descent across the pandemic and identified the role of sociocultural risk and protective factors on these changes. Mothers of Mexican descent (n = 141) with young children (ages 0-7) were administered surveys on mental health symptoms (anxiety and depression), stress-related sociocultural factors (perceived discrimination) before (pre-pandemic), within 3 months (early pandemic), and 18 months after the COVID-19 stay-at-home order (late pandemic). Another sociocultural factor, acculturative stress, was only measured pre-pandemic while during the later phase of the pandemic mothers reported their levels of loneliness, optimism, and coping styles. Repeated measures (RM) ANOVA demonstrated that depressive and anxiety symptoms as well as perceived discrimination increased from pre to early months of the COVID-19 pandemic and slightly lowered in late-COVID but did not return to pre-COVID levels. Two-way RM ANOVA showed that acculturative stress and perceived discrimination predicted worse mental health trajectories across the pandemic while moderations revealed that optimism buffered against, and avoidant coping increased the adverse effects of sociocultural factors on mental health. The effects of the COVID pandemic on mental health are lingering in mothers of young children; however, optimism may be a protective factor. The results also highlight the damaging effects of external factors, such as discrimination, on maternal mental health during times of crisis.
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Affiliation(s)
| | - Sandraluz Lara-Cinisomo
- Department of Kinesiology and Community Health, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Amy Non
- Department of Anthropology, University of California San Diego, La Jolla, CA, USA
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14
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Glassgow AE, Wagner-Schuman M, Knepper A, Holicky A, Angulo M, Handler A, Harris B, Hickey E, Manrique Y, Mauro A, Rodriguez A, Schulte J, Scott S, Wainwright S, Caskey R. Addressing Maternal Health Disparities: Building a Novel Two-Generation Approach to Comprehensive Postpartum Care. Popul Health Manag 2023; 26:275-282. [PMID: 37677001 DOI: 10.1089/pop.2023.0059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023] Open
Abstract
The United States is facing a maternal health crisis with increasing rates of severe maternal morbidity and mortality. To improve maternal health and promote health equity, the authors developed a novel 2-generation model of postpartum and pediatric care. This article describes the Two-Generation Clinic (Two-Gen) and model of care. The model combines a dyadic strategy for simultaneous maternal and pediatric care with the collaborative care model in which seamless primary and behavioral health care are delivered to address the physical health, behavioral health, and social service needs of families. The transdisciplinary team includes primary care physicians, nurse practitioners, psychiatrists, obstetrician-gynecologists, social workers, care navigators, and lactation specialists. Dyad clinic visits are coscheduled (at the same time) and colocated (in the same examination room) with the same primary care provider. In the Two-Gen, the majority (89%) of the mothers self-identify as racial and ethnic minorities. More than 40% have a mental health diagnosis. Almost all mothers (97.8%) completed mental health screenings, >50.0% have received counseling from a social worker, 17.2% had a visit with a psychiatrist, and 50.0% received lactation counseling. Over 80% of the children were up to date with their well-child visits and immunizations. The Two-Gen is a promising model of care that has the potential to inform the design of postpartum care models and promote health equity in communities with the highest maternal health disparities.
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Affiliation(s)
- Anne Elizabeth Glassgow
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Pediatrics, and College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Melissa Wagner-Schuman
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Psychiatry, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Amanda Knepper
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Abigail Holicky
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Maria Angulo
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Arden Handler
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Bianca Harris
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Erin Hickey
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Yolanda Manrique
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ana Mauro
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Aida Rodriguez
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Jennifer Schulte
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Shirley Scott
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Samuel Wainwright
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Rachel Caskey
- Department of Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
- Department of Pediatrics, and College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
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15
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Itoshima R, Tuura K, Toome L, Varendi H, Saik P, Axelin A, Lehtonen L, Ahlqvist-Björkroth S. Depressive symptoms in mothers of preterm infants before and during COVID-19 restrictions in neonatal intensive care units. Acta Paediatr 2023; 112:2164-2171. [PMID: 37354112 DOI: 10.1111/apa.16886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 06/26/2023]
Abstract
AIM Little is known about the specific restriction measures used in intensive care units (NICUs) during the COVID-19 pandemic and their impact on parental well-being. Hence, this study aimed to assess the association between restriction measures and mothers' post-partum depressive symptoms. METHODS This comparative cohort study included mothers who gave birth before 35 weeks of gestation in Estonia. The outcome measure was mothers' post-partum depressive symptoms at the time of infant discharge, evaluated using the Edinburgh Postnatal Depression Scale (EPDS). In addition to the pandemic itself, the number of restriction measures in the NICUs was analysed as a potential explanatory factor for depressive symptoms. RESULTS The study included 55 mothers before the pandemic in 2018-2019 and 54 mothers during the COVID-19 pandemic in 2021. No significant difference was found in the median EPDS scores between the cohorts: 7.0 [interquartile range (IQR): 4.0-12.0] and 8.0 (IQR: 5.0-12.8) respectively. The number of restriction measures was not associated with mothers' EPDS scores in either unadjusted or adjusted models. CONCLUSION The COVID-19 pandemic or the number of restriction measures used in Estonian NICUs did not associate with mothers' post = partum depressive symptoms.
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Affiliation(s)
- Ryo Itoshima
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
- Division of Neonatology, Nagano Children's Hospital, Azumino, Japan
| | - Kirsi Tuura
- Department of Psychology and Language Pathology, University of Turku, Turku, Finland
| | - Liis Toome
- Department of Neonatal and Infant Medicine, Tallinn Children's Hospital, Tallinn, Estonia
| | - Heili Varendi
- Neonatal Unit, Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - Pille Saik
- Department of Neonatology, West-Tallinn Central Hospital, Tallinn, Estonia
| | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Liisa Lehtonen
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Paediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Sari Ahlqvist-Björkroth
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Department of Psychology and Language Pathology, University of Turku, Turku, Finland
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16
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Chen S, Lan X, Yu H. A social network analysis: mental health scales used during the COVID-19 pandemic. Front Psychiatry 2023; 14:1199906. [PMID: 37706038 PMCID: PMC10495585 DOI: 10.3389/fpsyt.2023.1199906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/11/2023] [Indexed: 09/15/2023] Open
Abstract
Introduction The focus on psychological issues during COVID-19 has led to the development of large surveys that involve the use of mental health scales. Numerous mental health measurements are available; choosing the appropriate measurement is crucial. Methods A rule-based named entity recognition was used to recognize entities of mental health scales that occur in the articles from PubMed. The co-occurrence networks of mental health scales and Medical Subject Headings (MeSH) terms were constructed by Gephi. Results Five types of MeSH terms were filtered, including research objects, research topics, research methods, countries/regions, and factors. Seventy-eight mental health scales were discovered. Discussion The findings provide insights on the scales used most often during the pandemic, the key instruments used to measure healthcare workers' physical and mental health, the scales most often utilized for assessing maternal mental health, the tools used most commonly for assessing older adults' psychological resilience and loneliness, and new COVID-19 mental health scales. Future studies may use these findings as a guiding reference and compass.
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Affiliation(s)
| | - Xue Lan
- Department of Health Management, China Medical University, Shenyang, China
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17
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Sarhaddi F, Azimi I, Niela-Vilen H, Axelin A, Liljeberg P, Rahmani AM. Maternal Social Loneliness Detection Using Passive Sensing Through Continuous Monitoring in Everyday Settings: Longitudinal Study. JMIR Form Res 2023; 7:e47950. [PMID: 37556183 PMCID: PMC10448281 DOI: 10.2196/47950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Maternal loneliness is associated with adverse physical and mental health outcomes for both the mother and her child. Detecting maternal loneliness noninvasively through wearable devices and passive sensing provides opportunities to prevent or reduce the impact of loneliness on the health and well-being of the mother and her child. OBJECTIVE The aim of this study is to use objective health data collected passively by a wearable device to predict maternal (social) loneliness during pregnancy and the postpartum period and identify the important objective physiological parameters in loneliness detection. METHODS We conducted a longitudinal study using smartwatches to continuously collect physiological data from 31 women during pregnancy and the postpartum period. The participants completed the University of California, Los Angeles (UCLA) loneliness questionnaire in gestational week 36 and again at 12 weeks post partum. Responses to this questionnaire and background information of the participants were collected through our customized cross-platform mobile app. We leveraged participants' smartwatch data from the 7 days before and the day of their completion of the UCLA questionnaire for loneliness prediction. We categorized the loneliness scores from the UCLA questionnaire as loneliness (scores≥12) and nonloneliness (scores<12). We developed decision tree and gradient-boosting models to predict loneliness. We evaluated the models by using leave-one-participant-out cross-validation. Moreover, we discussed the importance of extracted health parameters in our models for loneliness prediction. RESULTS The gradient boosting and decision tree models predicted maternal social loneliness with weighted F1-scores of 0.897 and 0.872, respectively. Our results also show that loneliness is highly associated with activity intensity and activity distribution during the day. In addition, resting heart rate (HR) and resting HR variability (HRV) were correlated with loneliness. CONCLUSIONS Our results show the potential benefit and feasibility of using passive sensing with a smartwatch to predict maternal loneliness. Our developed machine learning models achieved a high F1-score for loneliness prediction. We also show that intensity of activity, activity pattern, and resting HR and HRV are good predictors of loneliness. These results indicate the intervention opportunities made available by wearable devices and predictive models to improve maternal well-being through early detection of loneliness.
