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Martínez Vázquez S, Perete AR, de la Torre-Luque A, Nakić Radoš S, Brekalo M, Amezcua-Prieto C, Caparros-Gonzalez RA. Assessment of Postpartum Stress Using the Maternal Postpartum Stress Scale (MPSS) in Spanish Women. Healthcare (Basel) 2024; 12:1032. [PMID: 38786442 PMCID: PMC11121621 DOI: 10.3390/healthcare12101032] [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: 03/19/2024] [Revised: 04/16/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
Although scales that evaluate postpartum stress exist, they lack specificity in maternal postpartum stress. The MPSS was created because there was a need to assess maternal stress during the postpartum stage. The introduction of the MPSS has enriched the evaluation tools for postpartum stress and has helped understand maternal stress at various postpartum time points and identify women at high risk for postpartum stress during this period. The aim was to translate the MPSS into Spanish and study its psychometric properties. Postpartum women (N = 167) with a mean age of 34.26 (SD = 4.71) were involved in this study. In addition to the MPSS, a battery of instruments was administered: a demographic sheet, the Birth Satisfaction Scale-Revised (BSS-R) and the Edinburgh Postnatal Depression Scale (EPDS). The MPSS data were analyzed, checking item communality first. As a result, three items showed unsatisfactory communality values (h2 < 0.40). Confirmatory Factor Analysis was conducted, comparing factor models using the full pool of MPSS items or the version without items with unacceptable communality. As a result, the original three-factor structure was endorsed on the Spanish MPSS, with better fit indices when removing items with low communality (RMSEA = 0.067, CFI = 0.99, TLI = 0.99). The reliability of this version was satisfactory (ω = 0.93). Finally, group comparisons for some perinatal variables were performed, showing no significant differences between groups of interest (p = 0.05 and above). To conclude, the MPSS will contribute to the existing literature, having a wider capacity to assess perinatal mental health difficulties in Spanish-speaking populations.
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Affiliation(s)
| | - Adrián Ruíz Perete
- Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain; (A.R.P.); (A.d.l.T.-L.)
| | - Alejandro de la Torre-Luque
- Faculty of Medicine, University Complutense of Madrid, 28040 Madrid, Spain; (A.R.P.); (A.d.l.T.-L.)
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain
| | - Sandra Nakić Radoš
- University Department of Psychology, Catholic University of Croatia, 10 000 Zagreb, Croatia; (S.N.R.); (M.B.)
| | - Maja Brekalo
- University Department of Psychology, Catholic University of Croatia, 10 000 Zagreb, Croatia; (S.N.R.); (M.B.)
| | - Carmen Amezcua-Prieto
- Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Granada, 18016 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs GRANADA, 18071 Granada, Spain;
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain
| | - Rafael A. Caparros-Gonzalez
- Instituto de Investigación Biosanitaria ibs GRANADA, 18071 Granada, Spain;
- Department of Nursing, University of Granada, 18016 Granada, Spain
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Jibril MK, Yimam AA, Abdu NR, Ali SY. Psychological impact and associated factors of the COVID-19 pandemic among pregnant women in Fafan Zone health institutions, Somali Region, Eastern Ethiopia, 2021. BMC Womens Health 2024; 24:270. [PMID: 38689303 PMCID: PMC11059579 DOI: 10.1186/s12905-024-03109-9] [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: 08/20/2023] [Accepted: 04/23/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Despite pregnant women's vulnerability to respiratory illnesses and pregnancy complications during the COVID-19 pandemic, research on its psychological impact in the study area, is limited. OBJECTIVE This study aims to fill this gap by examining the prevalence and factors linked to the psychological impact among pregnant women in the Fafan zone, Somali region of Ethiopia. METHODS A cross-sectional study conducted from April 1st to April 30th, 2021, randomly selected health facilities for inclusion. The Impact of Event Scale-Revised (IES-R) assessed psychological impact, and data were analyzed using SPSS V 22. Variables with a p-value ≤ 0.25 in bivariate analysis were considered for multivariate analysis via multiple logistic regressions with the backward elimination method. RESULTS The study involved 294 pregnant women, constituting 73% of the respondents. The prevalence of psychological impact attributed to the COVID-19 pandemic was 27.2%. Factors such as being in the first trimester of pregnancy (AOR: 5.32), travel history to infected areas (AOR: 3.71), obtaining COVID-19 information from television (AOR: 4.81), and using social media for 1 to 2 hours daily for updates (AOR: 1.35) were significantly associated with this impact. CONCLUSION While the psychological impact among pregnant women in this study was relatively lower compared to other research, factors such as gestational age, TV media exposure, travel history, and social media usage for COVID-19 updates were strongly linked to this impact, highlighting the necessity for psychological support services for pregnant women during challenging times.
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Affiliation(s)
- Meka Kedir Jibril
- School of Nursing and Midwifery Department of Nursing, Integrated Clinical and Community Mental Health Jigjiga University College of Medicine and Health Science, Jigjiga, Ethiopia
| | - Ahmed Adem Yimam
- Department of Internal Medicine, Jigjiga University Comprehensive Specialized Hospital and College of Medicine and Health Science School of Medicine, Jigjiga, Ethiopia
| | - Neima Ridwan Abdu
- Warabe University College of Medicine and Health Science Department of Midwifery, Warabe, Ethiopia
| | - Seid Yimam Ali
- Jigjiga University College of Medicine and Health Science School Medicine, Jigjiga, Ethiopia.
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Horstman HK, Leverenz A, Morrison S, Jordan E, Baltazar A, Cen X, Charvat E, Okafor BE, Butauski M. Pregnancy During the COVID-19 Pandemic: Communicated Narrative Sense-Making and Resilience. HEALTH COMMUNICATION 2024; 39:205-215. [PMID: 36597255 DOI: 10.1080/10410236.2022.2163103] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Grounded in communicated narrative sense-making (CNSM) theory and communication theory of resilience (CTR), the current study investigated how women narratively constructed resilience surrounding pregnancy during the COVID-19 pandemic. Given the adverse effects of stress on pregnant individuals and their babies, it is important to understand the triggers and process of resilience in this context. We interviewed 21 cisgender women who were pregnant during the COVID-19 pandemic to solicit their stories of stress and resilience. Findings revealed that pregnant women managed structural, informational, and interpersonal stressors unique to the COVID-19 pandemic. They engaged in re-storying to reconcile the gap between their expected pregnancy, fueled by the U.S. master narrative of pregnancy and birth, and their lived pregnancy during a pandemic. Participants demonstrated narrative resilience through reconnecting, reframing, and recentering. These findings advance theorizing in communicated resilience by centering CNSM as the sense-making process of enacting resilience and recognizing the importance and burden of resilience during pregnancy. Practical applications are explored such as contributing to narrative-informed programming, interventions, and education efforts regarding future health crises.
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Affiliation(s)
| | | | | | - Ellen Jordan
- Department of Communication, University of Missouri
| | | | - Xu Cen
- Department of Communication, University of Missouri
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Sacchi C, Girardi P, Buri A, De Carli P, Simonelli A. The perinatal health secondary to pandemic: association between women's delivery concerns and infant's behavioral problems. J Reprod Infant Psychol 2024:1-16. [PMID: 38493474 DOI: 10.1080/02646838.2024.2330662] [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: 08/30/2023] [Accepted: 03/09/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND COVID-19 pandemic characterised a unique and vulnerable social, emotional, and health environment for pregnancy, with potential long-lasting risks to maternal and child health outcomes. In women who were pregnant at the peak of COVID-19 pandemic, we investigated the association between pandemic-related concerns about pregnancy and delivery and both the parent's (i.e. maternal parenting stress) and the infant's (i.e. emotional-behavioral problems) outcomes 12 months after birth. METHODS A sample of 352 Italian pregnant women completed a web-based survey from 8 April to 4 May 2020 and a follow-up at 12 months after delivery. Maternal assessment in pregnancy covered prenatal measures for: pandemic-related concerns about pregnancy and childbirth, COVID-19 stressful events exposure, pandemic psychological stress, and mental-health symptoms (i.e. depression, anxiety). The 12 months' assessment covered post-partum measures of social support, parenting stress and maternal reports of infants' behavioral problems. RESULTS The results of the Quasi-Poisson regression models on the association between COVID-19 related influencing factors and parenting stress and infant's behavioral problems showed that the presence of higher pandemic-related concerns about pregnancy and childbirth scores was associated with greater total and internalising behavioral problems but not with parenting stress levels. CONCLUSION Perinatal mother-infant health has been sensitively threatened by pandemic consequences with maternal concerns about childbirth in pregnancy being associated with 12 months' children's behavioral outcomes. There is a need to invest in psychological support for perinatal women throughout the transition to parenthood to protect risk conditions before they get chronic or severe and influence offspring development.
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Affiliation(s)
- Chiara Sacchi
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Paolo Girardi
- Department of Environmental Sciences, Informatics and Statistics, Ca' Foscari University of Venice, Venezia, Italy
| | - Alice Buri
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
| | - Pietro De Carli
- Department of Psychology, University of Milano Bicocca, Milano, Italy
| | - Alessandra Simonelli
- Department of Developmental and Social Psychology, University of Padova, Padova, Italy
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Nasri NM, Gan WY, Mohd Shukri NH. Mother-infant postnatal experience and its association with maternal emotion and coping during the COVID-19 pandemic. J Reprod Infant Psychol 2024:1-17. [PMID: 38407161 DOI: 10.1080/02646838.2024.2314187] [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: 08/22/2022] [Accepted: 01/30/2024] [Indexed: 02/27/2024]
Abstract
INTRODUCTION The COVID-19 pandemic resulted in a partial lockdown in Malaysia known as Movement-Controlled-Order (MCO), which has affected primary care management and social life norms. Thus, psychological health is a concern for mothers, particularly during the postpartum period. This study aimed to determine factors associated with maternal emotional experiences and coping during the pandemic. METHODOLOGY Mothers of infants aged < 18 months (n = 1449) in Malaysia completed an online survey during MCO (July 2020 to February 2021). The survey comprised questions on sociodemographics, pandemic livelihood impact, maternal experiences, and emotions. RESULTS More than one-third of mothers expressed feeling worried (54.7%), annoyed (48.1%), and tired (42.2%) to some or a high extent. Mothers who were younger (p = .001), more educated (p = .001), faced difficulty paying rent (p = .002), and whose husbands were unemployed (p < .001) expressed higher negative emotions. In contrast, mothers who received enough support for health (p = .001) and breastfeeding (p = .008), had infants sleep less (p = .042) and had more time to focus on health (p < .001) expressed better emotions. Higher coping was expressed among mothers with a higher household income (p = .004), had more time to focus on their health (p = .010), received additional breastfeeding support (p = 0.039), and practised traditional postpartum care (p < .001). In contrast, difficulty paying for essentials (p = .023) was associated with negative coping. CONCLUSION Maternal emotional experiences were significantly associated with sociodemographic characteristics, livelihood impact, postnatal experiences, and infant behaviours. Postpartum mental health screening is recommended to prevent severe distress, especially in first-time mothers. Coping interventions for mothers at risk may include comprehensive support and maternity care.
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Affiliation(s)
- Nuruljannah Mohamad Nasri
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Wan Ying Gan
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Nurul Husna Mohd Shukri
- Department of Nutrition, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
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Morris AR, Sellery PE, Truong V, Jeyasingh D, Haddan L, Saxbe DE. Maternal prenatal social contact during the COVID-19 pandemic predicts infant birth weight. Early Hum Dev 2023; 187:105881. [PMID: 37944266 PMCID: PMC10773973 DOI: 10.1016/j.earlhumdev.2023.105881] [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: 08/15/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Social connectedness and mental health have been associated with infant birth weight, and both were compromised by the COVID-19 pandemic. AIMS We sought to examine whether changes in maternal prenatal social contact due to the COVID-19 pandemic were associated with infant birth weight and if maternal prenatal mental health mediated this association. STUDY DESIGN A longitudinal study of mothers and their infants born during the first wave of the COVID-19 pandemic. SUBJECTS The sample consisted of 282 United States-based mother-infant dyads. OUTCOME MEASURES Depressive symptoms were measured with the Beck Depression Inventory-II, anxiety was measured with the State Anxiety Inventory, and stress was measured using the Perceived Stress Scale 14. We also asked participants about pandemic-related changes in social contact across various domains. Adjusted birth weight was calculated from birth records or participant-report when birth records were unavailable. RESULTS Decreases in social contact during the pandemic were associated with lower adjusted infant birth weight (B = 76.82, SE = 35.82, p = .035). This association was mediated by maternal prenatal depressive symptoms [Effect = 15.06, 95 % CI (0.19, 35.58)] but not by prenatal anxiety [95 % CI (-0.02, 32.38)] or stress [95 % CI (-0.31, 26.19)]. CONCLUSION These findings highlight concerns for both mothers and infants in the wake of the COVID-19 pandemic, since birth weight can have long-term health implications and the social restructuring occasioned by the pandemic may lead to lasting changes in social behavior.