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Affiliation(s)
| | - Iman Azimi
- Department of Computer Science, University of California, Irvine, CA, United States
- Institute for Future Health, University of California, Irvine, CA, United States
| | | | - Anna Axelin
- Department of Nursing Science, University of Turku, Turku, Finland
- Department of Obstetrics and Gynaecology, Turku University Hospital, Turku, Finland
- Faculty of Medicine, University of Turku, Turku, Finland
| | - Pasi Liljeberg
- Department of Computing, University of Turku, Turku, Finland
| | - Amir M Rahmani
- Department of Computer Science, University of California, Irvine, CA, United States
- Institute for Future Health, University of California, Irvine, CA, United States
- School of Nursing, University of California, Irvine, CA, United States
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18
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Ruyak SL, Roberts MH, Chambers S, Ma X, DiDomenico J, De La Garza R, Bakhireva LN. Impulsivity and Alcohol Use during Pregnancy and Postpartum: Insights from Novel Methodological Approaches within the Context of the COVID-19 Pandemic. Behav Sci (Basel) 2023; 13:600. [PMID: 37504047 PMCID: PMC10376597 DOI: 10.3390/bs13070600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/06/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
Impaired emotion regulation and impulsivity have been linked to substance use. This study evaluated the association between emotion regulation difficulties-specifically impulsivity-and substance use within the context of the COVID-19 pandemic among pregnant (n = 49) and postpartum (n = 20) women. Participants from a prospective cohort ENRICH-2 completed a baseline phone survey of COVID-19-related experiences and impulsivity followed by a 14-day (3x/day) mobile ecological momentary assessment (mEMA) of impulsivity and substance use. Between-subject (BS) and within-subject (WS) associations for baseline impulsivity and momentary impulsivity with respect to substance use were examined using mixed effects models. At the BS level, momentary impulsivity scores that were higher than the overall group average were positively associated with subsequent momentary reports of marijuana use (β = 1.25; p = 0.04) when controlling for pregnancy status and COVID-19-related stress. At the WS level, momentary impulsivity scores that were higher than an individual's average score were positively associated with subsequent reports of momentary alcohol use (β = 0.08; p = 0.04). This research supports the idea that impulsivity varies based on individual situations, such as stress associated with the COVID-19 pandemic, and may be an important correlate of substance use in pregnant and postpartum women. Future research might consider investigation of additional factors, which may serve to moderate or mediate the relationship between impulsivity and substance use.
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Affiliation(s)
- Sharon L Ruyak
- College of Nursing, University of New Mexico, Albuquerque, NM 87131, USA
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Melissa H Roberts
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Stephanie Chambers
- Department of Family and Community Medicine, University of New Mexico, Albuquerque, NM 87131, USA
| | - Xingya Ma
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Jared DiDomenico
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
| | - Richard De La Garza
- David Geffen School of Medicine, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA 90095, USA
| | - Ludmila N Bakhireva
- Substance Use Research and Education (SURE) Center, College of Pharmacy, University of New Mexico, Albuquerque, NM 87131, USA
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Harville EW, Wood ME, Sutton EF. Social distancing and mental health among pregnant women during the coronavirus pandemic. BMC Womens Health 2023; 23:189. [PMID: 37081476 PMCID: PMC10117246 DOI: 10.1186/s12905-023-02335-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 04/07/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND The effect of social distancing due to the COVID-19 pandemic on the mental health of pregnant women is of particular concern, given potential effects on physical health, family functioning, and child development. METHODS Pregnant women were recruited for the "Implications of and Experiences Surrounding being Pregnant during the COVID-19 Pandemic" study at Woman's Hospital in Baton Rouge, Louisiana. Participants enrolled at any point during their pregnancy and surveys were delivered weekly until the participant indicated that she had delivered her baby; a postpartum survey followed four weeks after delivery. This analysis includes 1037 participants with baseline, 596 with follow-up, and 302 with postpartum surveys. Questions on social distancing behaviors were asked at baseline and grouped based on whether they involved social distancing from work, friends and family, or public places. Symptoms of anxiety, stress, depression, and pregnancy-related anxiety were measured. Each type of social distancing was examined as a predictor of mental health using linear model with control for confounders. RESULTS The study population was largely white (84.1%), married (81.8%), and educated (76.2% with a bachelor's or higher degree). Women who were younger, Black, unmarried, or had less education or income reported fewer social distancing behaviors. Mean anxiety score in the highest quartile of overall social distancing was 8.3 (SD 5.6), while in the lowest quartile it was 6.0 (SD 5.0) (p < 0.01), while perceived stress postpartum and pregnancy-related stress were not associated with social distancing. Associations were substantially diminished when controlled for baseline levels of anxiety symptoms. CONCLUSIONS Greater social distancing was associated with more anxiety symptoms, but worse mental health, particularly anxiety, may also have contributed to greater social distancing behaviors.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, 1440 Canal St Ste 2001 #8318, New Orleans, LA, 70112-2715, USA.
| | - Moira E Wood
- Tulane University School of Medicine, New Orleans, LA, USA
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20
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Goyal D, Dol J, Leckey M, Naraine S, Dennis CL, Chan EK, Basu G. Scoping Review of Racial and Ethnic Representation of Participants in Mental Health Research Conducted in the Perinatal Period During the COVID-19 Pandemic. J Obstet Gynecol Neonatal Nurs 2023; 52:117-127. [PMID: 36462529 PMCID: PMC9710717 DOI: 10.1016/j.jogn.2022.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 11/09/2022] [Accepted: 11/14/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To identify the racial and ethnic representation of participants in mental health research conducted in the perinatal period during the COVID-19 pandemic. DATA SOURCES MEDLINE, CINAHL, Cochrane Library, PsycINFO, Scopus, Web of Science. STUDY SELECTION We included peer-reviewed research articles in which researchers reported mental health outcomes of women during the perinatal period who were living in the United States or Canada during the COVID-19 pandemic. We included 25 articles in the final review. DATA EXTRACTION We extracted the citation, publication date, design, aim, country of origin, participant characteristics, sampling method, method of measurement of race and ethnicity, and mental health outcome(s). DATA SYNTHESIS The combined racial and ethnic representation of the 16,841 participants in the included studies was White (76.5%), Black (9.8%), other/multiracial (6.2%), Asian (3.9%), Hispanic/Latina (2.6%), Indigenous or Ethnic Minority Canadian (0.9%), and Native American or Alaska Native (0.1%). Most studies were conducted in the United States, used a cross-sectional design, and incorporated social media platforms to recruit participants. Depression, anxiety, and stress were the most frequently assessed mental health outcomes. CONCLUSION Relatively few women of color who were pregnant or in the postpartum period during the pandemic participated in mental health research studies. Future studies should develop intentional recruitment strategies to increase participation of women of color. Researchers should use updated guidance on reporting race and ethnicity to accurately represent every participant, minimize misclassification of women of color, and report meaningful results.
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21
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Penna AL, de Aquino CM, Pinheiro MSN, do Nascimento RLF, Farias-Antúnez S, Araújo DABS, Mita C, Machado MMT, Castro MC. Impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices: a global scoping review. BMC Public Health 2023; 23:388. [PMID: 36823592 PMCID: PMC9950022 DOI: 10.1186/s12889-023-15003-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 01/05/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND In March 2020, the COVID-19 outbreak was declared a pandemic by the World Health Organization (WHO), generating stark economic and social repercussions that directly or indirectly affected families' wellbeing and health status. AIMS This review aims at mapping the existing evidence on the impact of the COVID-19 pandemic on maternal mental health, early childhood development, and parental practices, worldwide, to identify evidence gaps and better inform future delivery of care and health policy measures. METHODS Following the protocol defined by PRISMA-ScR, this scoping review has searched for relevant studies published between January 2020 and June 2021, selecting evidence sources based on pre-established criteria. From a total of 2,308 articles, data were extracted from 537 publications from 35 countries on all three health domains. RESULTS The combined stressors brought forth by the pandemic have exerted a heavy burden on the mental health of mothers and the development of young children, partly mediated by its impact on parental practices. CONCLUSIONS Despite remaining gaps, we have identified sufficient evidence pointing to an urgent need for more concerted global research efforts and rapid policy responses to timely address severe and pervasive negative impacts to the mental health of mothers and children at a key developmental stage.
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Affiliation(s)
- Ana Luiza Penna
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA.
| | - Camila Machado de Aquino
- grid.8395.70000 0001 2160 0329Department of Community Health, Federal University of Ceará, Fortaleza, Brazil
| | | | | | - Simone Farias-Antúnez
- grid.411237.20000 0001 2188 7235Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Brazil
| | | | - Carol Mita
- grid.38142.3c000000041936754XCountway Library, Harvard Medical School, Boston, USA
| | | | - Marcia C. Castro
- grid.38142.3c000000041936754XDepartment of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, USA
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22
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Falgas-Bague I, Thembo T, Kaiser JL, Hamer DH, Scott NA, Ngoma T, Paul R, Juntunen A, Rockers PC, Fink G. Trends in maternal mental health during the COVID-19 pandemic-evidence from Zambia. PLoS One 2023; 18:e0281091. [PMID: 36735688 PMCID: PMC9897519 DOI: 10.1371/journal.pone.0281091] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
The COVID-19 pandemic has increased social and emotional stressors globally, increasing mental health concerns and the risk of psychiatric illness worldwide. To date, relatively little is known about the impact of the pandemic on vulnerable groups such as women and children in low-resourced settings who generally have limited access to mental health care. We explore two rounds of data collected as part of an ongoing trial of early childhood development to assess mental health distress among mothers of children under 5-years-old living in two rural areas of Zambia during the COVID-19 pandemic. We examined the prevalence of mental health distress among a cohort of 1105 mothers using the World Health Organization's Self-Reporting Questionnaire (SRQ-20) before the onset of the COVID-19 pandemic in August 2019 and after the first two infection waves in October-November 2021. Our primary outcome was mental health distress, defined as SRQ-20 score above 7. We analyzed social, economic and family level characteristics as factors modifying to the COVID-19 induced changes in the mental health status. At baseline, 22.5% of women were in mental health distress. The odds of mental health distress among women increased marginally over the first two waves of the pandemic (aOR1.22, CI 0.99-1.49). Women under age 30, with lower educational background, with less than three children, and those living in Eastern Province (compared to Southern Province) of Zambia, were found to be at highest risk of mental health deterioration during the pandemic. Our findings suggest that the prevalence of mental health distress is high in this population and has further worsened during COVID-19 pandemic. Public health interventions targeting mothers' mental health in low resource settings may want to particularly focus on young mothers with limited educational attainment.