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Affiliation(s)
- Alyssa R Morris
- Department of Psychology, University of Southern California, Los Angeles, CA, United States.
| | - Pia E Sellery
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Van Truong
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Divya Jeyasingh
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Lila Haddan
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
| | - Darby E Saxbe
- Department of Psychology, University of Southern California, Los Angeles, CA, United States
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Caparros-Gonzalez RA, Essau C, Gouin JP, Pemau A, Galvez-Merlin A, de la Torre-Luque A. Perinatal, obstetric and parental risk factors for asthma in the offspring throughout childhood: a longitudinal cohort study. J Perinat Med 2023; 51:1163-1170. [PMID: 37326102 DOI: 10.1515/jpm-2022-0543] [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] [Received: 11/09/2022] [Accepted: 04/29/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES Asthma is a common chronic and burdensome disease which typically begins in childhood. The aim of this study was to assess perinatal and obstetric factors which may increase the risk of developing asthma in the offspring. METHODS Data from five consecutive waves (n=7,073 children, from birth to 15 years old) from a nationally-representative birth cohort of people born in the United Kingdom between 2000 and 2002, the Millennium Cohort Study (MCS), were used. The Kaplan-Meier survival curve was used to graphically display the risk of developing asthma from early childhood to adolescence. The Z-based Wald test was used to prove significant covariate loading. RESULTS Cox regression analyzing the influence of covariates on asthma development risk showed a significant likelihood ratio test, χ2(18)=899.30, p<0.01. A parent with asthma (OR=2.02, p<0.01), a younger maternal age at delivery (OR=0.98, p<0.05), and the use of assisted reproductive technology (OR=1.43, p<0.05) were associated with an increased risk of developing asthma in the offspring. CONCLUSIONS Perinatal factors (a younger maternal age, assisted reproductive technology) and a parental factor (a parent with asthma) increased the risk for developing asthma in the offspring.
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Affiliation(s)
- Rafael A Caparros-Gonzalez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigacion Biosanitaria ibs.GRANADA, Granada, Spain
| | - Cecilia Essau
- School of Psychology, University of Roehampton, London, UK
| | | | - Andres Pemau
- Department of Personality, Assessment and Clinical Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Alejandra Galvez-Merlin
- Department of Personality, Assessment and Clinical Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Universidad Complutense de Madrid, Madrid, Spain
- Centre for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
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Garcia-Leon MA, Martin-Tortosa PL, Cambio-Ledesma A, Caparros-Gonzalez RA. The COVID-19 Pandemic and Psychopathological symptoms in pregnant women in Spain. J Reprod Infant Psychol 2023; 41:503-515. [PMID: 35261321 DOI: 10.1080/02646838.2022.2047623] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 02/20/2022] [Indexed: 12/28/2022]
Abstract
BACKGROUND During the COVID-19 pandemic, pregnant women are exposed to potentially harmful stressors that might affect their health. The direct consequences that SARS-CoV-2 may have on perinatal mental health are still unknown. OBJECTIVE The present study aimed to explore the impact of the COVID-19 pandemic on psychopathological symptoms in a sample of Spanish pregnant women. METHODS A sample of 186 pregnant women was assessed using the revised Symptoms Check List-90 during the first lockdown in Spain. RESULTS The results showed clinical scores on the obsession and compulsion, anxiety and phobic anxiety subscales, as well as on the severity indexes. Phobic anxiety was the only variable that was inversely correlated with age and the number of previous miscarriages. A linear regression model showed that age was inversely associated with phobic anxiety scores. A younger age was associated with higher levels of phobic anxiety symptoms. CONCLUSIONS Our results indicated that younger pregnant women and women in the first trimester of pregnancy were more vulnerable to the effects of stress and concerns about COVID-19.
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Affiliation(s)
- Maria Angeles Garcia-Leon
- FIDMAG Sisters Hospitallers Research Foundation, Barcelona, Spain
- Mind, Brain and Behaviour Research Center, University of Granada, Granada, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | | | | | - Rafael A Caparros-Gonzalez
- Nursing Department, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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Doyle O, Wood EK, Sullivan EL, Mackiewicz-Seghete K, Graham A, Gustafsson HC. COVID-19 pandemic-related trauma symptoms are associated with postpartum alcohol consumption. Gen Hosp Psychiatry 2023; 85:19-27. [PMID: 37729720 PMCID: PMC10841071 DOI: 10.1016/j.genhosppsych.2023.09.001] [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: 01/15/2023] [Revised: 08/02/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has led to escalations in substance use, including alcohol consumption. Of particular concern are the potential impacts during the postpartum period, a time of heightened vulnerability to stress and potential transmission of the negative sequelae of substance use to offspring. However, postpartum alcohol consumption during the COVID-19 pandemic has not been well characterized. METHOD Postpartum drinking habits and COVID-19-related stress were repeatedly assessed (every two weeks for 12 weeks, and at one-, six-, and 12-months postpartum) from N = 378 individuals during the COVID-19 pandemic. Average alcohol use trajectories as well as heterogeneity in trajectories were characterized. COVID-19-related trauma symptoms and coping were examined in relation to alcohol use over time. RESULTS Average postpartum alcohol use included an initial quadratic increase from one-to-four-months postpartum, followed by a plateau between four-to-12-months. Higher (15.08%), moderate (26.90%), and lower consumption (57.90%) subgroups were identified. Endorsement of COVID-19-related trauma symptoms and using alcohol to cope with stress predicted higher consumption. CONCLUSIONS Findings suggest a potential sensitive period in establishing postpartum alcohol use patterns from one-to-four-months postpartum. Findings further suggest that postpartum alcohol use is heterogenous and that individual response to major traumatic stressors, like the COVID-19 pandemic, may influence emerging patterns of postpartum alcohol use.
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Affiliation(s)
- Olivia Doyle
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Elizabeth K Wood
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Elinor L Sullivan
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | | | - Alice Graham
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
| | - Hanna C Gustafsson
- Psychiatry Department, Oregon Health & Science University, Portland, OR 97239, USA.
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Florea C, Preiß J, Gruber WR, Angerer M, Schabus M. Birth and early parenting during the COVID-19 pandemic: A cross-sectional study in the Austrian and German population. Compr Psychiatry 2023; 126:152405. [PMID: 37499487 DOI: 10.1016/j.comppsych.2023.152405] [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] [Received: 02/03/2023] [Revised: 07/17/2023] [Accepted: 07/20/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, new mothers and their babies represent a particularly vulnerable group. This study investigates the effects of the pandemic on the pregnancy and childbirth experience, as well as on postnatal stress and depression levels. METHODS An online survey was completed by 1964 Austrian and German mothers who gave birth during the COVID-19 pandemic. The survey included the Pregnancy Distress Questionnaire (PDQ), the Childbirth Experience Questionnaire (CEQ), the Edinburgh Postnatal Depression Score (EPDS), the Perceived Stress Score (PSS), and additional pregnancy- and pandemic-related questions. We conducted multilinear regression models in order to investigate which factors predict childbirth experience, stress and depression scores. FINDINGS There was a high prevalence of depression symptoms (42%), though the mean EPDS score was 8·71 (SD = 5·70), below the cut-off for depression of 10. The prevalence of high stress scores was 9%, and the mean PSS score was 17·7 (SD = 6·64), which indicates moderate perceived stress. The pandemic reduced the time spent with grandparents, as well as the help received by the mother from relatives and friends. Not receiving help was associated with higher stress and depression scores. In the multilinear regression models, the most important predictor for a negative childbirth experience was a high-risk pregnancy, while the strongest predictors for high stress and depression levels were low social support and negatively perceived pandemic repercussions on financial, social or health aspects of family life. INTERPRETATION The results suggest that the pandemic had an impact on maternal mental health. While the perceived consequences due to the pandemic negatively affected the postnatal depression and stress levels, perceived social support acted as a protective factor.
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Affiliation(s)
- C Florea
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, Austria; Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, Austria.
| | - J Preiß
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, Austria; Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, Austria
| | - W R Gruber
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, Austria; Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, Austria
| | - M Angerer
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, Austria; Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, Austria
| | - M Schabus
- Laboratory for Sleep, Cognition and Consciousness Research, Department of Psychology, University of Salzburg, Austria; Centre for Cognitive Neuroscience Salzburg (CCNS), University of Salzburg, Austria
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Riquelme-Gallego B, Martínez-Vázquez S, Caparros-Gonzalez RA. Pandemic-related stress in pregnant women during the first COVID-19 lockdown and neonatal development. J Reprod Infant Psychol 2023:1-16. [PMID: 37469194 DOI: 10.1080/02646838.2023.2237527] [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: 07/08/2022] [Accepted: 06/26/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Maternal stress and psychopathology have a negative effect on mothers and neonates. Maternal stress may affect neonatal growth and development both physically and psychologically. PURPOSE To study the impact of pandemic-related pregnancy stress and maternal psychopathological symptoms during the COVID-19 lockdown in 2020 on neonatal development. METHODS A two-phase prospective study was carried out on a sample of 181 pregnant women ranged from 18 to 40 years old in Spain (Europe). Phase 1: Pandemic-related pregnancy stress (PREPS), Prenatal Distress Questionnaire (PDQ), Perceived Stress Scale (PSS) and the revised version of the Symptom Checklist-90 (SCL-90-R) were used to assess psychological symptoms during the lockdown. In the follow-up (Phase 2), obstetric, birth-related and anthropometric variables were collected from 81 pregnant women-neonates dyads. RESULTS Primiparous women showed higher psychopathological symptoms and higher levels of pandemic-related pregnancy stress than multiparous women. A multiple linear regression model showed that pandemic-related pregnancy stress could predict the length of neonate by adjusting for maternal age and gestational age, especially for primiparous women. IMPLICATIONS FOR RESEARCH Studies assessing neonates development should evaluate the long-term effect of the COVID-19 pandemic on neonates´ length. IMPLICATIONS FOR PRACTICE States the relation between pandemic-related pregnancy stress and neonatal development by being able to track the effects on neonates whose mothers had high levels of stress during the COVID-19 pandemic.
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Affiliation(s)
- Blanca Riquelme-Gallego
- Department of Nursing of the University of Granada, Ceuta Campus, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
| | | | - Rafael A Caparros-Gonzalez
- Department of Nursing of the University of Granada, Ceuta Campus, Spain
- Instituto de Investigación Biosanitaria Ibs. GRANADA, Granada, Spain
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Harrison S, Quigley MA, Fellmeth G, Stein A, Alderdice F. The impact of the Covid-19 pandemic on postnatal depression: analysis of three population-based national maternity surveys in England (2014-2020). THE LANCET REGIONAL HEALTH. EUROPE 2023:100654. [PMID: 37363795 PMCID: PMC10183799 DOI: 10.1016/j.lanepe.2023.100654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/27/2023] [Accepted: 04/28/2023] [Indexed: 06/28/2023]
Abstract
Background Few studies have evaluated postnatal depression before and during the Covid-19 pandemic using comparable data across time. We used data from three national maternity surveys in England to compare prevalence and risk factors for postnatal depression before and during the pandemic. Methods Analysis was conducted using population-based surveys carried out in 2014 (n = 4571), 2018 (n = 4509), and 2020 (n = 4611). Weighted prevalence estimates for postnatal depression (EPDS score ≥13) were compared across surveys. Modified Poisson regression was used to estimate adjusted risk ratios (aRR) for the association between sociodemographic, pregnancy- and birth-related, and biopsychosocial factors, and postnatal depression. Findings Prevalence of postnatal depression increased from 10.3% in 2014 to 16.0% in 2018 (difference = +5.7% (95% CI: 4.0-7.4); RR = 1.55 (95% CI: 1.36-1.77)) and to 23.9% in 2020 (difference = +7.9% (95% CI: 5.9-9.9); RR = 1.49 (95% CI: 1.34-1.66)). Having a long-term mental health problem (aRR range = 1.48-2.02), antenatal anxiety (aRR range = 1.73-2.12) and antenatal depression (aRR range = 1.44-2.24) were associated with increased risk of postnatal depression, whereas satisfaction with birth (aRR range = 0.89-0.92) and social support (aRR range = 0.73-0.78) were associated with decreased risk before and during the pandemic. Interpretation This analysis indicates that Covid-19 had an important negative impact on postnatal women's mental health and may have accelerated an existing trend of increasing prevalence of postnatal depression. Risk factors for postnatal depression were consistent before and during the pandemic. Timely identification, intervention and follow-up are key to supporting women at risk, and it is essential that mechanisms to support women are strengthened during times of heightened risk such as the pandemic. Funding NIHR Policy Research Programme.