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Affiliation(s)
- Irene Falgas-Bague
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Medicine, Mongan Research Institute, Disparities Research Unit, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- * E-mail:
| | - Thandiwe Thembo
- Department of Psychiatry, University of Zambia, Lusaka, Zambia
| | - Jeanette L. Kaiser
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Davidson H. Hamer
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Nancy A. Scott
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Thandiwe Ngoma
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Ravi Paul
- Department of Psychiatry, University of Zambia, Lusaka, Zambia
| | - Allison Juntunen
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Peter C. Rockers
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts, United States of America
| | - Günther Fink
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
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23
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Henke RM. Knowing Well, Being Well: well-being born of understanding: The COVID-19 Pandemic and Children: Implications for Future Health. Am J Health Promot 2023; 37:263-288. [PMID: 36646664 DOI: 10.1177/08901171221140641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Kerker BD, Willheim E, Weis JR. The COVID-19 Pandemic: Implications for Maternal Mental Health and Early Childhood Development. Am J Health Promot 2023; 37:265-269. [PMID: 36646659 DOI: 10.1177/08901171221140641b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Women are particularly susceptible to mental health challenges during the perinatal period. With the onset of the COVID-19 pandemic in 2020, much concern was raised about the impact that the associated isolation, uncertainty, grief, loss and economic upheaval would have on mental health. Women experienced a disproportionate amount of environmental strain during this time, including economic stress and challenges associated with being essential workers; stressors were perhaps most prevalent in communities of color and immigrant groups. For women who were pregnant during the height of the pandemic, it is clear that stress, anxiety, and depression were increased due to changes in medical care and decreases in social support. Increased mental health challenges in the perinatal period have been shown to impact social-emotional, cognitive and behavioral health in infants and children, so the potential consequences of the COVID-19 era are great. This paper discusses these potential impacts and describes important pathways for future research.
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Affiliation(s)
- Bonnie D Kerker
- Department of Population Health, NYU Grossman School of Medicine, USA.,Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, USA
| | - Erica Willheim
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, USA
| | - J Rebecca Weis
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, USA.,Bellevue Hospital, USA
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Delanerolle G, McCauley M, Hirsch M, Zeng Y, Cong X, Cavalini H, Sajid S, Shetty A, Rathod S, Shi JQ, Hapangama DK, Phiri P. The prevalence of mental ill-health in women during pregnancy and after childbirth during the Covid-19 pandemic: a systematic review and Meta-analysis. BMC Pregnancy Childbirth 2023; 23:76. [PMID: 36709255 PMCID: PMC9883834 DOI: 10.1186/s12884-022-05243-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/24/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND This systematic review aims to explore the prevalence of the impact of the COVID-19, MERS, and SARS pandemics on the mental health of pregnant women. METHODS All COVID-19, SARS and MERS studies that evaluated the mental health of pregnant women with/without gynaecological conditions that were reported in English between December 2000 - July 2021 were included. The search criteria were developed based upon the research question using PubMed, Science Direct, Ovid PsycINFO and EMBASE databases. A wide search criterion was used to ensure the inclusion of all pregnant women with existing gynaecological conditions. The Newcastle-Ottawa-Scale was used to assess the risk of bias for all included studies. Random effects model with restricted maximum-likelihood estimation method was applied for the meta-analysis and I-square statistic was used to evaluate heterogeneity across studies. The pooled prevalence rates of symptoms of anxiety, depression, PTSD, stress, and sleep disorders with 95% confidence interval (CI) were computed. RESULTS This systematic review identified 217 studies which included 638,889 pregnant women or women who had just given birth. There were no studies reporting the mental health impact due to MERS and SARS. Results showed that women who were pregnant or had just given birth displayed various symptoms of poor mental health including those relating to depression (24.9%), anxiety (32.8%), stress (29.44%), Post Traumatic Stress Disorder (PTSD) (27.93%), and sleep disorders (24.38%) during the COVID-19 pandemic. DISCUSSION It is important to note that studies included in this review used a range of outcome measures which does not allow for direct comparisons between findings. Most studies reported self-reported measure of symptoms without clinical diagnoses so conclusions can be made for symptom prevalence rather than of mental illness. The importance of managing mental health during pregnancy and after-delivery improves the quality of life and wellbeing of mothers hence developing an evidence-based approached as part of pandemic preparedness would improve mental health during challenging times. OTHER The work presented in this manuscript was not funded by any specific grants. A study protocol was developed and published in PROSPERO (CRD42021235356) to explore several key objectives.
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Affiliation(s)
- Gayathri Delanerolle
- Nuffield Department of Primary Health Care Sciences, Uuniversity of Oxford, Oxford, UK
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Mary McCauley
- Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Martin Hirsch
- University College London, London, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Yutian Zeng
- Southern University of Science and Technology, Shenzhen, China
| | - Xu Cong
- Southern University of Science and Technology, Shenzhen, China
| | - Heitor Cavalini
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Sana Sajid
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Ashish Shetty
- University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Shanaya Rathod
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Jian Qing Shi
- Southern University of Science and Technology, Shenzhen, China
- National Center for Applied Mathematics, Shenzhen, China
| | | | - Peter Phiri
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK.
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
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26
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Sangsawang N, Sangsawang B. Postpartum depression, social support and maternal self-efficacy between adolescent and adult mothers during the COVID-19 pandemic: A comparative cross-sectional study. J Adv Nurs 2023; 79:113-124. [PMID: 36117329 DOI: 10.1111/jan.15445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 08/11/2022] [Accepted: 08/30/2022] [Indexed: 12/15/2022]
Abstract
AIMS To determine the rate and level of postpartum depression (PPD), as well as to examine and compare PPD, social support and maternal self-efficacy between adolescent and adult mothers at 8 weeks postpartum during the COVID-19 pandemic. BACKGROUND Policy measures to reduce the rapid spread of COVID-19 have disrupted many aspects of life and decreased social connections, which negatively impacts psychological well-being of the general population. However, studies focused on the impact of COVID-19 on mental health and maternal self-efficacy in postpartum mothers, particularly adolescent mothers, are limited. DESIGN A comparative cross-sectional study was carried out following the STROBE guidelines. METHODS An online questionnaire was administered from February to March 2021. Data were collected by the Edinburgh Postnatal Depression Scale (EPDS), the Postpartum Support Questionnaire (PSQ) and the Parenting Sense of Competence (PSOC) at 8 weeks postpartum. One-way MANOVA was used to analyse the data. RESULTS Data from 63 adolescent mothers and 63 adult mothers were analysed. There were significant correlations between PPD, social support and maternal self-efficacy of the COVID-19 pandemic. Both adolescent and adult mothers had significantly negative impacts from the pandemic on mental health, social support and maternal self-efficacy. However, the adolescent mothers had higher rates of depressive symptoms (36.5% and 23.8%, respectively) as well as lower PSQ score (121.25 and 130.52, respectively) and PSOC scores (62.54 and 70.94, respectively) compared with adult mothers in the first 8 weeks postpartum during the pandemic. CONCLUSION Adolescent mothers had a significantly higher rate of depressive symptoms and significantly lower social support and maternal self-efficacy scores compared to adult mothers at 8 weeks postpartum during the COVID-19 pandemic. IMPACT Midwives or nurses should emphasize the negative mental health impacts during the COVID-19 situation and routinely screen for depressive symptoms, especially in adolescent mothers, which could help identify the at-risk mothers for developing PPD. PATIENT OR PUBLIC CONTRIBUTION Neither patients nor the public were directly involved in the study.
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Affiliation(s)
- Nucharee Sangsawang
- Department of Maternal-Child Nursing and Midwifery, Faculty of Nursing, Srinakharinwirot University, Nakhonnayok, Thailand
| | - Bussara Sangsawang
- Department of Maternal-Child Nursing and Midwifery, Faculty of Nursing, Srinakharinwirot University, Nakhonnayok, Thailand
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Sperber JF, Hart ER, Troller‐Renfree SV, Watts TW, Noble KG. The effect of the COVID-19 pandemic on infant development and maternal mental health in the first 2 years of life. INFANCY 2023; 28:107-135. [PMID: 36240072 PMCID: PMC9874599 DOI: 10.1111/infa.12511] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 09/15/2022] [Accepted: 09/26/2022] [Indexed: 01/29/2023]
Abstract
We investigated how exogenous variation in exposure to the COVID-19 pandemic during the first year of life is related to infant development, maternal mental health, and perceived stress. Ninety-three socioeconomically diverse pregnant women were recruited before the pandemic to participate in a longitudinal study. Infants ranged in age at the beginning of lockdown (0-9.5 months old), thus experiencing different durations of pandemic exposure across the first year of life. The duration of pandemic exposure was not associated with family demographic characteristics, suggesting it captured exogenous variability. We tested associations between this exogenous variation in pandemic exposure and child and family outcomes. We also examined whether mother-reported disruptive life events were correlated with child and family outcomes. We found no association between duration of pandemic exposure in the first year of life and infant socioemotional problems, infant language development, or maternal mental health and perceived stress symptoms, at 12 or 24 months. However, we found that self-reported exposure to pandemic-related disruptive life events predicted greater maternal depression, anxiety, and perceived stress at 12 months, and greater depression and anxiety at 24 months. Socioeconomic status did not moderate these associations. These findings suggest cautious optimism for infants raised during this period.
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Affiliation(s)
| | - Emma R. Hart
- Teachers CollegeColumbia UniversityNew YorkNew YorkUSA
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28
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The Impact of the COVID-19 Pandemic on Postpartum Maternal Mental Health. J Pers Med 2022; 13:jpm13010056. [PMID: 36675717 PMCID: PMC9866377 DOI: 10.3390/jpm13010056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/11/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES There are reports of mental health worsening during the COVID-19 pandemic. We aimed to assess whether this occurred in women who were pregnant at baseline (late 2019) and unaware of the pandemic, and who delivered after the implementation of COVID-19 restrictions and threat (March-April 2020). To compare the pandemic period with the pre-pandemic, we capitalized on a retrospective 2014-2015 perinatal sample which had had affective symptoms assessed. METHODS The COVID sample were administered the Postnatal Depression Scale (EPDS), Zung Self-Rating Anxiety Scale (SAS), Hypomania Checklist-32 (HCL-32), Pittsburgh Sleep Quality Index (PSQI), and Perceived Stress Scale (PSS) at T0 (pregnancy) and T1 (post-delivery). The Non-COVID sample had completed EPDS and HCL-32 at the same timepoints. RESULTS The COVID sample included 72 women, aged 21-46 years (mean = 33.25 years ± 4.69), and the Non-COVID sample included 68 perinatal women, aged 21-46 years (mean = 34.01 years ± 4.68). Our study showed greater levels of mild depression in T1 among the COVID sample compared to the Non-COVID sample. No significant differences in terms of major depression and suicidal ideation were found. The levels of hypomania were significantly different between the two groups at T1, with the COVID sample scoring higher than the Non-COVID sample. This may be related to the high levels of perceived stress we found during the postpartum evaluation in the COVID sample. LIMITATIONS There was a relatively small sample size. CONCLUSIONS New mothers responded to the pandemic with less mental health impairment than expected, differently from the general population. Women delivering amidst the pandemic did not differ in depressive and anxiety symptoms from their pre-pandemic scores and from pre-pandemic women. Because stress responses have high energy costs, it is optimal for maternal animals to minimize such high metabolic costs during motherhood. Evidence suggests that reproductive experience alters the female brain in adaptive ways. This maternal brain plasticity facilitates a higher purpose, the continuation of the species. This may point to the recruitment of motherhood-related resources, for potentially overcoming the effects of the pandemic on mental health.