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Affiliation(s)
- Siân Harrison
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Maria A Quigley
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Gracia Fellmeth
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
| | - Alan Stein
- Department of Psychiatry, Medical Sciences Division, University of Oxford, UK
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- African Health Research Institute, KwaZulu-Natal, South Africa
| | - Fiona Alderdice
- NIHR Policy Research Unit in Maternal and Neonatal Health and Care, National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, UK
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13
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Giesbrecht GF, van de Wouw M, Rioux C, Lai BPY, King S, Tomfohr-Madsen L, Lebel C. Cumulative effects of pre-pandemic vulnerabilities and pandemic-related hardship on psychological distress among pregnant individuals. Gen Hosp Psychiatry 2023; 83:93-100. [PMID: 37156219 PMCID: PMC10154060 DOI: 10.1016/j.genhosppsych.2023.04.016] [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: 12/07/2022] [Revised: 03/21/2023] [Accepted: 04/30/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Our primary objective was to determine whether pre-existing vulnerabilities and resilience factors combined with objective hardship resulted in cumulative (i.e., additive) effects on psychological distress in pregnant individuals during the COVID-19 pandemic. A secondary objective was to determine whether any of the effects of pandemic-related hardship were compounded (i.e., multiplicative) by pre-existing vulnerabilities. METHOD Data are from a prospective pregnancy cohort study, the Pregnancy During the COVID-19 Pandemic study (PdP). This cross-sectional report is based upon the initial survey collected at recruitment between April 5, 2020 and April 30, 2021. Logistic regressions were used to evaluate our objectives. RESULTS Pandemic-related hardship substantially increased the odds of scoring above the clinical cut-off on measures of anxiety and depression symptoms. Pre-existing vulnerabilities had cumulative (i.e., additive) effects on the odds of scoring above the clinical cut-off on measures of anxiety and depression symptoms. There was no evidence of compounding (i.e., multiplicative) effects. Social support had a protective effect on anxiety and depression symptoms, but government financial aid did not. CONCLUSION Pre-pandemic vulnerability and pandemic-related hardship had cumulative effects on psychological distress during the COVID-19 pandemic. Adequate and equitable responses to pandemics and disasters may require more intensive supports for those with multiple vulnerabilities.
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Affiliation(s)
- G F Giesbrecht
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute (ACHRI), Calgary, Alberta, Canada.
| | - M van de Wouw
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute (ACHRI), Calgary, Alberta, Canada
| | - C Rioux
- Department of Psychology, University of Oklahoma, Norman, OK, United States
| | - B P Y Lai
- Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada
| | - S King
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada; Canada & Douglas Hospital Research Centre, Verdun, Quebec, Canada
| | - L Tomfohr-Madsen
- Department of Counselling Psychology, University of British Columbia, Vancouver, British Columbia, Canada
| | - C Lebel
- Alberta Children's Hospital Research Institute (ACHRI), Calgary, Alberta, Canada; Department of Radiology, University of Calgary, Calgary, Alberta, Canada
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14
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Songco A, Minihan S, Fox E, Ladouceur C, Mewton L, Moulds M, Pfeifer J, Van Harmelen AL, Schweizer S. Social and cognitive vulnerability to COVID-19-related stress in pregnancy: A case-matched-control study of antenatal mental health. J Affect Disord 2023; 325:739-746. [PMID: 36690083 PMCID: PMC9852264 DOI: 10.1016/j.jad.2023.01.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 01/03/2023] [Accepted: 01/11/2023] [Indexed: 01/21/2023]
Abstract
Emerging evidence shows that compared to pre-pandemic norms pregnant women report significant increases in clinical levels of depressive and anxiety symptoms during COVID-19. This pre-registered study examined cognitive and social vulnerability factors for poor mental health in pregnancy during COVID-19. Understanding vulnerability profiles is key to identifying women at risk for deteriorating peripartum mental health. N = 742 pregnant women and N = 742 age and country-matched controls from the COVID-19 Risks Across the Lifespan Study were included. Using a case-match control design allowed us to explore whether the cognitive vulnerability profiles would differ between pregnant and non-pregnant women. The findings showed that COVID-19-related stress was associated with heightened levels of depression and anxiety during pregnancy. Its impact was greatest in women with cognitive (i.e., higher intolerance of uncertainty and tendency to worry) and social (i.e., higher level of self-reported loneliness) vulnerabilities. Importantly, our data show that the mental health impacts of the pandemic were greater in pregnant women compared to women who were not pregnant, especially those with cognitive and social vulnerabilities. The results highlight the urgent need to prioritize mental health care for pregnant women to mitigate the impact of COVID-19-related stress on women's postpartum mental health and their infants' well-being.
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Affiliation(s)
| | | | - Elaine Fox
- University of Oxford, Oxford, United Kingdom
| | | | | | | | | | | | - Susanne Schweizer
- University of New South Wales, Sydney, Australia; University of Cambridge, Cambridge, United Kingdom.
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15
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Gamberini C, Angeli F, Knight L, Zaami M, Al-Nasiry S, Ambrosino E. Effect of COVID-19 on antenatal care: experiences of medical professionals in the Netherlands. Reprod Health 2023; 20:40. [PMID: 36890561 PMCID: PMC9994402 DOI: 10.1186/s12978-023-01587-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 02/23/2023] [Indexed: 03/10/2023] Open
Abstract
BACKGROUND COVID-19 has greatly affected the delivery of all health care services globally. Antenatal care is one area of care that has been impacted, despite the fact that attending antenatal check-ups is essential for pregnant women and cannot be postponed. Little is known about how exactly ANC provision has changed in the Netherlands, or how the changes have impacted midwives and gynaecologists providing those services. METHODS This study used a qualitative research design to investigate changes in individual and national practice following the onset of the COVID-19 pandemic. The study involved a document analysis of protocols and guidelines for ANC provision to evaluate how those changed following the onset of the COVID-19 pandemic and semi-structured interviews with ANC care providers (i.e., gynaecologists and midwives). RESULTS Guidance was issued by multiple organizations, during the pandemic, on how to approach the risk of infection in pregnant women, recommending several changes to ANC to protect both pregnant women and ANC providers. Both midwives and gynaecologists reported changes in their practice. With less face-to-face consultations happening, digital technologies became critical in the care of pregnant women. Shorter and fewer visits were reported, with midwifery practices adjusting their guidelines further than hospitals. Challenges, with high workloads and lack of personal protective equipment were discussed. CONCLUSIONS The COVID-19 pandemic has had an immense impact on the health care system. This impact has had both negative and positive effects on the provision of ANC in the Netherlands. It is important to learn from the current COVID-19 pandemic and adapt ANC, as well as health care systems as a whole, to be better prepared for future health crises and ensure continuous provision of good quality care.
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Affiliation(s)
- Carlotta Gamberini
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Faculty of Health, Medicine & Life Sciences, Maastricht University, 6229 ER, Maastricht, The Netherlands.,Research School GROW for Oncology and Reproduction, Maastricht University, 6229 ER, Maastricht, The Netherlands
| | - Federica Angeli
- School for Business and Society, University of York, York, YO105DD, UK
| | - Lucia Knight
- Division of Social and Behavioural Sciences, School of Public Health, Faculty of Health Sciences, University of Cape Town, Cape Town, 7700, South Africa.,School of Public Health, Community and Health Sciences, University of the Western Cape, Bellville, 7535, South Africa
| | - Mariama Zaami
- Department of Geography and Resource Development, University of Ghana, LG25, Accra, Ghana
| | - Salwan Al-Nasiry
- Research School GROW for Oncology and Reproduction, Maastricht University, 6229 ER, Maastricht, The Netherlands.,Department of Obstetrics and Gynecology, Maastricht University Medical Centre+, 6229 HX, Maastricht, The Netherlands
| | - Elena Ambrosino
- Institute for Public Health Genomics (IPHG), Department of Genetics and Cell Biology, Faculty of Health, Medicine & Life Sciences, Maastricht University, 6229 ER, Maastricht, The Netherlands. .,Research School GROW for Oncology and Reproduction, Maastricht University, 6229 ER, Maastricht, The Netherlands.
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16
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Asfaw A. Association between reasons for not working and reporting of major depression and anxiety symptoms among U.S. adult population during the COVID-19 pandemic. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2023; 38:293-320. [PMID: 37608841 PMCID: PMC10440807 DOI: 10.1080/15555240.2023.2181178] [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: 09/08/2022] [Accepted: 02/05/2023] [Indexed: 02/27/2023]
Abstract
COVID-19 continues to take a large toll on the mental health of the not working population, particularly of those who were unable to work. This study, using the Household Pulse Survey, estimated the association between reasons for not working and major depression and anxiety symptoms (MDAS). The lowest MDAS was reported by retirees. Individuals who were unable to work because of transportation problems, layoffs, COVID-19 concerns, and sickness or disability reported the highest MDAS. Mediation analysis showed that the direct and indirect effects of reasons for not working were much higher for those individuals who were unable to work than for individuals who were working or decided not to work.
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Affiliation(s)
- Abay Asfaw
- Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Washington, DC, USA
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17
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The effect of COVID-19 lockdowns on women's perinatal mental health: a systematic review. Women Birth 2023; 36:47-55. [PMID: 35798661 PMCID: PMC9212959 DOI: 10.1016/j.wombi.2022.06.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 06/11/2022] [Accepted: 06/13/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Risk factors for poor maternal perinatal mental health include a previous mental health diagnosis, reduced access to perinatal services, economic concerns and decreased levels of social support. Adverse maternal perinatal mental health can negatively influence the psychological wellbeing of infants. The outbreak of the COVID-19 pandemic presented an additional stressor. While literature on the impact of COVID-19 on perinatal mental health exists, no systematic review has focused specifically on maternal perinatal mental health during periods of COVID-19 lockdown. AIMS This systematic review explores how periods of COVID-19 lockdown impacted women's perinatal mental health. METHODS Searches of CINAHL, PsycARTICLES, PsycINFO, PubMed, Scopus and Web of Science were conducted for literature from 1st January 2020-25th May 2021. Quantitative, peer-reviewed, cross-sectional studies published in English with perinatal women as participants, and data collected during a period of lockdown, were included. Data was assessed for quality and narratively synthesized. FINDINGS Sixteen articles from nine countries met the inclusion criteria. COVID-19 lockdowns negatively impacted perinatal mental health. Risk factors for negative perinatal mental health noted in previous literature were confirmed. In addition, resilience, educational attainment, trimester, and ethnicity were identified as other variables which may influence mental health during perinatal periods experienced during lockdown. Understanding nuance in experience and harnessing intra and interpersonal support could advance options for intervention. CONCLUSION Developing resources for perinatal women that integrate informal sources of support may aid them when normal routine is challenged, and may mediate potential long-term impacts of poor perinatal maternal health on infants.
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18
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Schaal NK, Hagenbeck C, Helbig M, Wulff V, Märthesheimer S, Fehm T, Hepp P. The influence of being pregnant during the COVID-19 pandemic on birth expectations and antenatal bonding. J Reprod Infant Psychol 2023; 41:15-25. [PMID: 34407711 DOI: 10.1080/02646838.2021.1962825] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of the present study was to compare birth expectations and antenatal bonding of women pregnant prior to and during the COVID-19 pandemic. MATERIALS AND METHODS In total, 74 pregnant women (mean age: 33.9 ± 4.1 years, gestational age: 36 ± 2 weeks) participated in the study, who were pregnant either during the the COVID-19 pandemic (corona group, N = 35, April-July 2020) or before the pandemic (control group, N = 39, October 2017-January 2019). Birth expectations were measured using the Wijma Delivery Expectancy Questionnaire (WDEQ) and Salmon's Item List (SIL) and antenatal bonding with the Maternal Antenatal Attachment Scale (MAAS). Additionally, the corona group indicated their level of worry regarding different pandemic-related aspects using visual analogue scales. RESULTS The corona group displayed significantly elevated fear of childbirth measured by the WDEQ and lower antenatal bonding quality compared to the control group. The additional items regarding COVID-19 burdens highlighted that the aspects that the partner may not be present during labour and that no visitors will be allowed in hospital were associated with the highest worries. CONCLUSIONS Midwives and gynaecologists should be aware of the negative impact of the COVID-19 pandemic on fear of childbirth and antenatal bonding .
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Affiliation(s)
- Nora K Schaal
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Carsten Hagenbeck
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Martina Helbig
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Verena Wulff
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Sarah Märthesheimer
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Tanja Fehm
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Philip Hepp
- Clinic for Gynecology and Obstetrics, University Clinic, Augsburg, Germany.,Clinic for Gynecology and Obstetrics, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany
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19
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Martinez-Vazquez S, Riquelme-Gallego B, Lugo-Toro LJ, Lucena-Prieto L, Garrido-Torres N, Lopez-Soto T, Caparros-Gonzalez RA, De la Torre-Luque A. Maternal Psychopathological Profile during Childbirth and Neonatal Development during the COVID-19 Pandemic: A Pre-Posttest Study. Behav Sci (Basel) 2023; 13:80. [PMID: 36829309 PMCID: PMC9952727 DOI: 10.3390/bs13020080] [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: 09/09/2022] [Revised: 01/12/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
The coronavirus SARS-CoV-2 generated an alert that became a state of emergency in health issues worldwide, a situation that affected the entire population, including pregnant women. The present study aims to understand the effect of the psychopathological profile of a sample of pregnant women at the time of the COVID-19 pandemic on themselves during childbirth (Phase 1) and after childbirth and the anthropometric measures of the neonate at birth (Phase 2). The total sample comprises 81 pregnant women aged 32.07 years (SD = 5.45) and their neonates. Sociodemographic and obstetric data of the sample were collected. During pregnancy, psychopathology was measured by means of the SCL-90, as well as other psychological measures on stress and social support. Cluster k-means techniques were used to uncover the heterogeneous profiles of psychopathology in Phase 1. Two main psychopathological profiles were found (Cluster 1: High psychopathological symptoms; Cluster 2: Low psychopathological symptoms). The clusters generated show significant differences in all the SCL-90-R subscales used and in the general index at Phase 1. After childbirth, high psychopathology profile membership was associated with a greater probability of having a non-eutocic delivery. On the other hand, the low psychopathological symptoms cluster shows higher levels of depressive symptoms, hostility, paranoid ideation, and psychotic symptoms in Phase 2. In conclusion, there seemed to exist two heterogeneous profiles of psychopathology in pregnant women during the pandemic; the stress related to the pandemic seemed uninfluential on the development of a profile of high psychopathological symptoms and the psychopathology profile may influence delivery and postpartum outcomes.