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29
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Gimbel LA, Allshouse AA, Neff D, Silver RM, Conradt E, Crowell SE. Mental health symptom changes in pregnant individuals across the COVID-19 pandemic: a prospective longitudinal study. BMC Pregnancy Childbirth 2022; 22:897. [PMID: 36463120 PMCID: PMC9719623 DOI: 10.1186/s12884-022-05144-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 10/21/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Initial studies found that mental health symptoms increased in pregnant and postpartum individuals during the COVID-19 pandemic. Less research has focused on if these putative increases persist over time and what factors influence these changes. We examined the longitudinal change in mental health symptoms in pregnant and postpartum individuals and investigated moderation by maternal emotion dysregulation and the incidence of coronavirus. METHODS Pregnant and postpartum individuals at the University of Utah were invited to join the COVID-19 and Perinatal Experiences (COPE) Study. Beginning on April 23, 2020 participants were sent a survey comprised of demographics, medical and social history, pregnancy information and self-assessments (Time 1). Participants were contacted 90 days later and invited to participate in a follow-up questionnaire (Time 2). Daily coronavirus case counts were accessed from the state of Utah and a 7-day moving average calculated. Within-subject change in mental health symptom scores, as measured by the Brief Symptom Inventory, was calculated. Linear mixed effects regression modeling adjusted for history of substance abuse and mental health disorders. RESULTS 270 individuals responded between April 23rd, 2020 and July 15th, 2021. Mental health symptom scores improved by 1.36 points (0.7-2.0 p < 0.001). The decrease in mental health symptoms was not moderated by the prevalence of COVID-19 cases (p = 0.19) but was moderated by emotion dysregulation (p = 0.001) as defined by the Difficulties in Emotion Regulation Scale short form. Participants with higher emotion dysregulation also had higher mental health symptom scores. CONCLUSION Mental health symptoms improved over the course of the pandemic in the same pregnant or postpartum participant. Our findings do not negate the importance of mental health care during the pandemic. Rather, we believe this identifies some aspect of resiliency and adaptability. Examining emotion dysregulation, or asking about a history of mental health, may be helpful in identifying persons at higher risk of heightened responses to stressors.
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Affiliation(s)
- Lauren A Gimbel
- Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, USA.
| | - Amanda A Allshouse
- Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, USA
| | - Dylan Neff
- Department of Psychology, University of Utah, Salt Lake City, USA
| | - Robert M Silver
- Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, USA
| | - Elisabeth Conradt
- Departments of Psychiatry and Pediatrics, Duke University, Durham, USA
| | - Sheila E Crowell
- Department of Obstetrics & Gynecology, University of Utah Health, Salt Lake City, USA
- Department of Psychology, University of Utah, Salt Lake City, USA
- Department of Psychiatry, University of Utah, Salt Lake City, USA
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30
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Abstract
The COVID-19 pandemic has taken a large toll on population health and well-being. We examine the consequences of prenatal exposure for infant health, through which the pandemic may have lasting intergenerational effects. We examine multiple pathways by which the pandemic shaped birth outcomes and socioeconomic disparities in these consequences. Analysis of more than 3.5 million birth records in California with universal information on COVID infection among persons giving birth at the time of delivery reveals deep inequalities in infection by education, race/ethnicity, and place-based socioeconomic disadvantage. COVID infection during pregnancy, in turn, predicts a large increase in the probability of preterm birth, by approximately one third. At the population level, a surprising reduction in preterm births during the first months of the pandemic was followed by an increase in preterm births during the surge in COVID infections in the winter of 2021. Whereas the early-pandemic reduction in preterm births benefited primarily highly educated mothers, the increase in preterm births during the winter infection surge was entirely concentrated among mothers with low levels of schooling. The COVID-19 pandemic is expected to exacerbate U.S. inequality in multiple ways. Our findings highlight a particularly enduring pathway: the long-term legacy of prenatal exposure to an unequal pandemic environment.
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Affiliation(s)
| | - Jenna Nobles
- Department of Sociology, University of Wisconsin-Madison, Madison, WI, USA
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31
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Davis KM, Lu L, Williams B, Roas-Gomez MV, Leziak K, Jackson J, Feinglass J, Yee LM. The Stress of Parenting in the Postpartum Period During the COVID-19 Pandemic. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:895-903. [PMID: 36479375 PMCID: PMC9712040 DOI: 10.1089/whr.2022.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/07/2022] [Indexed: 11/11/2022]
Abstract
Background The COVID-19 pandemic produced a major shift in parental roles, which disproportionally exacerbated existing challenges for low-income new parents. Our objective was to identify pandemic-related parenting challenges experienced by low-income postpartum individuals in the context of the early months of the COVID-19 pandemic. Methods Semistructured interviews with 40 low-income postpartum individuals were conducted within 10 weeks after giving birth in April 2020-June 2020. Interviews addressed maternal health and well-being, parental stress, including COVID-related barriers to providing for children, and access to essential services. Interview themes were developed using the constant comparative method. Results Half (n = 20) the participants identified as non-Hispanic Black and 38% (n = 15) as Hispanic; 75% (n = 30) were parents of multiple children. Parenting-related themes included challenges of parenting multiple children, barriers to maintaining self-care, and novel barriers to providing for children. Participants discussed handling new roles as educators, struggles with entertaining, allocating time among children, and effects of the pandemic on older children. Participants frequently described their lack of alone time, changes in self-care and coping strategies due to continuous parenting, and effects on maternal mental health like increased anxiety. Many participants reported lack of communal support, financial stress, and difficulty accessing services. Conclusions New burdens introduced by the pandemic challenged low-income individuals' health and well-being. Understanding these psychosocial stressors and developing interventions to ameliorate these burdens may be key to promoting family health during difficult times; one potential solution for preventing postpartum depression is offering continual social services. Clinical Trial No.: NCT03922334.
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Affiliation(s)
- Ka'Derricka M. Davis
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Layna Lu
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Brittney Williams
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Maria V. Roas-Gomez
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Karolina Leziak
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Jenise Jackson
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Joe Feinglass
- Division of General Internal Medicine, Department of Medicine, and Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Lynn M. Yee
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.,Address correspondence to: Lynn M. Yee, MD, MPH, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, 250 E. Superior Street, Suite 5-2145, Chicago, IL 60611, USA,
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32
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Cevik A, Onat Koroglu C, Karacam Z, Gokyildiz Surucu S, Alan S. Effects of the Covid-19 Pandemic on the Prevalence of Insomnia, Anxiety, and Depression During Pregnancy: A Systematic Review and Meta-Analysis. Clin Nurs Res 2022; 31:1405-1421. [PMID: 35912813 DOI: 10.1177/10547738221112748] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
This systematic review and meta-analysis study aims to determine the effects of the Covid-19 pandemic on the prevalence of insomnia, anxiety, and depression symptoms during pregnancy. Reviews were done through PubMed, EBSCO (Medline, CINAHL), Embase (OVID), Web of Science, PsycINFO, TR Index, Turkish Thesis Center databases using (pregnancy OR pregnant) and (sleep OR sleep disorders OR insomnia), and (anxiety OR depression) keywords between April and May 2021. The meta-analysis included 48 articles (sample: 77,299). It was found that the Covid-19 pandemic did not affect the prevalence of depression symptoms and anxiety during pregnancy, but it increased insomnia. While insomnia ratio was reported 39.6% (95% CI: 0.253-0.560) in the studies conducted before the pandemic, it was reported 88.8% (95% CI: 0.821-0.921) in the studies conducted during the pandemic. This study found that the Covid-19 pandemic did not have effects on depression symptoms and anxiety, but it increased insomnia complaints.
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Gow ML, Rossiter C, Roberts L, Henderson MJ, Yang L, Roche J, Hayes E, Canty A, Denney-Wilson E, Henry A. COVID-19, lifestyle behaviors and mental health: A mixed methods study of women 6 months following a hypertensive pregnancy. Front Public Health 2022; 10:1000371. [PMID: 36330103 PMCID: PMC9623114 DOI: 10.3389/fpubh.2022.1000371] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/04/2022] [Indexed: 01/26/2023] Open
Abstract
Introduction The COVID-19 pandemic introduced unprecedented challenges to both the physical and psychological health of postpartum women. The aim of this study was to determine how the COVID-19 pandemic affected the diet, physical activity and mental health of women 6 months following a hypertensive disorder of pregnancy. Methods Mixed methods sub-study of the Blood Pressure Postpartum trial, which recruited women following a hypertensive disorder of pregnancy from six Sydney metropolitan hospitals. Cross sectional analysis of baseline quantitative data, collected at 6-months postpartum from March 2019-February 2022, and qualitative data analysis from semi-structured telephone interviews, was performed. Dates of COVID-19 lockdowns for Sydney, Australia were collected from government websites. Diet (vegetable, fruit, alcohol, take away intake) and physical activity (walking, vigorous activity, strength training frequency and duration) were assessed using the self-report NSW Population Health Survey. Depression and anxiety were assessed using the Edinburgh Depression Scale and GAD-7 scale, respectively. Outcome data were compared between women who completed surveys "In Lockdown" vs. "Not in Lockdown" as well as "Prior to any Lockdown" vs. "During or Following any Lockdown". Results Of 506 participants, 84 women completed the study surveys "In Lockdown," and 149 completed the surveys "Prior to any Lockdown." Thirty-four participants were interviewed. There were no statistically significant differences in diet, physical activity, depression and anxiety among women who completed the survey "In Lockdown" vs. "Not in Lockdown." "Prior to any Lockdown," participants were more likely to do any walking (95% vs. 89%, p = 0.017), any vigorous activity (43% vs. 30%, p = 0.006) or any strength training (44% vs. 33%, p = 0.024), spent more time doing vigorous activity (p = 0.003) and strength training (p = 0.047) and were more likely to drink alcohol at least monthly (54% vs. 38%, p < 0.001) compared with "During or Following any Lockdown." Conclusions Our findings suggest that the confinements of lockdown did not markedly influence the mental health, diet and physical activity behaviors of women 6 months following hypertensive pregnancy. However, physical activity levels were reduced following the emergence of COVID-19, suggesting targeted efforts may be necessary to re-engage postpartum women with exercise. Trial registration https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376286&isReview=true, identifier: ACTRN12618002004246.
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Affiliation(s)
- Megan L. Gow
- The University of Sydney Children's Hospital Westmead Clinical School, Westmead, NSW, Australia,Discipline of Paediatrics and Child Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia,Women's and Children's Health, St George Hospital, Kogarah, NSW, Australia,*Correspondence: Megan L. Gow
| | - Chris Rossiter
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia
| | - Lynne Roberts
- Women's and Children's Health, St George Hospital, Kogarah, NSW, Australia,St George and Sutherland Clinical Campus, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Maddison J. Henderson
- The University of Sydney Children's Hospital Westmead Clinical School, Westmead, NSW, Australia
| | - Lin Yang
- Women's and Children's Health, St George Hospital, Kogarah, NSW, Australia,Office of Medical Education, University of New South Wales, Sydney, NSW, Australia
| | - Judith Roche
- Royal Hospital for Women, Randwick, NSW, Australia
| | - Erin Hayes
- Royal Prince Alfred Hospital, Camperdown, NSW, Australia
| | - Alison Canty
- Women's Health Initiative Translational Unit, South Western Sydney Local Health District, Liverpool, NSW, Australia
| | - Elizabeth Denney-Wilson
- Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia,Sydney Local Health District, Sydney, NSW, Australia
| | - Amanda Henry
- Women's and Children's Health, St George Hospital, Kogarah, NSW, Australia,Discipline of Women's Health, School of Clinical Medicine, University of New South Wales, Sydney, NSW, Australia
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Redmond ML, Mayes P, Morris K, Ramaswamy M, Ault KA, Smith SA. Learning from maternal voices on COVID-19 vaccine uptake: Perspectives from pregnant women living in the Midwest on the COVID-19 pandemic and vaccine. JOURNAL OF COMMUNITY PSYCHOLOGY 2022; 50:2630-2643. [PMID: 35419848 PMCID: PMC9088262 DOI: 10.1002/jcop.22851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 02/21/2022] [Accepted: 03/12/2022] [Indexed: 05/07/2023]
Abstract
The aim of this study was to understand COVID-19 vaccine perceptions and decision-making among a racially/ethnically diverse population of pregnant and lactating women in the Midwest. Pregnant female participants (N = 27) at least 18 years. or older living in the Midwest were recruited to participate in a maternal voices survey. A mix-methods approach was used to capture the perceptions of maternal voices concerning the COVID-19 vaccine. Participants completed an online survey on COVID-19 disease burden, vaccine knowledge, and readiness for uptake. A total of 27 participants completed the Birth Equity Network Maternal Voices survey. Most participants were African American (64%). Sixty-three percent intend to get the vaccine. Only 25% felt at-risk for contracting COVID-19, and 74% plan to consult their provider about getting the COVID-19 vaccine. At least 66% had some concerns about the safety of the vaccine. Participants indicated a willingness to receive the COVID-19 vaccine, especially if recommended by their provider. We found little racial/ethnic differences in perceptions of COVID-19 and low vaccine hesitancy.
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Affiliation(s)
- Michelle L. Redmond
- Department of Population HealthUniversity of Kansas School of Medicine‐WichitaWichitaKansasUSA
| | - Paigton Mayes
- Department of Population HealthUniversity of Kansas School of Medicine‐WichitaWichitaKansasUSA
| | - Kyla Morris
- Department of Population HealthUniversity of Kansas School of Medicine‐WichitaWichitaKansasUSA
- Department of Population HealthUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Megha Ramaswamy
- Department of Population HealthUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Kevin A. Ault
- Department of Obstetrics and GynecologyUniversity of Kansas Medical CenterKansas CityKansasUSA
| | - Sharla A. Smith
- Department of Population HealthUniversity of Kansas Medical CenterKansas CityKansasUSA
- Department of Obstetrics and GynecologyUniversity of Kansas Medical CenterKansas CityKansasUSA
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Depression in pregnant and postpartum women during COVID-19 pandemic: systematic review and meta-analysis. Obstet Gynecol Sci 2022; 65:287-302. [PMID: 35754363 PMCID: PMC9304439 DOI: 10.5468/ogs.21265] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 05/19/2022] [Indexed: 11/08/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) emerged as a global pandemic in March 2020 and caused a big crisis, especially the health crisis. Pregnant and postpartum women experienced significant physical, social, and mental changes that put them at higher risk for several conditions during the pandemic. This study aimed to report the prevalence of depression in pregnant and postpartum women during the COVID-19 pandemic. Eligible studies were identified using several databases. Prevalence analysis was conducted using MedCalc ver. 19.5.1. This systematic review and meta-analysis was registered in PROSPERO on July 12, 2021 with registration number CRD42021266976. We included 54 studies with 95.326 participants. The overall prevalence of depression was 32.60% among pregnant and postpartum women during the COVID-19 pandemic. The rate was higher among pregnant women (31.49%) compared to postpartum women (27.64%). The prevalence of depression among pregnant and postpartum women increased during the COVID-19 pandemic.
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The Impact of COVID-19 on Anxious and Depressive Symptomatology in the Postpartum Period. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137833. [PMID: 35805494 PMCID: PMC9265928 DOI: 10.3390/ijerph19137833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/22/2022] [Accepted: 06/23/2022] [Indexed: 11/17/2022]
Abstract
Background: Women in the postpartum period may be particularly vulnerable to the psychological effects of the COVID-19 pandemic. The aim of our study was to evaluate the impact of the coronavirus pandemic on postpartum depression and anxiety levels and the role of the fear of COVID-19 in its development. Methods: Women who delivered at the Bissaya Barreto Maternity Hospital, between 16 March and 16 June 2020 (Group 1: Birth in COVID-19 period, n = 207), recruited in the postpartum period, filled in a set of self-reported validated questionnaires: Perinatal Depression Screening Scale, Perinatal Anxiety Screening Scale, Profile of Mood States, Perseverative Thinking Questionnaire, Dysfunctional Beliefs Towards Maternity Scale, and the Fear of COVID-19 Scale. Levels of depressive and anxious symptomatology, negative affect, negative repetitive thinking, and the dysfunctional beliefs towards motherhood of these women were compared with data from samples of previous studies that included women whose delivery had occurred at the same Maternity Hospital before the COVID-19 pandemic period (Group 2: Birth before the COVID-19 period, n = 212). Results: Based on the cutoff points of the screening scales, the prevalence of clinically relevant depressive and anxious symptoms in Group 1 was 40.1% and 36.2%, respectively. Women in Group 1 had significantly higher levels of anxious and depressive symptoms, negative affect, negative repetitive thinking, and dysfunctional beliefs towards motherhood than women in Group 2 (p < 0.05). Fear of COVID-19 in the postpartum period was a predictor of depressive (ß = 0.262) and anxious (ß = 0.371) symptoms, explaining 6.9% and 13.7% of their variability, respectively (p < 0.001). Conclusion: During the COVID-19 pandemic, women in the postpartum period present greater depressive and anxious symptomatology, as well as increased risk factors.
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Lim M, Van Hulst A, Pisanu S, Merry L. Social Isolation, Loneliness and Health: A Descriptive Study of the Experiences of Migrant Mothers With Young Children (0–5 Years Old) at La Maison Bleue. Front Glob Womens Health 2022; 3:823632. [PMID: 35814837 PMCID: PMC9265247 DOI: 10.3389/fgwh.2022.823632] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 06/02/2022] [Indexed: 11/24/2022] Open
Abstract
Background Migrant women with young children, including asylum seekers and refugees, have multiple vulnerability factors that put them at increased risk of social isolation and loneliness, which are associated with negative health outcomes. This study explored the experiences of social isolation and loneliness among migrant mothers with children aged 0–5 years as well as their perceptions on possible health impacts. Methods A qualitative descriptive study was conducted at La Maison Bleue, a non-profit organization providing perinatal health and social services to vulnerable women in Montreal, Canada. Recruitment and data collection occurred concurrently during the COVID-19 pandemic, between November and December 2020. Eleven women participated in individual semi-structured interviews and provided socio-demographic information. Interview data were thematically analyzed. Results Migrant women in this study described social isolation as the loss of family support and of their familiar social/cultural networks, and loneliness as the feelings of aloneness that stemmed from being a mother in a new country with limited support. Multiple factors contributed to women's and children's social isolation and loneliness, including migration status, socioeconomic circumstances, language barriers, and being a single mother. Women expressed that the COVID-19 pandemic exacerbated pre-existing experiences of social isolation and loneliness. Mothers' experiences affected their emotional and mental health, while for children, it reduced their social opportunities outside the home, especially if not attending childcare. However, the extent to which mothers' experiences of social isolation and loneliness influenced the health and development of their children, was less clear. Conclusion Migrant mothers' experiences of social isolation and loneliness are intricately linked to their status as migrants and mothers. Going forward, it is critical to better document pandemic and post-pandemic consequences of social isolation and loneliness on young children of migrant families. Supportive interventions for migrant mothers and their young children should not only target social isolation but should also consider mothers' feelings of loneliness and foster social connectedness and belongingness. To address social isolation and loneliness, interventions at the individual, community and policy levels are needed.