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Affiliation(s)
| | | | | | - Lidia Lucena-Prieto
- Department of Obstetrics and Gynecology, Delivery Ward, Hospital Antequera, 29200 Malaga, Spain
| | | | - Teresa Lopez-Soto
- English Language Department, University of Seville, 41004 Seville, Spain
| | - Rafael A. Caparros-Gonzalez
- Instituto de Investigación Biosanitaria (ibs.GRANADA), 18014 Granada, Spain
- Department of Nursing, The University of Granada, 18071 Granada, Spain
| | - Alejandro De la Torre-Luque
- Department of Legal Medicine, Psychiatry and Pathology, Complutense University of Madrid, CIBERSAM ISCIII, 28040 Madrid, Spain
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20
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Giving Birth in Unpredictable Conditions: Association between Parents' COVID-19 Related Concerns, Family Functioning, Dyadic Coping, Perceived Social Support and Depressive Symptoms. Healthcare (Basel) 2022; 10:healthcare10122550. [PMID: 36554073 PMCID: PMC9778005 DOI: 10.3390/healthcare10122550] [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: 11/02/2022] [Revised: 12/11/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The way postpartum parents' COVID-19-related concerns are associated with the family environment, support resources and depressive symptoms areunder-investigated. METHODS Two hundred and forty-three new parents (132 mothers, 111 fathers) completed self-report questionnaires within an 8-week period after birth. Parental concerns for COVID-19-related life changes were assessed with the COVID-19 Questionnaire, perceived social support with the Multidimensional Scale of Perceived Social Support, perceived family functioning with the Family Adaptability and Cohesion Evaluation Scales IV Package, dyadic coping behaviors with the Dyadic Coping Inventory and maternal/paternal postnatal depression with the Edinburgh Postnatal Depression Scale. RESULTS (a) Higher levels of COVID-19-related concerns about daily life were associated with lower levels of family communication, satisfaction and increased depressive symptomatology in both parents, and with lower levels of family functioning in mothers; (b) Maternal health care COVID-19-related concerns were linked with lower levels of family communication, lower perceived social support and with an increase in maternal depressive symptoms; and (c) COVID-19-related concerns about neonate hospitalization were associated with increased maternal depressive symptoms. CONCLUSION Τhese findings suggest that COVID-19-related concerns had a common negative effect on both postpartum mothers' and fathers' mental health and on certain aspects of family functioning.
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21
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Daugherty JC, Bueso-Izquierdo N, Lara-Cinisomo S, Lozano-Ruiz A, Caparros-Gonzalez RA. Partner relationship quality, social support and maternal stress during pregnancy and the first COVID-19 lockdown. J Psychosom Obstet Gynaecol 2022; 43:563-573. [PMID: 35867716 DOI: 10.1080/0167482x.2022.2101446] [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] [Indexed: 10/17/2022] Open
Abstract
Introduction: Pregnancy has been associated with diminished maternal mental health and a deterioration in partner relationship quality. The recent COVID-19 quarantine measures have created additional stressors for pregnant women due to isolation and a surge in partner conflict.Objective: The purpose of this study was to assess how partner relationship conflict and social support may mediate mental health outcomes during the COVID-19 lockdown.Methods: A cross-sectional study with a sample of 152 pregnant women using psychological measures, (i.e. Prenatal Distress Questionnaire, Symptom Checklist-90-R, Duke-UNC-11 Functional Social Support Questionnaire, Perceived Stress Scale). Demographic characteristics, obstetrics history, and partner relationship conflict were assessed using questionnaires.Results: While there were few reports of physical violence in this sample, between 18% and 59% of women reported partner relationship conflict on the psychological subscale (e.g. afraid of one's partner or screamed at by one's partner). Further, the psychological subscale was significantly associated with symptoms of psychopathology. There was a significant negative association between social support and pregnancy-specific stress (p = .005), and perceived stress (p= .038).Conclusions: These findings suggest that partner relationship conflict and social support may act as important buffers for prenatal mental health in childbearing women during vulnerable situations, such as the COVID-19 pandemic.
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Affiliation(s)
- Julia C Daugherty
- Faculty of Education. Psychology Department, University of Valladolid, Valladolid, Spain
| | - Natalia Bueso-Izquierdo
- Faculty of Education & Psychology. Psychology & Anthropology Department, University of Extremadura, Badajoz, Spain
| | | | | | - Rafael A Caparros-Gonzalez
- Faculty of Health Sciences, Department of Nursing, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
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22
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Smith CL, Waters SF, Spellacy D, Burduli E, Brooks O, Carty CL, Ranjo S, McPherson S, Barbosa-Leiker C. Substance use and mental health in pregnant women during the COVID-19 pandemic. J Reprod Infant Psychol 2022; 40:465-478. [PMID: 33870821 PMCID: PMC8963362 DOI: 10.1080/02646838.2021.1916815] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 04/09/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES We examined the prevalence of substance use as a coping mechanism and identified relationships between maternal mental health over time and use of substances to cope during the Coronavirus Disease 2019 (COVID-19) pandemic among pregnant women in the U.S.A. METHODS Self-reported repeated measures from 83 pregnant women were collected online in April 2020 and May 2020. Women retrospectively reported their mental/emotional health before the pandemic, as well as depression, stress, and substance use as a result of the pandemic at both time points. Linear regression measured cross-sectional and longitudinal associations between mental health and substance use. RESULTS Pre-COVID-19 reports of poorer mental/emotional health (b = 0.46) were significantly (p < .05) associated with number of substances used to cope with the pandemic. Elevated stress (b = 0.35) and depressive symptoms (b = 0.27) and poorer mental/emotional health (b = 0.14) in April were also significantly related to higher numbers of substances used in May (p < .05). CONCLUSION Pregnant women's psychological well-being may be a readily measured indicator substance use risk during crises such as the COVID-19 pandemic. Interventions addressing increased stress and depression may also mitigate the emergence of greater substance use among pregnant women.
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Affiliation(s)
- Crystal Lederhos Smith
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, U.S.A
- Program of Excellence in Addictions Research, Washington State University, Spokane, WA, U.S.A
- Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, U.S.A
| | - Sara F. Waters
- Department of Human Development, Washington State University, Vancouver, WA, U.S.A
| | - Danielle Spellacy
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, U.S.A
| | - Ekaterina Burduli
- Program of Excellence in Addictions Research, Washington State University, Spokane, WA, U.S.A
- Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, U.S.A
- College of Nursing, Washington State University, Spokane, WA, U.S.A
| | - Olivia Brooks
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, U.S.A
- Program of Excellence in Addictions Research, Washington State University, Spokane, WA, U.S.A
| | - Cara L. Carty
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, U.S.A
| | - Samantha Ranjo
- College of Nursing, Washington State University, Spokane, WA, U.S.A
| | - Sterling McPherson
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, U.S.A
- Program of Excellence in Addictions Research, Washington State University, Spokane, WA, U.S.A
- Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, U.S.A
| | - Celestina Barbosa-Leiker
- Analytics and PsychoPharmacology Laboratory (APPL), Washington State University, Spokane, WA, U.S.A
- College of Nursing, Washington State University, Spokane, WA, U.S.A
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23
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Nicolás-López M, González-Álvarez P, Sala de la Concepción A, Giralt-López M, Lorente B, Velasco I, Wichner PSV, Ginovart G. Maternal mental health and breastfeeding amidst the Covid-19 pandemic: cross-sectional study in Catalonia (Spain). BMC Pregnancy Childbirth 2022; 22:733. [PMID: 36163015 PMCID: PMC9511438 DOI: 10.1186/s12884-022-05036-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background Covid-19 pandemic became an unexpected stressor for the entire population and, particularly, for pregnant women and lactating mothers. The alarming infectious risk together with the lockdown period could affect the emotional state of mothers-to-be, as well as breastfeeding rates, mother-baby bonding, or neonatal weight gain. The aim of this study is to describe the impact of this world health emergency in mother-baby pairs right after the first wave of Sars-Cov-2 pandemic (from March to May 2020). Study design A prospective observational study was carried out in mother–child dyads from those women who gave birth between June and August 2020 in a tertiary hospital. 91 mother-baby pairs were initially enrolled and 56 of them completed the follow-up. The study design had two separate steps: i) Step one: A clinical interview plus three psychometric tests (EPDS: Edinburgh Postnatal Depression Scale, PBQ: Postpartum Bonding Questionnaire and STAI-S: State-Trait Anxiety Inventory); ii) Step two: mother–child dyads were followed using a round of three brief telephone interviews (conducted at the newborn’s 7, 14 and 28 days of age) to accurately depict the newborn’s outcome in the neonatal period. Results In terms of maternal mental health, 25% of the sample screens positively in the EPDS, requiring further evaluation to rule out depressive symptoms. STAI-state and PBQ detect no abnormalities in either anxiety levels or mother–child bonding in our sample, as 100% of the mothers score below the cut-off points in each test (34 and 26 respectively). When comparing feeding practices (breast/bottle feeding) in 2020 to those practices during pre-pandemic years (2017–2019), a significant increase in breastfeeding was found in pandemic times. All newborns in the sample showed an adequate weight gain during their first month of life. Conclusion Women and newborns in our sample did not experience an increase in adverse outcomes in the neonatal period in terms of maternal mental health, breastfeeding rates, bonding and further neonatal development. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-05036-9.
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Affiliation(s)
- Marta Nicolás-López
- Department of Pediatrics, Neonatal Unit, Hospital Universitari Germans Trias I Pujol, Carretera de Canyet s/n, 08916, Badalona, Spain. .,Department of Pediatrics, Neonatal Unit, Hospital Universitari Germans Trias I Pujol, Badalona, Spain.
| | - Pablo González-Álvarez
- Department of Pediatrics, Neonatal Unit, Hospital Universitari Germans Trias I Pujol, Carretera de Canyet s/n, 08916, Badalona, Spain
| | - Anna Sala de la Concepción
- Department of Pediatrics, Neonatal Unit, Hospital Universitari Germans Trias I Pujol, Carretera de Canyet s/n, 08916, Badalona, Spain
| | - Maria Giralt-López
- Department of Paidopsychiatry, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
| | - Beatriz Lorente
- Department of Gynecology and Obstetrics, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
| | - Inés Velasco
- Department of Gynecology and Obstetrics, Hospital Universitari Germans Trias I Pujol, Badalona, Spain.,Research Institute Germans Trias I Pujol (IGPT), Badalona, Spain
| | - Paula Sol Ventura Wichner
- Department of Pediatrics, Neonatal Unit, Hospital Universitari Germans Trias I Pujol, Carretera de Canyet s/n, 08916, Badalona, Spain.,Research Institute Germans Trias I Pujol (IGPT), Badalona, Spain
| | - Gemma Ginovart
- Department of Pediatrics, Neonatal Unit, Hospital Universitari Germans Trias I Pujol, Carretera de Canyet s/n, 08916, Badalona, Spain.,Department of Pediatrics, Neonatal Unit, Hospital Universitari Germans Trias I Pujol, Badalona, Spain
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Hübner T, Wolfgang T, Theis AC, Steber M, Wiedenmann L, Wöckel A, Diessner J, Hein G, Gründahl M, Kämmerer U, Kittel-Schneider S, Bartmann C. The impact of the COVID-19 pandemic on stress and other psychological factors in pregnant women giving birth during the first wave of the pandemic. Reprod Health 2022; 19:189. [PMID: 36064560 PMCID: PMC9444078 DOI: 10.1186/s12978-022-01493-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 08/16/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND The onset of mental illness such as depression and anxiety disorders in pregnancy and postpartum period is common. The coronavirus induced disease 2019 (COVID-19) pandemic and the resulting public policy responses represent an exceptional situation worldwide and there are hints for adverse psychosocial impact, hence, the study of psychological effects of the pandemic in women during hospitalization for delivery and in the postpartum period is highly relevant. METHODS Patients who gave birth during the first wave of the COVID-19 pandemic in Germany (March to June 2020) at the Department of Obstetrics and Gynecology, University of Würzburg, Germany, were recruited at hospital admission for delivery. Biosamples were collected for analysis of SARS-CoV-2 infection and various stress hormones and interleukin-6 (IL-6). In addition to sociodemographic and medical obstetric data, survey questionnaires in relation to concerns about and fear of COVID-19, depression, stress, anxiety, loneliness, maternal self-efficacy and the mother-child bonding were administered at T1 (delivery stay) and T2 (3-6 months postpartum). RESULTS In total, all 94 recruited patients had a moderate concern of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at T1 with a significant rise at T2. This concern correlated with low to low-medium general psychosocial stress levels and stress symptoms, and the women showed a significant increase of active coping from T1 to T2. Anxiety levels were low and the Edinburgh Postnatal Depression Scale showed a medium score of 5 with a significant (T1), but only week correlation with the concerns about SARS-CoV-2. In contrast to the overall good maternal bonding without correlation to SARS-CoV-2 concern, the maternal self-efficiency correlated negatively with the obstetric impairment caused by the COVID-19 pandemic. CONCLUSION Obstetric patients` concerns regarding SARS-CoV-2 and the accompanying pandemic increased during the course of the pandemic correlating positively with stress and depression. Of note is the increase in active coping over time and the overall good mother-child-bonding. Maternal self-efficacy was affected in part by the restrictions of the pandemic. Clinical trial registration DRKS00022506.