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Affiliation(s)
- Mona Lim
- Ingram School of Nursing, McGill University, Montreal, QC, Canada
| | | | | | - Lisa Merry
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada
- West Central Montreal CIUSSS, SHERPA University Institute, Montreal, QC, Canada
- InterActions Centre de recherche et de partage des savoirs, CIUSSS du Nord-de-l'île-de-Montréal, Montreal, QC, Canada
- *Correspondence: Lisa Merry
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Gómez-Baya D, Gómez-Gómez I, Domínguez-Salas S, Rodríguez-Domínguez C, Motrico E. The influence of lifestyles to cope with stress over mental health in pregnant and postpartum women during the COVID-19 pandemic. CURRENT PSYCHOLOGY 2022; 42:1-20. [PMID: 35729900 PMCID: PMC9200375 DOI: 10.1007/s12144-022-03287-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2022] [Indexed: 11/23/2022]
Abstract
The COVID-19 pandemic affected daily life routines and lifestyles of pregnant and postpartum women and increased their stress and risk of suffering from mental health problems. The aim of this study was to analyse which sociodemographic variables, COVID-19 exposure variables and lifestyles to cope with stress variables predicted anxiety, depression, and PTSD symptoms in pregnant and postpartum women during the COVID-19 pandemic. A cross-sectional design was performed with a sample of 3356 Spanish women participating in the Riseup-PPD-COVID-19 study. These participants completed an online survey composed of measures of anxiety (GAD-7), depression (EPDS), and PTSD related to COVID-19 (Checklist DSM-5), as well as demographics, exposure to COVID-19, and lifestyles to cope with stress. Regarding results, 47.2% showed depression and a third reported anxiety, whereas moderate scores were observed in PTSD symptoms. The most commonly used strategies to cope with stress in the COVID-19 pandemic were talking with friends and family and increasing time with social networks. Better results in mental health were associated with coping strategies such as talking with family and friends or participating in family activities, physical activity, sleeping well at night, eating healthier, and increasing personal care. Furthermore, poor results in mental health were observed in those participants who increased time with screens, ate fast food, reported substance use, and talked more frequently with health professionals. More symptoms were also observed in younger women, primiparous women, and those who reported more exposure to COVID-19. The results underline the need to strengthen the mental health of pregnant and postpartum women. Trial registration: ClinicalTrials.gov Identifier: NCT04595123.
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Affiliation(s)
- Diego Gómez-Baya
- Department of Social, Developmental and Educational Psychology, Universidad de Huelva, Huelva, Spain
| | - Irene Gómez-Gómez
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville Spain
| | - Sara Domínguez-Salas
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville Spain
| | | | - Emma Motrico
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Seville Spain
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Njoroge WFM, White LK, Waller R, Forkpa M, Himes MM, Morgan K, Seidlitz J, Chaiyachati BH, Barzilay R, Kornfield SL, Parish-Morris J, Rodriguez Y, Riis V, Burris HH, Elovitz MA, Gur RE. Association of COVID-19 and Endemic Systemic Racism With Postpartum Anxiety and Depression Among Black Birthing Individuals. JAMA Psychiatry 2022; 79:600-609. [PMID: 35416928 PMCID: PMC9008565 DOI: 10.1001/jamapsychiatry.2022.0597] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
IMPORTANCE The intersection of endemic structural racism and the global health crisis secondary to the COVID-19 pandemic represents a syndemic, defined as the aggregation of 2 or more endemic and epidemic conditions leading to adverse repercussions for health. Long-standing inequities have placed Black individuals at disproportionate risk for negative postpartum mental health outcomes. Studies are urgently needed to understand how the COVID-19 pandemic has added to this risk (eg, syndemic associations). OBJECTIVE To examine the association between the syndemic and the postpartum mental health of Black birthing individuals. DESIGN, SETTING, AND PARTICIPANTS A longitudinal cohort of Black birthing individuals were followed up from pregnancy (April 17 to July 8, 2020) through the early postpartum period (August 11, 2020, to March 2, 2021) from urban university medical center prenatal clinics. Pregnant Black participants were recruited via email and completed 2 online surveys. MAIN OUTCOMES AND MEASURES Composite variables capturing negative experiences of the COVID-19 pandemic and racism (structural racism [general], structural racism [neighborhood], and interpersonal racism) were created. Logistic regressions examined main and interactive associations between these variables and postpartum depression (Edinburgh Postnatal Depression Scale) and anxiety (Generalized Anxiety Disorder 7-item scale). RESULTS The mean (SD) age of 151 Black participants was 30.18 (5.65) years. The association between higher negative COVID-19 pandemic experiences and postpartum depression may be influenced by experiences of interpersonal racism and general systemic racism. Negative COVID-19 pandemic experiences were associated with greater likelihood of screening positive for depression only at higher levels of systemic racism (odds ratio, 2.52; 95% CI, 1.38-4.60) and interpersonal racism (odds ratio, 1.90; 95% CI, 1.04-3.48) but not at lower levels of systemic or interpersonal racism. Similarly, negative COVID-19 experiences were associated with anxiety only at higher levels of interpersonal racism (odds ratio, 1.85; 95% CI, 0.86-4.01) but not at lower levels of interpersonal racism. Overall, 44 (29%) met screening criteria for postpartum depression and 20 (13%) for postpartum anxiety. CONCLUSIONS AND RELEVANCE In this longitudinal cohort study of Black birthing individuals, the experience of the syndemic was associated with negative postpartum mental health. Associations between interpersonal racism, structural racism, and negative COVID-19 pandemic experiences were associated with greater risk for postpartum depression and anxiety. Research is needed to address how systemic racism perturbs biobehavioral pathways to magnify associations between acute stressors and mental health. Such research can inform the creation of effective, culturally informed preventive interventions to improve the postpartum mental health of Black individuals.
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Affiliation(s)
- Wanjikũ F. M. Njoroge
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Policy Lab, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
| | - Lauren K. White
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
| | - Rebecca Waller
- Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia,Department of Psychology, University of Pennsylvania, Philadelphia
| | - Markolline Forkpa
- Dornsife School of Public Health Drexel University, Philadelphia, Pennsylvania
| | - Megan M. Himes
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
| | | | - Jakob Seidlitz
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
| | - Barbara H. Chaiyachati
- Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia,Center for Pediatric Clinical Effectiveness, Division General Pediatrics, Children’s Hospital Philadelphia, Philadelphia, Pennsylvania,Leonard Davis Institute, University of Pennsylvania, Philadelphia, Pennsylvania,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ran Barzilay
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
| | - Sara L. Kornfield
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia,Penn Center for Women’s Behavioral Wellness, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Julia Parish-Morris
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Valerie Riis
- Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Heather H. Burris
- Center for Pediatric Clinical Effectiveness, Division General Pediatrics, Children’s Hospital Philadelphia, Philadelphia, Pennsylvania,Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Michal A. Elovitz
- Maternal and Child Health Research Center, Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Raquel E. Gur
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia,Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania,Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
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Perinatal Depression in Australian Women during the COVID-19 Pandemic: The Birth in the Time of COVID-19 (BITTOC) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095062. [PMID: 35564456 PMCID: PMC9103175 DOI: 10.3390/ijerph19095062] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 02/01/2023]
Abstract
The COVID-19 pandemic has impacted perinatal mental health globally. We determined the maternal factors and pandemic-related experiences associated with clinically significant perinatal (pregnant and post-partum) depressive symptoms in Australian women. Participants (n = 2638; pregnant n = 1219, postnatal n = 1419) completed an online survey (August 2020 through February 2021) and self-reported on depression, social support, and COVID-19 related experiences. We found elevated depressive symptoms amongst 26.5% (pregnant) and 19% (postnatal) women. Multiple logistic regression analyses showed higher likelihood of elevated depression associated with residence in Victoria, lower education, past/current mental health problems, greater non-pandemic prenatal stress, age ≥ 35 years (pregnant women) and existing physical health issues or disability in self or others (postnatal women). Greater family stress/discord and lower social support (friends) was associated with higher odds of elevated perinatal depression, while lower social support (family) was significantly associated with elevated depressive symptoms in pregnant women. Greater depression was associated with social distancing, pandemic-related news exposure and changes to prenatal care (pregnant women). Single postnatal women showed lower odds of elevated depression than partnered women. Our findings underscore the importance of universal screening for depression and targeted support during a pandemic for perinatal women displaying vulnerability factors.
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Pascal R, Crovetto F, Casas I, Youssef L, Trilla C, Larroya M, Cahuana A, Boada D, Foraster M, Llurba E, Sunyer J, Crispi F, Gratacos E, Gómez-Roig MD. Impact of the COVID-19 Pandemic on Maternal Well-Being during Pregnancy. J Clin Med 2022; 11:jcm11082212. [PMID: 35456306 PMCID: PMC9032494 DOI: 10.3390/jcm11082212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/08/2022] [Accepted: 04/13/2022] [Indexed: 12/10/2022] Open
Abstract
The outbreak of a pandemic has negative psychological effects. We aimed to determine the impact of the SARS-CoV-2 pandemic during pregnancy and identify the risk factors for maternal well-being. A multicenter, prospective, population-based study was carried out that included women (n = 1320) who were pregnant during the SARS-CoV-2 pandemic in Barcelona (Spain) compared against a pre-pandemic cohort (n = 345). Maternal well-being was assessed using the validated World Health Organization Well-Being Index Questionnaire (WHO-5 Index). Pregnant women attended during the COVID-19 pandemic showed worst WHO-5 well-being scores (median (IQR) of 56 (36−72) for the pandemic cohort vs. 64 (52−76) for the pre-pandemic cohort p < 0.001), with 42.8% of women presenting a poor well-being score vs. 28% for the pre-pandemic cohort (p < 0.001). Presence of a previous psychiatric disorder (OR 7.1; 95% CI 2.6−19, p < 0.001), being in the third trimester of pregnancy (OR 1.7; 95% CI 1.5−2, p < 0.001), or requiring hospital admission for COVID-19 (OR 4.7; 95% CI 1.4−16.7, p = 0.014), significantly contributed to low maternal well-being during the COVID-19 pandemic (multivariate analysis). Being infected by SARS-CoV-2 was not associated with a lower well-being score. We conclude that, during the COVID-19 pandemic, there were higher rates of poor maternal well-being; the infection of SARS-CoV-2 itself did not worsen maternal well-being, but other factors as psychiatric disorders, being in the third trimester of pregnancy or hospital admission for COVID-19 disease did.
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Affiliation(s)
- Rosalia Pascal
- BCNatal, Fetal Medicine Research Center, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain; (R.P.); (I.C.); (L.Y.); (M.L.); (A.C.); (D.B.); (F.C.); (E.G.); (M.D.G.-R.)