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Affiliation(s)
- Theresa Hübner
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany.
| | - Tanja Wolfgang
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany.,Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Ann-Catrin Theis
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Magdalena Steber
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Lea Wiedenmann
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Joachim Diessner
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Grit Hein
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Marthe Gründahl
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Ulrike Kämmerer
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Catharina Bartmann
- Department of Obstetrics and Gynaecology, University Hospital of Würzburg, Josef-Schneider-Str. 4, 97080, Würzburg, Germany
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25
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Jefford E, Charmer L, Stulz V, Jomeen J, Hawley G, Davis D. Pandemic Changes to Maternity Services—Short- and Long-Term Consequences. INTERNATIONAL JOURNAL OF CHILDBIRTH 2022. [DOI: 10.1891/ijc-2022-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Iverson KM, Dardis CM, Cowlishaw S, Webermann AR, Shayani DR, Dichter ME, Mitchell KS, Mattocks KM, Gerber MR, Portnoy GR. Effects of Intimate Partner Violence During COVID-19 and Pandemic-Related Stress on the Mental and Physical Health of Women Veterans. J Gen Intern Med 2022; 37:724-733. [PMID: 36042090 PMCID: PMC9427167 DOI: 10.1007/s11606-022-07589-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 04/01/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about women veterans' intimate partner violence (IPV) experiences during the COVID-19 pandemic or the impacts of pandemic-related stress on their mental and physical health. OBJECTIVES To identify IPV experiences among women veterans prior to and during the pandemic, pandemic-related stressors, and examine their respective contributions to mental and physical health. DESIGN National sample of women veterans drawn from a larger web-based longitudinal study. Relationships between recent IPV and pandemic-related stressors were tested with linear regressions, controlling for pre-pandemic IPV and mental and physical health symptoms, demographic, and military-related covariates. PARTICIPANTS One hundred forty-two women veterans (Mage=58.8 years). MAIN MEASURES We assessed IPV (CTS-2), PTSD (PCL-5), depression (CESD), anxiety (DASS-A), physical health (PHQ-15), and physical health-related quality of life (SF-12) prior to the pandemic (June 2016-December 2016/January 2017) and during the pandemic study period (March 2020-December 2020/January 2021). We assessed pandemic-related stressors (EPII) during the pandemic study period. KEY RESULTS Over a third (38.7%) of participants experienced IPV during the pandemic study period (psychological: 35.9%, physical: 9.9%, sexual: 4.2%). Overall rates, frequency, and severity of IPV experience did not significantly differ between the pre-pandemic and pandemic study periods. Few participants tested positive for COVID-19 (4.2%); however, most participants reported experiencing pandemic-related stressors across life domains (e.g., social activities: 88%, physical health: 80.3%, emotional health: 68.3%). IPV during the pandemic and pandemic-related stressors were both associated with greater PTSD and depressive symptoms. Pandemic-related stressors were associated with worse anxiety and physical health symptoms. Neither IPV during the pandemic nor pandemic-related stressors were associated with physical health-related quality of life. CONCLUSIONS IPV experiences during the pandemic were common among women veterans, as were pandemic-related stressors. Although IPV did not increase in the context of COVID-19, IPV experiences during the pandemic and pandemic-related stressors were linked with poorer mental and physical health.
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Affiliation(s)
- Katherine M Iverson
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
| | | | - Sean Cowlishaw
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, Australia
| | | | - Danielle R Shayani
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - Melissa E Dichter
- VA Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
- School of Social Work, Temple University, Philadelphia, PA, USA
| | - Karen S Mitchell
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Kristin M Mattocks
- VA Central Western Massachusetts Healthcare System, Leeds, MA, USA
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Megan R Gerber
- Division of General Medicine, Albany Medical College, Albany, NY, USA
- Albany Stratton VA Medical Center, Albany, NY, USA
| | - Galina R Portnoy
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
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27
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"I feel more protective over my body:" A brief report on pregnant women's embodied experiences during the COVID-19 pandemic. Body Image 2022; 42:197-204. [PMID: 35753096 PMCID: PMC9212952 DOI: 10.1016/j.bodyim.2022.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/24/2022] [Accepted: 06/10/2022] [Indexed: 11/21/2022]
Abstract
The COVID-19 pandemic has dramatically altered the experiences of pregnant people. For example, the pandemic has disrupted access to healthcare, social distancing has reduced social support, and vaccine rollout has led to safety concerns. Consistent with the Developmental Theory of Embodiment, which posits that our experiences of our bodies are influenced by social factors, studies have revealed an uptick in body dissatisfaction and disordered eating during this time. However, research on pregnant people's experiences of their body and body image during the pandemic has been largely overlooked. In this exploratory qualitative study, we aimed to broadly understand how the pandemic and quarantine have impacted the way pregnant women (N = 190) in the US and UK relate to their bodies. We used Consensual Qualitative Research-Modified (CQR-M) to analyze pregnant women's brief textual accounts of their embodied experiences during the pandemic and identified eight core domains across the dataset. Some participants reported no change in their embodied experiences, whereas others reported accounts of appearance and weight concerns, health behavior self-judgment, gratitude for isolation, body appreciation, maternal healthcare concerns, COVID health concerns, and health and safety strategies. We conclude with implications and recommendations for supporting pregnant people and their embodied well-being during health crises.
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28
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Tohme P, Abi-Habib R, Nassar E, Hamed N, Abou-Ghannam G, Chalouhi GE. The Psychological Impact of the COVID-19 Outbreak on Pregnancy and Mother-infant Prenatal Bonding. Matern Child Health J 2022; 26:2221-2227. [PMID: 35972590 PMCID: PMC9379892 DOI: 10.1007/s10995-022-03464-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 07/14/2022] [Accepted: 07/18/2022] [Indexed: 11/25/2022]
Abstract
This study aimed to assess the impact of the COVID-19 stress and anxiety on prenatal attachment during the second trimester of gestation. Pregnancy is an important stage for mothers-to-be in creating representations of themselves as a “mother”, with the developing attachment relationship to the unborn child considered as a milestone in the future parent’s developmental trajectory. The outbreak of the COVID-19 pandemic and the national health measures installed can hence have consequences on these representations and on prenatal attachment. Our sample consisted of 95 mothers that were recruited from a prenatal ultrasound screening center. Results suggested that the COVID-19 pandemic significantly affected prenatal attachment (PAI) with significant correlations between PAI total score and age, anxiety (DASS) and stress (IES-R). When entered in one model looking for predictors of PAI total score, age and COVID-19 stress were the only variables found to significantly predict prenatal attachment. We argue for a cultural component in explaining these results, hypothesizing that stress could trigger defensive strategies, leading to more investment in the attachment relationship, potentially playing the role of a protective factor.
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Affiliation(s)
- Pia Tohme
- Department of Social And Education Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Rudy Abi-Habib
- Department of Social And Education Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon.
| | - Elma Nassar
- Department of Social And Education Sciences, School of Arts and Sciences, Lebanese American University, Beirut, Lebanon
| | - Nouran Hamed
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
| | - Gaël Abou-Ghannam
- Department of Obstetrics and Gynecology, Bellevue Medical Center, Beirut, Lebanon
| | - Gihad E Chalouhi
- Department of Obstetrics and Gynecology, American University of Beirut Medical Center, Beirut, Lebanon
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29
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Moltrecht B, de Cassan S, Rapa E, Hanna JR, Law C, Dalton LJ. Challenges and opportunities for perinatal health services in the COVID-19 pandemic: a qualitative study with perinatal healthcare professionals. BMC Health Serv Res 2022; 22:1026. [PMID: 35962401 PMCID: PMC9372985 DOI: 10.1186/s12913-022-08427-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/03/2022] [Indexed: 11/15/2022] Open
Abstract
Background Perinatal healthcare professionals (PHCPs) provide essential support to all parents in the perinatal period, including young parents aged 16–24, who are at an increased risk of morbidity and mortality. Little is known about the impact of COVID-19 restrictions on the provision of perinatal services, and on perinatal healthcare professionals, caring for young parents in the UK. Methods A UK based qualitative study using semi-structured interviews with perinatal healthcare professionals (n = 17). Data were analysed using thematic analysis. Results Two themes were identified describing perinatal healthcare professionals’ perceptions of providing care to young parents during the pandemic. Perinatal healthcare professionals perceived that young parents’ needs were amplified by the pandemic and that pandemic-related changes to the service, such as the use of telemedicine to replace face-to-face interactions, did not manage to successfully mitigate the increased feelings of anxiety and isolation experienced by young parents. Concerns were raised by perinatal healthcare professionals that these changes reduced young parent’s access to vital support for themselves and their child and may contribute to exacerbating pre-existing inequalities. Conclusions This study provides insight into the impact of the COVID-19 pandemic on the provision of perinatal care to young parents. Perinatal mental health professionals felt these negative impacts could be overcome by using a blended approach of technology and face-to-face interactions allowing regular contact with young parents and facilitating the exchange of vital information, while maintaining access to opportunities for social interactions with other parents. Findings from this study could be used to future-proof services against further COVID-19 restrictions.
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Affiliation(s)
- Bettina Moltrecht
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK.,Evidence-Base Practice Unit, University College London, London, N1 9JH, UK.,Centre for Longitudinal Studies, University College London, London, WC1H 0NU, UK
| | - Simone de Cassan
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK
| | - Elizabeth Rapa
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK
| | - Jeffrey R Hanna
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK.,School of Nursing and Midwifery, Queen's University Belfast, Belfast, BT9 7BL, UK
| | - Clare Law
- Centre for Early Child Development, Blackpool Better Start (NSPCC), Blackpool, UK
| | - Louise J Dalton
- Department of Psychiatry, Warneford Hospital, University of Oxford, Oxford, OX3 7JX, UK.
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30
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Liu CH, Hyun S, Erdei C, Mittal L. Prenatal distress during the COVID-19 pandemic: clinical and research implications. Arch Gynecol Obstet 2022; 306:397-405. [PMID: 34716818 PMCID: PMC8556835 DOI: 10.1007/s00404-021-06286-2] [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] [Received: 12/17/2020] [Accepted: 10/13/2021] [Indexed: 12/03/2022]
Abstract
PURPOSE The objective of this study was to identify risk and protective factors related to general prenatal distress and COVID-19-specific prenatal distress to inform intervention targets among women pregnant during the COVID-19 pandemic. METHODS The study relied on data obtained from U.S. pregnant women (N = 701) who participated in the Perinatal Experiences and COVID-19 Effects (PEACE) Study from May 21 to October 3, 2020. The present cross-sectional study examined the potential risk and protective factors associated with different features of prenatal distress among U.S. pregnant women during the COVID-19 pandemic. RESULTS Approximately two-thirds of expectant mothers indicated being more stressed about going to the hospital because of COVID-19. Generalized anxiety and PTSD were associated with higher levels of general and COVID-19-specific prenatal distress. Depression symptoms were associated with higher general prenatal distress. Higher levels of distress tolerance were associated with lower levels of general prenatal distress (B = - 0.192, p < .001) and COVID-19-specific prenatal distress (B = - 0.089, p < .05). Higher levels of instrumental social support were marginally associated with lower COVID-19-specific prenatal distress (B = - 0.140, p < 0.1). CONCLUSION Findings draw attention to prenatal distress experiences during the COVID-19 pandemic, including new types of distress arising from the pandemic itself. Women might benefit from the introduction of interventions such as mindfulness-based or relaxation therapy. Coverage of responsibilities and financial assistance is particularly needed during the COVID-19 pandemic. Limitations include a majority White and high socioeconomic sample. These findings provide specificity regarding potential targets for addressing prenatal distress.
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Affiliation(s)
- Cindy H Liu
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA.
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
| | - Sunah Hyun
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Carmina Erdei
- Department of Newborn Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Leena Mittal
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Wilson CA, Gómez-Gómez I, Parsons J, Costa R, Mesquita A, Vousoura E, Contreras-García Y, Levy D, Mateus V, Christoforou A, Felice E, Dikmen-Yildiz P, Domínguez-Salas S, Motrico E. The Mental Health of Women with Gestational Diabetes During the COVID-19 Pandemic: An International Cross-Sectional Survey. J Womens Health (Larchmt) 2022; 31:1232-1240. [PMID: 35856836 DOI: 10.1089/jwh.2021.0584] [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] [Indexed: 11/12/2022] Open
Abstract
Introduction: There is evidence that women with gestational diabetes are at increased risk of the common mental disorders of anxiety and depression. The COVID-19 pandemic may have exerted an additional burden on the mental health of this population. The aim of this analysis was to compare levels of symptoms of common mental disorders and experiences during the COVID-19 pandemic between pregnant and postnatal women exposed and unexposed to gestational diabetes. Methods: Cross-sectional study utilizing quantitative data from an online survey administered across 10 countries to women who were pregnant or up to 6 months postpartum from 15 June to October 31, 2020. Women self-reported gestational diabetes and completed the Edinburgh Postnatal Depression Scale and GAD-7 (Generalized Anxiety Disorder 7 items) measures. The COPE-IS (Coronavirus Perinatal Experiences-Impact Survey) tool was also administered. Complete case analyses were conducted on a sample of 7,371 women. Results: There was evidence of an association between gestational diabetes and increased levels of depression symptoms, which was robust to adjustment for age, education, and employment status. There was only evidence of an association with anxiety in postnatal women. There was also evidence that women with gestational diabetes, particularly those in the postnatal period, experienced higher levels of pandemic-related distress, although they did not experience higher levels of COVID-19 infection in this sample. Conclusions: The increased risk of common mental disorders in women with gestational diabetes underscores the importance of integrated physical and mental health care for pregnant and postnatal women both during and beyond the pandemic. Clinical Trial Registration no. NCT04595123.
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Affiliation(s)
- Claire A Wilson
- Section of Women's Mental Health, King's College London, London, United Kingdom
| | | | - Judith Parsons
- Care in Long Term Conditions Research Division, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Raquel Costa
- Unidade de Investigação em Epidemiologia (EPIUnit, UIDB/04750/2020), Instituto de Saúde Pública da Universidade do Porto (ISPUP), Porto, Portugal
| | - Ana Mesquita
- School of Psychology, Universidade do Minho, Braga, Portugal
| | - Eleni Vousoura
- Department of Psychology, American College of Greece, Athens, Greece
| | - Yolanda Contreras-García
- Departamento de Obstetricia y Puericultura, Facultad de Medicina, Universidad de Concepción, Concepción, Chile
| | - Drorit Levy
- School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | - Vera Mateus
- Graduate Program on Developmental Disorders, Center for Biological and Health Sciences, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Andri Christoforou
- Department of Social and Behavioral Sciences, European University Cyprus, Nicosia, Cyprus
| | - Ethel Felice
- Department Of Psychiatry, Faculty Of Medicine & Surgery, University of Malta, Msida, Malta
| | | | | | - Emma Motrico
- Psychology Department, Universidad Loyola Andalucía, Cordoba, Spain
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32
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Wilson CA. Perinatal mental health during the COVID‐19 pandemic. PROGRESS IN NEUROLOGY AND PSYCHIATRY 2022. [DOI: 10.1002/pnp.751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Claire A Wilson
- Dr Wilson is NIHR Academic Clinical Lecturer and Psychiatry Specialist Registrar, Section of Women's Mental Health, King's College London and South London and Maudsley NHS Foundation Trust, UK
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Oddo-Sommerfeld S, Schermelleh-Engel K, Konopka M, La Rosa VL, Louwen F, Sommerlad S. Giving birth alone due to COVID-19-related hospital restrictions compared to accompanied birth: psychological distress in women with caesarean section or vaginal birth - a cross-sectional study. J Perinat Med 2022; 50:539-548. [PMID: 35357796 DOI: 10.1515/jpm-2021-0368] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 02/07/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVES We examined the mental health of mothers after unaccompanied birth (unaccompanied group, UG) due to COVID-19-related visiting bans and compared the data with a control group with accompanied birth (AG). Additionally, a distinction was made between caesarean section (CS) and vaginal birth (VB), as existing research indicates a higher risk for mental distress after CS. METHODS The cross-sectional study included 27 mothers in the UG and 27 matched controls (AG). Anxiety, depression, postpartum traumatic stress symptoms (PTSS), and psychological well-being were assessed. Additionally, emotions and attitudes related to the restrictions were measured by self-developed items. RESULTS Psychological distress was high especially in the UG (anxiety: 23%, PTSS: 34.6%, low well-being: 42.3%, depression: 11.5%). Mothers in the AG had lower psychological distress than those in the UG, but still had enhanced rates of PTSS (11.1%) and diminished well-being (22.2%). In both groups, women with CS reported higher anxiety and trauma scores and lower well-being than women with VB. Unaccompanied mothers with CS perceived visitation restrictions as less appropriate and felt more helpless, angry, worried, and frustrated about the partner's absence than women with VB. CONCLUSIONS The partner's absence during, but also after childbirth has a major impact on psychological outcomes. Particularly, higher rates of anxiety and PTSS can lead to negative consequences for mothers and their children. Therefore, it is strongly recommended to relax visitation bans and avoid unaccompanied births. Psychological treatment in obstetric units is more urgently needed than ever, especially for women with a caesarean section.
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Affiliation(s)
- Silvia Oddo-Sommerfeld
- Division of Obstetrics and Fetomaternal Medicine, University Hospital of Frankfurt, Frankfurt, Germany
| | | | - Marie Konopka
- Division of Obstetrics and Fetomaternal Medicine, University Hospital of Frankfurt, Frankfurt, Germany
| | | | - Frank Louwen
- Division of Obstetrics and Fetomaternal Medicine, University Hospital of Frankfurt, Frankfurt, Germany
| | - Sarah Sommerlad
- Division of Obstetrics and Fetomaternal Medicine, University Hospital of Frankfurt, Frankfurt, Germany
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Muramoto M, Kita S, Tobe H, Ikeda M, Kamibeppu K. The association between self-compassion in the postnatal period and difficult experiences with COVID-19 pandemic-related changes during pregnancy: An observational study for women at 1-month postnatal in Japan. Jpn J Nurs Sci 2022; 19:e12494. [PMID: 35661592 PMCID: PMC9348379 DOI: 10.1111/jjns.12494] [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: 12/02/2021] [Revised: 04/11/2022] [Accepted: 04/24/2022] [Indexed: 12/01/2022]
Abstract
Aim This observational study aimed to describe the rate and degree of difficult experiences with COVID‐19 pandemic‐related changes (DE) during pregnancy, clarify the relationship between DE and self‐compassion of women postnatally, and investigate the influence of compassion from a partner (CP) and compassion from the woman's mother (CM) on this relationship. Methods Data from 46 1‐month postnatal women in Japan were collected through a self‐report questionnaire from October to December 2020. Self‐compassion was measured using the Japanese version of the Self‐Compassion Scale; DE, CP, and CM were measured using original questions based on prior studies. Results Almost all participants (97.8%) experienced more than one DE during pregnancy. Data analyses revealed that DE in maternity hospitals (d = 0.76), DE in social support (d = 0.53), and CM (d = 0.64) were associated with self‐compassion. A two‐way analysis of variance suggested that CM moderated the relationship between self‐compassion and DE in preparation for the baby (η2 = 0.11) and the birth plan (η2 = 0.11), whereas CP moderated the relationship between self‐compassion and DE in social support (η2 = 0.07). Conclusions Our findings suggest that self‐compassion negatively correlates with DE in maternity hospitals and social support. Additionally, CM may buffer the influence of DE in preparation for the baby and the birth plan on self‐compassion; moreover, CP may buffer the influence of DE in social support on self‐compassion. This study highlights the importance of supporting perinatal women to adapt to COVID‐19‐related changes through cooperation with their families, which may increase self‐compassion.
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Affiliation(s)
- Miyuki Muramoto
- Department of Family Nursing, Division of Health Science & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sachiko Kita
- Department of Family Nursing, Division of Health Science & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Hiromi Tobe
- Department of Family Nursing, Division of Health Science & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mari Ikeda
- Department of Family Nursing, Division of Health Science & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kiyoko Kamibeppu
- Department of Family Nursing, Division of Health Science & Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,QOL Research Center for Children and Family, Tokyo, Japan
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Hildersley R, Easter A, Bakolis I, Carson L, Howard LM. Changes in the identification and management of mental health and domestic abuse among pregnant women during the COVID-19 lockdown: regression discontinuity study. BJPsych Open 2022; 8:e96. [PMID: 35657694 PMCID: PMC9171064 DOI: 10.1192/bjo.2022.66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 04/20/2022] [Accepted: 04/23/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Domestic violence and abuse (DVA) and mental illness during pregnancy have long-lasting and potentially serious consequences, which may have been exacerbated during the COVID-19 pandemic. AIMS To investigate how the UK COVID-19 lockdown policy influenced the identification of DVA and depressive symptoms during pregnancy in health services in South-East London in Spring 2020, using eLIXIR (Early-Life Data Cross-Linkage in Research) maternity and mental routine healthcare data. METHOD We used a regression discontinuity approach, with a quasi-experimental study design, to analyse the effect of the transition into and out of the COVID-19 lockdown on the rates of positive depression screens, DVA recorded in maternity and secondary mental health services, and contact with secondary mental health services during pregnancy. RESULTS We analysed 26 447 pregnancies from 1 October 2018 to 29 August 2020. The rate of DVA recorded in maternity services was low throughout the period (<0.5%). Within secondary mental health services, rates of DVA dropped by 78% (adjusted odds ratio 0.219, P = 0.012) during lockdown, remaining low after lockdown. The rate of women screening positive for depression increased by 40% (adjusted odds ratio 1.40, P = 0.023), but returned to baseline after lockdown lifted. CONCLUSIONS Rates of DVA identification in secondary mental health services dropped during and after lockdown, whereas overall rates of DVA identified in maternity services were concerningly low. Healthcare services must adopt guidance to facilitate safe enquiry, particularly in remote consultations. Further research is vital to address the longer-term impact on women's mental health caused by the increase in depression during the lockdown.
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Affiliation(s)
- Rosanna Hildersley
- Section of Women's Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Abigail Easter
- Section of Women's Mental Health, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Department of Women and Children's Health, School of Life Course Sciences, King's College London, UK
| | - Ioannis Bakolis
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Centre for Implementation Science, Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Lauren Carson
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, UK; and Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Louise M. Howard
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, UK
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COVID-19 and Decision-Making for Pregnant Women: Taking or Relinquishing Control in Response to a Pandemic. J Pregnancy 2022; 2022:6436200. [PMID: 35602336 PMCID: PMC9115605 DOI: 10.1155/2022/6436200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/21/2022] [Indexed: 11/17/2022] Open
Abstract
COVID-19 has uniquely impacted pregnant women. From the initial unknowns about its virulence during pregnancy, to frequent and rapidly changing hospital guidelines for prenatal care and delivery, pregnant women have felt intense uncertainty and, based on recent research, increased anxiety. This study sought to determine the impact COVID-19 had on women’s birth plans. Open-ended qualitative responses from an anonymous, online survey of pregnant women in the United States, conducted on April 3-24, 2020, were analyzed using the Attride-Stirling qualitative framework. A conceptual framework for understanding the impact of COVID-19 on women’s birth plans was generated. 2,320 pregnant women (mean age 32.7 years, mean weeks pregnant 24.6 weeks) responded to the open-ended prompts, reflecting the following themes: the impact(s) of COVID-19 on pregnant women (including unanticipated changes and uncertainty), the effect of COVID-19 on decision-making (including emotional reactions and subsequent questioning of the healthcare system), and how both of those things led women to either exercise or relinquish their agency related to their birth plan. These findings indicate that the changes and uncertainty surrounding COVID-19 are causing significant challenges for pregnant women, and absent more clarity and more provider-driven support, women seeking to cope are considering changes to their birth plans. Health systems and providers should heed this warning and work to provide pregnant women and their families with more information, support, and collaborative planning to ensure a positive, healthy birth experience, even during a pandemic.
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Kokkinaki T, Hatzidaki E. COVID-19 Pandemic-Related Restrictions: Factors That May Affect Perinatal Maternal Mental Health and Implications for Infant Development. Front Pediatr 2022; 10:846627. [PMID: 35633965 PMCID: PMC9133722 DOI: 10.3389/fped.2022.846627] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 03/30/2022] [Indexed: 11/28/2022] Open
Abstract
This review aims to discuss the factors that may affect maternal mental health and infant development in COVID-19 pandemic condition. Toward this direction, the two objectives of this review are the following: (a) to discuss possible factors that may have affected negatively perinatal mental health through the pandemic-related restrictions; and (b) to present the implications of adversely affected maternal emotional wellbeing on infant development. We conclude that the pandemic may has affected maternal mental health with possible detrimental effects for the infants of the COVID-19 generation. We highlight the need for evidence-based interventions to be integrated within the health system for prenatal and postpartum care in an effort to promote maternal mental health and infant development.
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Affiliation(s)
- Theano Kokkinaki
- Child Development and Education Unit, Laboratory of Applied Psychology, Department of Psychology, University of Crete, Rethymno, Greece
| | - Eleftheria Hatzidaki
- Department of Neonatology, Neonatal Intensive Care Unit (NICU), School of Medicine, University of Crete, Rethymno, Greece
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Larotonda A, Mason KA. New life, new feelings of loss: Journaling new motherhood during Covid-19. SSM - MENTAL HEALTH 2022; 2:100120. [PMID: 35665094 PMCID: PMC9148859 DOI: 10.1016/j.ssmmh.2022.100120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 11/26/2022] Open
Abstract
In this article we analyze the longitudinal journals of 32 Pandemic Journaling Project (PJP) participants who were pregnant, planned a pregnancy, or gave birth between January 2020 and July 2021. Employing a grounded theory approach, we coded journals in NVivo for emerging themes related to the influence of the Covid-19 pandemic on perinatal experiences in North America and Europe. In the paper we first provide some brief background on perinatal mental health and on the particular conditions for pregnancy and birth during Covid-19, before introducing major themes that emerged from the data, along with three in-depth case studies. We argue that the new mothers and prospective mothers in our sample associated new life with new feelings of loss during Covid-19. New motherhood during Covid-19 has meant for PJP participants a loss of seemingly irretrievable opportunities and moments that they see as necessary for establishing themselves as mothers and integrating their babies into their families through a process of “kinning” (Howell, 2003). Feelings of loss associated with disruptions to kinning may be partially responsible for the increase in perinatal mental distress observed during the pandemic.