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin, RD21/0012/0001, Instituto de Salud Carlos III, 28029 Madrid, Spain;
| | - Francesca Crovetto
- BCNatal, Fetal Medicine Research Center, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain; (R.P.); (I.C.); (L.Y.); (M.L.); (A.C.); (D.B.); (F.C.); (E.G.); (M.D.G.-R.)
- Institut de Recerca Sant Joan de Déu, 08950 Barcelona, Spain
- Center for Biomedical Network Research on Rare Diseases, 28029 Madrid, Spain
- Correspondence:
| | - Irene Casas
- BCNatal, Fetal Medicine Research Center, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain; (R.P.); (I.C.); (L.Y.); (M.L.); (A.C.); (D.B.); (F.C.); (E.G.); (M.D.G.-R.)
| | - Lina Youssef
- BCNatal, Fetal Medicine Research Center, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain; (R.P.); (I.C.); (L.Y.); (M.L.); (A.C.); (D.B.); (F.C.); (E.G.); (M.D.G.-R.)
| | - Cristina Trilla
- Department of Obstetrics and Gynecology, Hospital de la Santa Creu i de Sant Pau, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain;
| | - Marta Larroya
- BCNatal, Fetal Medicine Research Center, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain; (R.P.); (I.C.); (L.Y.); (M.L.); (A.C.); (D.B.); (F.C.); (E.G.); (M.D.G.-R.)
| | - Alex Cahuana
- BCNatal, Fetal Medicine Research Center, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain; (R.P.); (I.C.); (L.Y.); (M.L.); (A.C.); (D.B.); (F.C.); (E.G.); (M.D.G.-R.)
| | - David Boada
- BCNatal, Fetal Medicine Research Center, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain; (R.P.); (I.C.); (L.Y.); (M.L.); (A.C.); (D.B.); (F.C.); (E.G.); (M.D.G.-R.)
| | | | - Elisa Llurba
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin, RD21/0012/0001, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Department of Obstetrics and Gynecology, Hospital de la Santa Creu i de Sant Pau, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain;
| | - Jordi Sunyer
- ISGlobal, 08003 Barcelona, Spain; (M.F.); (J.S.)
| | - Fàtima Crispi
- BCNatal, Fetal Medicine Research Center, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain; (R.P.); (I.C.); (L.Y.); (M.L.); (A.C.); (D.B.); (F.C.); (E.G.); (M.D.G.-R.)
- Center for Biomedical Network Research on Rare Diseases, 28029 Madrid, Spain
- Institut de Recerca August Pi Sunyer, 08036 Barcelona, Spain
| | - Eduard Gratacos
- BCNatal, Fetal Medicine Research Center, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain; (R.P.); (I.C.); (L.Y.); (M.L.); (A.C.); (D.B.); (F.C.); (E.G.); (M.D.G.-R.)
- Institut de Recerca Sant Joan de Déu, 08950 Barcelona, Spain
- Center for Biomedical Network Research on Rare Diseases, 28029 Madrid, Spain
- Institut de Recerca August Pi Sunyer, 08036 Barcelona, Spain
| | - María Dolores Gómez-Roig
- BCNatal, Fetal Medicine Research Center, Hospital Sant Joan de Déu and Hospital Clínic, University of Barcelona, 08036 Barcelona, Spain; (R.P.); (I.C.); (L.Y.); (M.L.); (A.C.); (D.B.); (F.C.); (E.G.); (M.D.G.-R.)
- Primary Care Interventions to Prevent Maternal and Child Chronic Diseases of Perinatal and Development Origin, RD21/0012/0001, Instituto de Salud Carlos III, 28029 Madrid, Spain;
- Institut de Recerca Sant Joan de Déu, 08950 Barcelona, Spain
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McKinlay AR, Fancourt D, Burton A. Factors affecting the mental health of pregnant women using UK maternity services during the COVID-19 pandemic: a qualitative interview study. BMC Pregnancy Childbirth 2022; 22:313. [PMID: 35413807 PMCID: PMC9005019 DOI: 10.1186/s12884-022-04602-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/22/2022] [Indexed: 01/16/2023] Open
Abstract
Background People using maternity services in the United Kingdom (UK) have faced significant changes brought on by the COVID-19 pandemic and social distancing regulations. We focused on the experiences of pregnant women using UK maternity services during the pandemic and the impact of social distancing rules on their mental health and wellbeing. Methods We conducted 23 qualitative semi-structured interviews from June 2020 to August 2021, with women from across the UK who experienced a pregnancy during the pandemic. Nineteen participants in the study carried their pregnancy to term and four had experienced a miscarriage during the pandemic. Interviews took place remotely over video or telephone call, discussing topics such as mental health during pregnancy and use of UK maternity services. We used reflexive thematic analysis to analyse interview transcripts. Results We generated six higher order themes: [1] Some pregnancy discomforts alleviated by social distancing measures, [2] The importance of relationships that support coping and adjustment, [3] Missed pregnancy and parenthood experiences, [4] The mental health consequences of birth partner and visitor restrictions, [5] Maternity services under pressure, and [6] Lack of connection with staff. Many participants felt a sense of loss over a pregnancy experience that differed so remarkably to what they had expected because of the pandemic. Supportive relationships were important to help cope with pregnancy and pandemic-related changes; but feelings of isolation were compounded for some participants because opportunities to build social connections through face-to-face parent groups were unavailable. Participants also described feeling alone due to restrictions on their partners being present when accessing UK maternity services. Conclusions Our findings highlight some of the changes that may have affected pregnant women’s mental health during the COVID-19 pandemic. Reduced social support and being unable to have a partner or support person present during maternity service use were the greatest concerns reported by participants in this study. Absence of birth partners removed a protective buffer in times of uncertainty and distress. This suggests that the availability of a birth partner or support person must be prioritised wherever possible in times of pandemics to protect the mental health of people experiencing pregnancy and miscarriage. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04602-5.
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Affiliation(s)
- A R McKinlay
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - D Fancourt
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
| | - A Burton
- Research Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK
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Vacaru SV, Beijers R, de Weerth C. Internalizing symptoms and family functioning predict adolescent depressive symptoms during COVID-19: A longitudinal study in a community sample. PLoS One 2022; 17:e0264962. [PMID: 35303003 PMCID: PMC8932580 DOI: 10.1371/journal.pone.0264962] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 02/18/2022] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and lockdown pose a threat for adolescents' mental health, especially for those with an earlier vulnerability. Accordingly, these adolescents may need increased support from family and friends. This study investigated whether family functioning and peer connectedness protects adolescents with earlier internalizing or externalizing symptoms from increased depressive symptoms during the first Dutch COVID-19 lockdown in a low-risk community sample. METHODS This sample comprised 115 adolescents (Mage = 13.06; 44% girls) and their parents (N = 111) and is part of an ongoing prospective study on child development. Internalizing and externalizing symptoms were self-reported a year before the COVID-19 lockdown. In an online survey during the first Dutch lockdown (April-May 2020), adolescents reported depressive symptoms and perceived peer connectedness, and parents reported family functioning. RESULTS Twenty-four percent of adolescents reported clinically relevant symptoms of depression during the first COVID-19 lockdown. Depressive symptoms were significantly predicted by earlier internalizing, but not externalizing symptoms. Furthermore, higher quality of family functioning, but not peer connectedness, predicted fewer adolescent depressive symptoms. Family functioning and peer connectedness did not moderate the link between pre-existing internalizing symptoms and later depressive symptoms. CONCLUSIONS In a low-risk community sample, one-in-four adolescents reported clinically relevant depressive symptoms at the first COVID-19 lockdown. Higher earlier internalizing symptoms and lower quality of family functioning increased risks. These results indicate that even in low-risk samples, a substantial group of adolescents and their families are vulnerable during times of crisis.
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Affiliation(s)
- Stefania V. Vacaru
- Donders Institute for Brain, Cognition & Behavior, Radboud University Medical Center, Nijmegen, Netherlands
- * E-mail:
| | - Roseriet Beijers
- Donders Institute for Brain, Cognition & Behavior, Radboud University Medical Center, Nijmegen, Netherlands
- Radboud University, Nijmegen, The Netherlands
| | - Carolina de Weerth
- Donders Institute for Brain, Cognition & Behavior, Radboud University Medical Center, Nijmegen, Netherlands
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Prevalence and Risk Factors of Postpartum Depression in Romanian Women during Two Periods of COVID-19 Pandemic. J Clin Med 2022; 11:jcm11061628. [PMID: 35329954 PMCID: PMC8950465 DOI: 10.3390/jcm11061628] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 12/23/2022] Open
Abstract
Postpartum depression is a major mental health disorder that can negatively affect both mother and baby. In addition, the COVID-19 pandemic associated with extreme measures of the lockdown had profound effects on humanity, increasing the rates of anxiety and depression, especially among women in the postpartum period. The aim of this study was threefold: to determine the prevalence of postpartum depression, to compare the prevalence of postpartum depression at two different times during the COVID-19 pandemic, and to assess a possible association between the timing of childbirth in a given period of the pandemic and the risk of postpartum depression. A cross-sectional study involving 154 women who were interviewed immediately postpartum, using the EPDS scale, was conducted at the Timisoara Municipal Hospital, Romania at two different periods during the COVID-19 pandemic (March−April 2020 during the first wave and August−September 2021 during the fourth wave). The overall prevalence of postpartum depression (EPDS score > 13) was 18.8%, with a statistically significantly higher rate among participants surveyed during the fourth wave of the COVID-19 pandemic in Romania; the COVID-19 pandemic represents an impact on women’s mental health in the postpartum period, increasing the risk of developing postpartum depression.
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Raiff EM, D’Antonio KM, Mai C, Monk C. Mental Health in Obstetric Patients and Providers During the COVID-19 Pandemic. Clin Obstet Gynecol 2022; 65:203-215. [PMID: 34857681 PMCID: PMC8767924 DOI: 10.1097/grf.0000000000000668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Psychiatric morbidity is the most common childbirth complication with 1 in 5 women experiencing a perinatal mood or anxiety disorder. The cost of this psychiatric morbidity is pervasive, contributing to devastating maternal health, child developmental, and economic consequences. The coronavirus disease 2019 (COVID-19) pandemic, and associated changes to perinatal experiences, resulted in profound psychological reactions including increased anxiety, depression, stress disorders, and sleep disturbance, further impacting obstetric patients. Providers' mental health has been challenged by moral injury and shared trauma. This article reviews mental health outcomes in regard to the COVID-19 pandemic for obstetric patients and their providers.