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Adverse Mental Health Sequelae of COVID-19 Pandemic in the Pregnant Population and Useful Implications for Clinical Practice. J Clin Med 2022; 11:jcm11082072. [PMID: 35456165 PMCID: PMC9032065 DOI: 10.3390/jcm11082072] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/31/2022] [Accepted: 04/03/2022] [Indexed: 02/05/2023] Open
Abstract
The COVID-19 pandemic has increased risk of disturbances in the functioning of everyday life, directly or indirectly has influenced the risk of mental disorders in the most vulnerable populations, including pregnant women. The aim of this study was to analyze adverse mental health effects in the pregnant population during the COVID-19 pandemic, investigate risk factors for adverse mental health outcomes, identify protective factors, and create practical implications for clinical practice, bearing in mind the need to improve perinatal mental healthcare during such pandemics. Qualitative research was conducted in the electronic databases PubMed and Web of Sciences for the keywords COVID-19, pregnancy, depression, anxiety, and telemedicine for relevant critical articles (n = 3280) published from 2020 until October 2021, outlining the outcomes of control studies, meta-analysis, cross-sectional studies, face-to-face evaluation survey studies, remotely administered survey studies, and observational studies regarding the main topic; all were evaluated. Mental health problems among pregnant women linked to the COVID-19 pandemic, in most cases, show symptoms of depression, anxiety, insomnia, and PTSD and may cause adverse outcomes in pregnancy and fetus and newborn development, even at later stages of life. Therefore, useful implications for clinical practice for improving the adverse mental health outcomes of pregnant women associated with the COVID-19 pandemic are highly desirable. Our research findings support and advocate the need to modify the scope of healthcare provider practice in the event of a disaster, including the COVID-19 pandemic, and may be implemented and adopted by healthcare providers as useful implications for clinical practice.
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Perez A, Göbel A, Stuhrmann LY, Schepanski S, Singer D, Bindt C, Mudra S. Born Under COVID-19 Pandemic Conditions: Infant Regulatory Problems and Maternal Mental Health at 7 Months Postpartum. Front Psychol 2022; 12:805543. [PMID: 35153928 PMCID: PMC8826543 DOI: 10.3389/fpsyg.2021.805543] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/09/2021] [Indexed: 11/24/2022] Open
Abstract
Background The SARS-COVID-19 pandemic and its associated disease control restrictions have in multiple ways affected families with young children, who may be especially vulnerable to mental health problems. Studies report an increase in perinatal parental distress as well as symptoms of anxiety or depression in children during the pandemic. Currently, little is known about the impact of the pandemic on infants and their development. Infant regulatory problems (RPs) have been identified as early indicators of child socio-emotional development, strongly associated with maternal mental health and the early parent–infant interaction. Our study investigates whether early parenthood under COVID-19 is associated with more maternal depressive symptoms and with a perception of their infants as having more RPs regarding crying/fussing, sleeping, or eating, compared to mothers assessed before the pandemic. Methods As part of a longitudinal study, 65 women who had given birth during the first nationwide disease control restrictions in Northern Germany, were surveyed at 7 months postpartum and compared to 97 women assessed before the pandemic. RPs and on maternal depressive symptoms were assessed by maternal report. Number of previous children, infant negative emotionality, and perceived social support were assessed as control variables. Results Compared to the control cohort, infants born during the COVID-19 pandemic and those of mothers with higher depressive symptoms were perceived as having more sleeping and crying, but not more eating problems. Regression-based analyses showed no additional moderating effect of parenthood under COVID-19 on the association of depressive symptoms with RPs. Infant negative emotionality was positively, and number of previous children was negatively associated with RPs. Limitations Due to the small sample size and cross-sectional assessment, the possibility for more complex multivariate analysis was limited. The use of parent-report questionnaires to assess infant RPs can support but not replace clinical diagnosis. Conclusions The pandemic conditions affecting everyday life may have a long-term influence on impaired infant self- and maternal co-regulation and on maternal mental health. This should be addressed in peripartum and pediatric care. Qualitative and longitudinal studies focusing on long-term parental and infant outcomes under ongoing pandemic conditions are encouraged.
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Affiliation(s)
- Anna Perez
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steven Schepanski
- Division of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Developmental Neurophysiology, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominique Singer
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Kakaraparthi VN, Alshahrani MS, Reddy RS, Samuel PS, Tedla JS, Dixit S, Gautam AP, Rengaramanujam K, Gular K, Kakaraparthi L, Ahmad I. Anxiety, depression, worry, and stress-related perceptions among antenatal women during the COVID-19 pandemic: Single group repeated measures design. Indian J Psychiatry 2022; 64:64-72. [PMID: 35400735 PMCID: PMC8992752 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_1359_20] [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: 12/07/2020] [Revised: 10/03/2021] [Accepted: 11/25/2021] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) has rapidly spread across the globe, which has affected the health of all populations including antenatal women. AIMS The aim of the study was to evaluate the levels of anxiety, depression, stress, and worry in antenatal women during COVID-19 compared with the pre-COVID-19 levels and to evaluate the associations between the sociodemographic factors of antenatal women and Hospital Anxiety Depression Scale (HADS)-D, HADS-A, Generalized Anxiety Disorder (GAD)-7, Perceived Stress Scale (PSS), and Brief Measure of Worry Severity (BMWS) scores. MATERIALS AND METHODS This single group repeated measures design was conducted on 101 antenatal women who were referred to outpatient antenatal clinics from January 2020 (pre-COVID-19) to April 2020 (during the COVID-19 pandemic). Data were collected using four questionnaires including the HADS, GAD-7 scale, PSS, and BMWS. RESULTS Antenatal women (n = 101, Mage = 32.73 years, standard deviation = 5.67) during COVID-19 demonstrated significantly increased (P < 0.001) levels of anxiety, depression, stress, and worry compared with pre-COVID-19 levels. Multiple regression analysis indicated that panic disorder was significantly associated with HADS, PSS, and BMWS scores; pregnancy complications were significantly associated with HADS scores; associated health problems were significantly associated with PSS and BMWS scores; and current anxiety, depression, stress, and worry were significantly associated with HADS, GAD-7, and BMWS scores in antenatal women during COVID-19. CONCLUSION Increased attention should be paid to the psychological health of antenatal women during this COVID-19 pandemic. Proper management of this current catastrophe is likely to result in global changes in social experiences, and interventions are necessary to address associated changes in mental health, especially among antenatal women.
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Affiliation(s)
- Venkata Nagaraj Kakaraparthi
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Mastour Saeed Alshahrani
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Ravi Shankar Reddy
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Paul Silvian Samuel
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Jaya Shanker Tedla
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Snehil Dixit
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Ajay Prashad Gautam
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Kanagaraj Rengaramanujam
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Kumar Gular
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | | | - Irshad Ahmad
- Department of Medical Rehabilitation Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
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Vardi N, Zalsman G, Madjar N, Weizman A, Shoval G. COVID-19 pandemic: Impacts on mothers' and infants' mental health during pregnancy and shortly thereafter. Clin Child Psychol Psychiatry 2022; 27:82-88. [PMID: 33855857 PMCID: PMC8819552 DOI: 10.1177/13591045211009297] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The COVID-19 pandemic brought about a global crisis, with profound implications on public mental health. The current review focuses on the impact of the pandemic on the mental health of mothers and their infants during pregnancy and shortly after delivery. Literature shows that in similar disaster situations, mothers' stress reaction and mental health have a critical impact on infant development. Research data on perinatal mental health during the current COVID-19 pandemic is reviewed in conjunction with studies on the relationship between maternal stress, infant development, and psychopathology. Recommendations for perinatal mental health enhancement are discussed and topics for future research suggested.
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Affiliation(s)
- Noa Vardi
- Child and Adolescent Division, Geha Mental Health Center, Petah Tikva, Israel
| | - Gil Zalsman
- Child and Adolescent Division, Geha Mental Health Center, Petah Tikva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Israel.,Division of Molecular Imaging and Neuropathology, Department of Psychiatry, Columbia University, New York, NY, USA.,Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Israel
| | - Nir Madjar
- School of Education, Bar-Ilan University, Ramat Gan, Israel
| | - Abraham Weizman
- Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Israel.,Felsenstein Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.,Research Unit, Geha Mental Health Center, Petah Tikva, Israel
| | - Gal Shoval
- Child and Adolescent Division, Geha Mental Health Center, Petah Tikva, Israel.,Department of Psychiatry, Sackler Faculty of Medicine, Tel Aviv University, Israel
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Abrahams Z, Boisits S, Schneider M, Prince M, Lund C. The relationship between common mental disorders (CMDs), food insecurity and domestic violence in pregnant women during the COVID-19 lockdown in Cape Town, South Africa. Soc Psychiatry Psychiatr Epidemiol 2022; 57:37-46. [PMID: 34282488 PMCID: PMC8288830 DOI: 10.1007/s00127-021-02140-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 07/09/2021] [Indexed: 12/01/2022]
Abstract
PURPOSE We aimed to explore the relationship between common mental disorders (CMDs), food insecurity and experiences of domestic violence among pregnant women attending public sector midwife obstetric units and basic antenatal care clinics in Cape Town during the COVID-19 lockdown. METHODS Perinatal women, attending 14 healthcare facilities in Cape Town, were enrolled in the study during baseline data collection before the COVID-19 lockdown. During the lockdown period, fieldworkers telephonically contacted the perinatal women who were enrolled in the study and had provided contact details. The following data were collected from those who consented to the study: socio-demographic information, mental health assessment, food insecurity status and experiences of domestic violence. Poisson regression was used to model the associations of a number of risk factors with the occurrence of CMDs. RESULTS Of the 2149 women enrolled in the ASSET study, 885 consented to telephonic interviews. We found that 12.5% of women had probable CMDs and 43% were severely food insecure. Psychological distress increased significantly during the lockdown period, compared to before the COVID-19 outbreak. Using multivariate Poisson regression modelling, we showed that the risk of CMDs was increased in women who were severely food insecure or who experienced psychological or sexual abuse. CONCLUSIONS This study provides evidence of the effect of the COVID-19 lockdown on the mental health status of perinatal women living in low-resource settings in Cape Town and highlights how a crisis such as the COVID-19 lockdown amplifies the psycho-social risk factors associated with CMDs in perinatal women.
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Affiliation(s)
- Zulfa Abrahams
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, South Africa.
| | - Sonet Boisits
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, South Africa
| | - Marguerite Schneider
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, South Africa
| | - Martin Prince
- Health Service and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s Global Health Institute, King’s College London, London, UK
| | - Crick Lund
- Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Building B, 46 Sawkins Road, Rondebosch, Cape Town, South Africa ,Health Service and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s Global Health Institute, King’s College London, London, UK
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Yazdanpanahi Z, Vizheh M, Azizi M, Hajifoghaha M. Paternal Postnatal Depression During COVID-19 Pandemic: The Role of Health Care Providers. J Prim Care Community Health 2022; 13:21501319221110421. [PMID: 35818667 PMCID: PMC9280795 DOI: 10.1177/21501319221110421] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: The fast spread of COVID-19 can cause some psychological disorders for men. One of the psychological disorders is paternal postpartum depression (PPD). The aim of the present research was to review studies that have investigated paternal postpartum depression during the COVID-19 pandemic. Materials and Methods: For this narrative review, databases such as Google Scholar, Scientific Information Databases (SID), Magiran, PubMed, Web of Science, and Scopus were searched for the full texts of published studies in the Persian and English languages in the period of 2019 to 2021. Finally, 3 articles were selected and reviewed in this study. Results: The results of this review study were classified into 3 main categories such as (1) The psychological status of men during the COVID-19 pandemic, (2) The effect of paternal PPD on children’s development and family psychological status during the COVID-19 pandemic, and (3) The role of healthcare providers in the management of paternal PPD. The findings of the studies showed that paternal PPD increases the rate of child maltreatment, maternal depression, and domestic violence. The promotion of the interpersonal skills of healthcare providers with fathers suffering from depression or psychological problems is the determinant factor of successful results. Conclusions: The results showed that paternal PPD has a wide range of consequences in this pandemic. Therefore, it would be recommended that healthcare staff have close contact with families and screen fathers for paternal PPD during the COVID-19 pandemic.
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Affiliation(s)
- Zahra Yazdanpanahi
- Community Based Psychiatric Care Research Center, Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Vizheh
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Marzieh Azizi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahboubeh Hajifoghaha
- Department of Midwifery, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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Perez A, Schepanski S, Göbel A, Stuhrmann LY, Singer D, Bindt C, Mudra S. Experience of early motherhood during the first wave of the COVID-19 pandemic in Northern Germany: a single-centre before and after comparison. J Reprod Infant Psychol 2021:1-17. [PMID: 34918988 DOI: 10.1080/02646838.2021.2013458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE To assess maternal mental health during the first weeks after birth including birth experience, postpartum adjustment to early motherhood and the perception of newborn behaviour, and how this may be influenced by the first wave of the COVID-19 pandemic. METHODS Ninety women who gave birth after the first enforcement of nation-wide disease control restrictions in Germany between 16 March and 10 May 2020 were surveyed and compared with 101 women who had given birth before the pandemic. Information on maternal mental health and maternal perception of early motherhood and neonatal behaviour were assessed at 3-8 weeks postpartum. RESULTS Mothers who gave birth under the COVID-19-associated disease control restrictions did not show significant differences in depression, anxiety and social support scales compared to mothers before the pandemic. Birth experience was similar, while support during birth was perceived to be higher under the COVID-19 restrictions. Confidence in caretaking of the newborn and perception of neonatal behaviour were comparable between the two groups. Mothers expressed significantly higher dissatisfaction with the maternal role during the pandemic. CONCLUSIONS Overall, maternal mental health and the perception of the newborn and early caretaking during the first COVID-19 wave did not substantially differ from the perceptions of mothers before the pandemic. A potential influence of the pandemic on higher dissatisfaction with the maternal role may be associated with the pandemic conditions affecting everyday life and should be addressed in postpartum care and in future qualitative and longitudinal studies.
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Affiliation(s)
- Anna Perez
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steven Schepanski
- Division of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Developmental Neurophysiology, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominique Singer
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Jiang Q, Guo Y, Zhang E, Cohen N, Ohtori M, Sun A, Dill SE, Singh MK, She X, Medina A, Rozelle SD. Perinatal Mental Health Problems in Rural China: The Role of Social Factors. Front Psychiatry 2021; 12:636875. [PMID: 34950062 PMCID: PMC8688533 DOI: 10.3389/fpsyt.2021.636875] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 11/08/2021] [Indexed: 01/22/2023] Open
Abstract
Background: Perinatal mental health is important for the well-being of the mother and child, so the relatively high prevalence of perinatal mental health problems in developing settings poses a pressing concern. However, most studies in these settings focus on the demographic factors associated with mental health problems, with very few examing social factors. Hence, this study examines the prevalence of the depressive, anxiety and stress symptoms among pregnant women and new mothers in rural China, and the associations between these mental health problems and social factors, including decision-making power, family conflicts, and social support. Methods: Cross-sectional data were collected from 1,027 women in their second trimester of pregnancy to 6 months postpartum in four low-income rural counties in Sichuan Province, China. Women were surveyed on symptoms of mental health problems using the Depression, Anxiety, and Stress Scale (DASS-21) and social risk factors. Multivariate logistic regression analyses were conducted to examine social risk factors associated with maternal mental health problems, with results reported as odds ratios (OR) and 95% confidence intervals (CI). Results: Among all respondents, 13% showed symptoms of depression, 18% showed symptoms of anxiety, 9% showed symptoms of stress, and 23% showed symptoms of any mental health problem. Decision-making power was negatively associated with showing symptoms of depression (OR = 0.71, CI: 0.60-0.83, p < 0.001) and stress (OR = 0.76, CI: 0.63-0.90, p = 0.002). Family conflict was positively associated with depression (OR = 1.53, CI: 1.30-1.81, p < 0.001), anxiety (OR = 1.34, CI: 1.15-1.56, p < 0.001), and stress (OR = 1.68, CI: 1.41-2.00, p < 0.001). In addition, social support was negatively associated with depression (OR = 0.56, CI: 0.46-0.69, p < 0.001), anxiety (OR = 0.76, CI: 0.63-0.91, p = 0.002), and stress (OR = 0.66, CI: 0.53-0.84, p < 0.001). Subgroup analyses revealed that more social risk factors were associated with symptoms of anxiety and stress among new mothers compared to pregnant women. Conclusion: Perinatal mental health problems are relatively prevalent among rural women in China and are strongly associated with social risk factors. Policies and programs should therefore promote individual coping methods, as well as target family and community members to improve the social conditions contributing to mental health problems among rural women.
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Affiliation(s)
- Qi Jiang
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Yian Guo
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Evelyn Zhang
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Nourya Cohen
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Mika Ohtori
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Adrian Sun
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Sarah-Eve Dill
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Manpreet Kaur Singh
- Stanford Pediatric Mood Disorders Program, Stanford University, Stanford, CA, United States
| | - Xinshu She
- School of Medicine, Stanford University, Stanford, CA, United States
| | - Alexis Medina
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
| | - Scott D. Rozelle
- Stanford Center on China's Economy and Institutions, Freeman Spogli Institute for International Studies, Stanford University, Stanford, CA, United States
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Wyszynski DF, Hernandez-Diaz S, Gordon-Dseagu V, Ramiro N, Basu A, Kim HH, Koenen KC. Frequency and source of worries in an International sample of pregnant and postpartum women during the Covid-19 pandemic. BMC Pregnancy Childbirth 2021; 21:768. [PMID: 34772345 PMCID: PMC8586614 DOI: 10.1186/s12884-021-04241-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 10/27/2021] [Indexed: 11/25/2022] Open
Abstract
Background Pregnant and postpartum women face unique challenges and concerns during the COVID-19 pandemic. Thus far, no studies have explored the factors associated with increased levels of worry in this population globally. The current study sought to assess the frequency and sources of worry during the COVID-19 pandemic in an international sample of pregnant and postpartum women. Methods We conducted an anonymous, online, cross-sectional survey in 64 countries between May and June 2020. The survey was available in 12 languages and hosted on the Pregistry platform for COVID-19 studies. Participants were sought mainly on social media platforms and online parenting forums. The survey included questions related to demographics, level of worry, support, stress, COVID-19 exposure, frequency of media usage, and mental health indicators. Results The study included 7561 participants. Eighty-three percent of all participants indicated that they were either ‘somewhat’ or ‘very’ worried. Women 13–28 weeks pregnant were significantly more likely to indicate that they were ‘very worried’ compared to those who were postpartum or at other stages of pregnancy. When compared with women living in Europe, those in Africa, Asia and Pacific, North America and South/Latin America were more likely to have increased levels of worry, as were those who more frequently interacted with social media. Different forms of support and stress also had an impact upon level of worry, while indicators of stress and anxiety were positively associated with worry level. Conclusion Pregnant and postpartum women are vulnerable to the changes in societal norms brought about by the COVID-19 pandemic. Understanding the factors associated with levels of worry within this population will enable society to address potential unmet needs and improve the current and future mental health of parents and children. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04241-2.
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Affiliation(s)
| | | | | | | | - Archana Basu
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Massachusetts General Hospital, Boston, MA, USA
| | - Hannah H Kim
- Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Karestan C Koenen
- Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Massachusetts General Hospital, Boston, MA, USA
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Psychometric properties of the Italian version of the Pandemic-Related Pregnancy Stress Scale (PREPS) and its correlation with anxiety and depression. J Affect Disord 2021; 294:48-53. [PMID: 34271249 PMCID: PMC9757146 DOI: 10.1016/j.jad.2021.06.076] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 06/21/2021] [Accepted: 06/28/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND In the beginning of 2020, Italy was the first European country to face the COVID-19 outbreak. Restrictions imposed during the pandemic, social isolation, and the cancellation of medical appointments likely resulted in stress that may have affected pregnant women adversely. AIMS To determine the psychometric validity of the Italian version of the Pandemic-Related Pregnancy Stress Scale (PREPS) in assessing COVID-19-related stress in pregnant women and to examine correlations between PREPS scales and symptoms of anxiety and depression. METHODS 232 pregnant women attending the Obstetric-Gynecologic Clinic of an Academic Hospital were assessed with the PREPS, the Revised Prenatal Distress Questionnaire (NuPDQ), the General Anxiety Disorder-7 (GAD-7), and the Patient Health Questionnaire-2 (PHQ-2). We analyzed the internal consistency and factor structure of the PREPS. Convergent validity was examined by comparison with the NuPDQ. PHQ-2 and GAD-7 were used to measure the association with depression and anxiety. RESULTS Acceptable-to-good internal consistency was found for the three PREPS scales: Preparedness Stress (PS, α=0.760), Prenatal Infection Stress (PIS, α=0.857), and Positive Appraisal (PA, α=0.747). Correlations of the NuPDQ with both PREPS stress scale scores (PS and PIS) were statistically significant, but on multiple regression analysis only the PS scale was correlated with the NuPDQ. Prenatal infection stress predicted GAD-7 score, while Preparedness stress predicted PHQ-2 score. LIMITATIONS The main limitations were the small sample size and the cross-sectional design of the study. CONCLUSION The Italian PREPS exhibited good psychometric properties and associations with clinical symptoms of anxiety and depression.
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Saad A, Magwood O, Aubry T, Alkhateeb Q, Hashmi SS, Hakim J, Ford L, Kassam A, Tugwell P, Pottie K. Mobile interventions targeting common mental disorders among pregnant and postpartum women: An equity-focused systematic review. PLoS One 2021; 16:e0259474. [PMID: 34714882 PMCID: PMC8555821 DOI: 10.1371/journal.pone.0259474] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Pregnant and postpartum women face major psychological stressors that put them at higher risk of developing common mental disorders, such as depression and anxiety. Yet, their limited access to and uptake of traditional mental health care is inequitable, especially during the COVID-19 pandemic. Mobile interventions emerged as a potential solution to this discontinued healthcare access, but more knowledge is needed about their effectiveness and impact on health equity. This equity-focused systematic review examined the effectiveness and equity impact of mobile interventions targeting common mental disorders among pregnant and postpartum women. METHODS AND RESULTS We systematically searched MEDLINE, EMBASE, PsychINFO and 3 other databases, from date of database inception and until January 2021, for experimental studies on mobile interventions targeting pregnant and postpartum women. We used pooled and narrative synthesis methods to analyze effectiveness and equity data, critically appraised the methodological rigour of included studies using Cochrane tools, and assessed the certainty of evidence using the GRADE approach. Our search identified 6148 records, of which 18 randomized and non-randomized controlled trials were included. Mobile interventions had a clinically important impact on reducing the occurrence of depression (OR = 0.51 [95% CI 0.41 to 0.64]; absolute risk reduction RD: 7.14% [95% CI 4.92 to 9.36]; p<0.001) and preventing its severity perinatally (MD = -3.07; 95% CI -4.68 to -1.46; p<0.001). Mobile cognitive behavioural therapy (CBT) was effective in managing postpartum depression (MD = -6.87; 95% CI -7.92 to -5.82; p<0.001), whereas other support-based interventions had no added benefit. Results on anxiety outcomes and utilization of care were limited. Our equity-focused analyses showed that ethnicity, age, education, and being primiparous were characteristics of influence to the effectiveness of mobile interventions. CONCLUSION As the COVID-19 pandemic has increased the need for virtual mental health care, mobile interventions show promise in preventing and managing common mental disorders among pregnant and postpartum women. Such interventions carry the potential to address health inequity but more rigorous research that examines patients' intersecting social identities is needed.
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Affiliation(s)
- Ammar Saad
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- C.T. Lamont Primary Healthcare Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Olivia Magwood
- C.T. Lamont Primary Healthcare Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
| | - Tim Aubry
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
- Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, Ontario, Canada
| | - Qasem Alkhateeb
- Department of Medicine, Schulich School of Medicine, Western University, London, Ontario, Canada
| | | | - Julie Hakim
- Division of Pediatric and Adolescent Gynecology, Department of Obstetrics and Gynecology, Dallas, Texas, United States of America
| | - Leanne Ford
- Rebirth Wellness Centre Inc., London, Ontario, Canada
| | - Azaad Kassam
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
- Pinecrest Queensway Community Health Centre, Ottawa, Ontario, Canada
- Ottawa Newcomer Health Centre, Ottawa, Ontario, Canada
| | - Peter Tugwell
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Kevin Pottie
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- C.T. Lamont Primary Healthcare Centre, Bruyère Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
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The risk and protective factors of heightened prenatal anxiety and depression during the COVID-19 lockdown. Sci Rep 2021; 11:20261. [PMID: 34642429 PMCID: PMC8511267 DOI: 10.1038/s41598-021-99662-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 09/21/2021] [Indexed: 12/22/2022] Open
Abstract
While pregnant women are already at-risk for developing symptoms of anxiety and depression, this is heightened during the COVID-19 pandemic. We compared anxiety and depression symptoms, as indicators of psychological distress, before and during COVID-19, and investigated the role of partner, social network and healthcare support on COVID-19-related worries and consequently on psychological distress. A national survey, conducted during the first lockdown in The Netherlands, assessed COVID-19 experiences and psychological distress (N = 1421), whereas a comparison sample (N = 1439) was screened for psychological distress in 2017-2018. During COVID-19, the percentage of mothers scoring above the questionnaires' clinical cut-offs doubled for depression (6% and 12%) and anxiety (24% and 52%). Women reported increased partner support during COVID-19, compared to pre-pandemic, but decreased social and healthcare support. Higher support resulted in lower COVID-19-related worries, which in turn contributed to less psychological distress. Results suggest that a global pandemic exerts a heavy toll on pregnant women's mental health. Psychological distress was substantially higher during the pandemic than the pre-pandemic years. We identified a protective role of partner, social, and healthcare support, with important implications for the current and future crisis management. Whether increased psychological distress is transient or persistent, and whether and how it affects the future generation remains to be determined.
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