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Affiliation(s)
| | | | - Christine Mai
- College of Medicine, University of Cincinnati, Cincinnati, Ohio
| | - Catherine Monk
- Departments of Obstetrics and Gynecology
- Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York
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Abstract
PURPOSE To explore the experiences of pregnant women who were living in the United States during the COVID-19 pandemic. STUDY DESIGN AND METHODS Using a qualitative design, we used data obtained from women in their second or third trimester of pregnancy who participated in the Perinatal Experiences and COVID-19 Effects (PEACE) Study from May 21 to December 22, 2020. RESULTS 361 of 408 pregnant women (88%) who participated in the PEACE study during that timeframe provided narrative comments. Participants had a mean age of 33.2 years (SD = 3.7) with a high percentage of White women (91.4%). At the time of participation, women were between 2.4 and 8.6 months into the COVID-19 pandemic. Just under half were pregnant for the first time (n = 177). Content analysis of responses revealed an overall sense of "unmet expectations" within two themes involving the role of relationships: 1) losing the experience of going through pregnancy together and 2) loss of social support and expected relationship building. Differences were noted between participants giving birth for the first time and participants with other children at home. CLINICAL IMPLICATIONS This study offers insight for nurses and other clinicians taking care of pregnant women during times of public health crises and provides implications for the care of women as the pandemic continues. Nurses can help women plan for future health care changes that may disrupt their support needs as seen during the COVID-19 pandemic. Nurses should also be aware of possible enduring effects of prenatal unmet needs on later outcomes.
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Sudhinaraset M, Landrian A, Mboya J, Golub G. The Economic Toll of
COVID
‐19: A Cohort Study of Prevalence and Economic Factors Associated with postpartum depression in Kenya. Int J Gynaecol Obstet 2022; 158:110-115. [PMID: 35152420 PMCID: PMC9087701 DOI: 10.1002/ijgo.14142] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 02/09/2022] [Indexed: 11/28/2022]
Abstract
Objective The aim of the study is to examine the risk of postpartum depression (PPD) among women who delivered during the COVID‐19 pandemic compared to women who delivered before the COVID‐19 pandemic and how economic challenges are associated with PPD. Methods Data were collected from 2332 women. This includes 1197 women from healthcare facilities in 2019 who were followed up at 2–4 and 10 weeks postpartum. Additionally, we recruited 1135 women who delivered from March 16, 2020 onward when COVID‐19 restrictions were mandated in Kenya in the same catchment areas as the original sample to compare PPD rates. Results Adjusting for covariates, women who delivered during COVID‐19 had 2.5 times higher odds of screening positive for PPD than women who delivered before COVID‐19 (95% confidence interval [CI] 1.92–3.15). Women who reported household food insecurity, required to pay a fee to cover the cost of PPE during labor and delivery and/or postnatal visit(s), and those who reported COVID‐19 employment‐related impacts had a higher likelihood of screening for PPD compared to those who did not report these experiences. Conclusion The COVID‐19 pandemic has greatly increased the economic vulnerability of women, resulting in increases in PPD. The COVID‐19 pandemic has greatly increased the economic vulnerability of women and has increased PPD.
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Affiliation(s)
- May Sudhinaraset
- Fielding School of Public Health University of California Los Angeles USA
| | - Amanda Landrian
- Fielding School of Public Health University of California Los Angeles USA
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Christie HE, Beetham K, Stratton E, Francois ME. “Worn-out but happy”: Postpartum Women's Mental Health and Well-Being During COVID-19 Restrictions in Australia. Front Glob Womens Health 2022; 2:793602. [PMID: 35072152 PMCID: PMC8777212 DOI: 10.3389/fgwh.2021.793602] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022] Open
Abstract
Background: From late 2019, COVID-19 disease has infiltrated the global population causing widespread challenges to public health. One cohort that has received less attention, but who may be more vulnerable to the mental and physical health related impacts of COVID-19 restrictions are postpartum mothers. The aim of this study was to explore the mental health, well-being, and health behaviours of mothers up to 12 months postpartum whilst living in Australia under COVID-19 level 3 and 4 restrictions. Methods: 351 women in their first year postpartum residing in Australia whilst under level 3/4 social distancing restrictions (during April 13 and June 11, 2020) were recruited to participate in an online questionnaire. The survey measured symptoms of depression, anxiety, and stress (DASS), wellness (SF-36), physical activity (Godin-Shephard score), perceived value of health outcomes, diet, and sleep. Descriptive statistics and linear regressions were performed. Results: Data was analysed for 139 eligible women. Of these women, 74% scored “normal” for depression, 84% for anxiety, and 72% for stress. Over half (58%) of women reported being worn out all, most, or a good bit of the time and 77% reported being a happy person all, most, or a good bit of the time. Analysis of the perceived values of health outcome revealed women had high value for “getting out of the house,” “achieving a better overall mood,” and “to feel better physically.” Women were considered physically active according to the Godin Leisure score, however only 41% of women met the current Australian national physical activity guidelines of 150 min.week−1. Conclusions: Overall the majority of postpartum mums that were surveyed, have normal mental health symptoms, and despite being worn out most are happy at least a good bit of the time. This study highlights the importance of health values in maintaining leisure physical activity and mental health. In addition it appears women may benefit from virtual group exercise and community programs to encourage being physically active and socialising with friends simultaneously.
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Affiliation(s)
- Hannah E. Christie
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
| | - Kassia Beetham
- School of Behavioural and Health Sciences, Australian Catholic University, Banyo, QLD, Australia
| | - Elizabeth Stratton
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Monique E. Francois
- School of Medicine, University of Wollongong, Wollongong, NSW, Australia
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW, Australia
- *Correspondence: Monique E. Francois
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Hernandez-Castro I, Toledo-Corral CM, Chavez T, Habre R, Grubbs B, Al-Marayati L, Lerner D, Lurvey N, Lagomasino I, Eckel SP, Dunton GF, Farzan SF, Breton CV, Bastain TM. Perceived vulnerability to immigration policies among postpartum Hispanic/Latina women in the MADRES pregnancy cohort before and during the COVID-19 pandemic. WOMEN'S HEALTH (LONDON, ENGLAND) 2022; 18:17455057221125103. [PMID: 36148937 PMCID: PMC9511002 DOI: 10.1177/17455057221125103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/22/2022] [Accepted: 08/16/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION AND OBJECTIVES Research suggests that perceived immigration policy vulnerability has important health implications. Coupled with the mental and physical stressors accompanying the postpartum period and a growing awareness of the discrimination and structural racism experienced by marginalized communities globally, the coronavirus disease 2019 period may have exacerbated stress among vulnerable populations, specifically postpartum Hispanic/Latina women. This study evaluated perceived immigration policy vulnerability (i.e. discrimination, social isolation, and family threats) in early postpartum Hispanic/Latina women in Los Angeles before and during the coronavirus disease 2019 pandemic. METHODS The Perceived Immigration Policy Effects Scale (PIPES) was administered cross-sectionally at 1 month postpartum to 187 Hispanic/Latina women in the MADRES cohort. Respondents between September 2018 and March 2020 were classified as "pre-pandemic" (N = 128), between March 2020 and July 2020 as "early pandemic" (N = 38), and between August 2020 and November 2021 as "later pandemic" (N = 21). Average PIPES subscale scores were dichotomized into "higher" and "lower" groups (⩽median, >median) and logistic regression models were performed. RESULTS Approximately half of participants had incomes of <$50,000 (50.3%) and were Latin American born (54.6%). After adjusting for age, nativity, education, income, postpartum distress, and employment status, early pandemic respondents had 5.05 times the odds of a higher score on the perceived discrimination subscale (95% CI: 1.81, 14.11), 6.47 times the odds of a higher score on the social isolation subscale (95% CI: 2.23, 18.74), 2.66 times the odds of a higher score on the family threats subscale (95% CI: 0.97, 7.32), and 3.36 times the odds of a higher total score (95% CI: 1.19, 9.51) when compared to pre-pandemic respondents. There were no significant subscale score differences between later pandemic and pre-pandemic periods. CONCLUSION Higher perceived immigration policy vulnerability was reported among postpartum women during the early coronavirus disease 2019 pandemic versus pre-pandemic periods. This suggests greater social inequities during the early pandemic period.
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Affiliation(s)
- Ixel Hernandez-Castro
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claudia M Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Health Sciences, California State University Northridge, Northridge, CA, USA
| | - Thomas Chavez
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brendan Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Isabel Lagomasino
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Experiences of Discrimination and Depression Trajectories over Pregnancy. Womens Health Issues 2022; 32:147-155. [PMID: 34774402 PMCID: PMC9701536 DOI: 10.1016/j.whi.2021.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 09/27/2021] [Accepted: 10/08/2021] [Indexed: 01/19/2023]
Abstract
INTRODUCTION Research on risk factors for prenatal depression is critical to improve the understanding, prevention, and treatment of women's psychopathology. The current study examines the relation between experiences of racial discrimination and trajectories of depression symptoms over the course of pregnancy. METHOD Participants completed standardized measures regarding symptoms of depression at four timepoints during pregnancy and reported on experiences of racial discrimination at one timepoint. Latent growth curve modeling was used to examine the relation between discrimination and initial levels (intercept) and trajectories (slope) of depression symptoms over pregnancy. RESULTS Participants were 129 pregnant individuals recruited from obstetric clinics and oversampled for elevated depression symptoms. Thirty-six percent of the participants were living at or below 200% of the federal poverty line. Fifty-four percent of the sample identified as non-Latinx White, 26% as Latinx, and 13% as non-Latinx Black. An unconditional latent growth curve modeling revealed a negative quadratic trajectory of depression symptoms during pregnancy. When women's report of discrimination was added as a predictor of depression trajectories, discrimination predicted the initial value (intercept) of depression symptoms, but not change over the course of pregnancy (slope). Specifically, higher levels of experiences of discrimination were associated with higher levels of depression symptoms. When sociodemographic and contextual covariates were included in the model, a low family income-to-needs ratio was also related to higher levels of depression symptoms. CONCLUSIONS These findings provide evidence that women's experiences of racial discrimination and family financial strain are risk factors for prenatal depression, with implications for screening, treatment, and policy.
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