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Birkelund KS, Rasmussen SS, Shwank SE, Johnson J, Acharya G. Impact of the COVID-19 pandemic on women's perinatal mental health and its association with personality traits: An observational study. Acta Obstet Gynecol Scand 2023; 102:270-281. [PMID: 36825665 PMCID: PMC9951299 DOI: 10.1111/aogs.14525] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 12/30/2022] [Accepted: 01/18/2023] [Indexed: 02/25/2023]
Abstract
INTRODUCTION The burden of perinatal mental health problems was expected to increase during the COVID-19 pandemic. We prospectively investigated the impact of the COVID-19 pandemic on the mental health of pregnant and postpartum women in Norway and explored associations with their sociodemographic characteristics and personality traits. MATERIAL AND METHODS Sociodemographic information and the self-reported impact of pandemic on wellbeing of pregnant women was collected using an online survey. To assess women's mental health, two validated questionnaires, the Edinburgh Postpartum Depression Scale (EPDS) and the Generalized Anxiety Disorder-7 item Scale (GAD-7), were used prenatally and postnatally. Personality traits were evaluated using HumanGuide, a web-based ipsative psychological evaluation instrument. RESULTS 772 women were included prenatally, of which 526 also responded to the survey 4-6 weeks postnatally. The median age was 29 years, 53.6% of the women were nulliparous when enrolled, and 35.1% worked in the healthcare sector. The median EPDS (6.0; interquartile range [IQR] 3.0-10.0 vs 6.0; IQR: 3.0-10.0) and the median GAD-7 (5.0; IQR 2.0-9.0 vs 5.0; IQR 2.0-9.0) were similar pre-and postnatally. Prenatally, the proportion of women scoring ≥13 on EPDS and ≥10 on GAD-7 was 14.5% (112/772) and 21.5% (166/772), whereas the postnatal figures were 15.6% (82/526) and 21.5% (113/526), respectively. The differences were not significant (P = 0.59 and P = 0.99). Being <25 years of age, being on pre-pregnancy psychotherapy or psychotropic medication, frequent voluntary isolation, perception of maternity care not proceeding normally, avoiding seeking medical assistance due to fear of infection and having negative economic consequences during the COVID19 pandemic significantly increased the risk of both anxiety (GAD-7 ≥10) and depression (EPDS ≥13). Nullipara had a higher risk of anxiety, whereas being a healthcare worker had a lower risk. The personality trait factors Power (P = 0.008), Quality (P = 0.008), Stability (P < 0.001) and Contacts (P < 0.001) were significant predictors of depression among pregnant women, whereas the Quality (P = 0.005) and Contacts (P = 0.003) were significant predictors of anxiety. CONCLUSIONS During the initial phase of the COVID-19 pandemic, the prevalence of depression (EPDS ≥ 13) and anxiety (GAD-7 ≥ 10) was 14.5% and 21.5%, respectively, among Norwegian pregnant women. Certain sociodemographic characteristics and personality traits were significant predictors of depression and anxiety.
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Affiliation(s)
- Karine S. Birkelund
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health SciencesUiT‐The Arctic University of NorwayTromsøNorway,Department of Obstetrics and GynecologyUniversity Hospital of North NorwayTromsøNorway
| | - Solrun S. Rasmussen
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health SciencesUiT‐The Arctic University of NorwayTromsøNorway,Department of Obstetrics and GynecologyUniversity Hospital of North NorwayTromsøNorway
| | - Simone E. Shwank
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health SciencesUiT‐The Arctic University of NorwayTromsøNorway,Department of Obstetrics and GynecologyUniversity Hospital of North NorwayTromsøNorway,Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention & Technology (CLINTEC)Karolinska InstitutetStockholmSweden
| | - Jonas Johnson
- Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention & Technology (CLINTEC)Karolinska InstitutetStockholmSweden
| | - Ganesh Acharya
- Women's Health and Perinatology Research Group, Department of Clinical Medicine, Faculty of Health SciencesUiT‐The Arctic University of NorwayTromsøNorway,Department of Obstetrics and GynecologyUniversity Hospital of North NorwayTromsøNorway,Division of Obstetrics and Gynecology, Department of Clinical Science, Intervention & Technology (CLINTEC)Karolinska InstitutetStockholmSweden,Department of Women's Health, Center for Fetal MedicineKarolinska University HospitalStockholmSweden
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Delanerolle G, McCauley M, Hirsch M, Zeng Y, Cong X, Cavalini H, Sajid S, Shetty A, Rathod S, Shi JQ, Hapangama DK, Phiri P. The prevalence of mental ill-health in women during pregnancy and after childbirth during the Covid-19 pandemic: a systematic review and Meta-analysis. BMC Pregnancy Childbirth 2023; 23:76. [PMID: 36709255 PMCID: PMC9883834 DOI: 10.1186/s12884-022-05243-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/24/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND This systematic review aims to explore the prevalence of the impact of the COVID-19, MERS, and SARS pandemics on the mental health of pregnant women. METHODS All COVID-19, SARS and MERS studies that evaluated the mental health of pregnant women with/without gynaecological conditions that were reported in English between December 2000 - July 2021 were included. The search criteria were developed based upon the research question using PubMed, Science Direct, Ovid PsycINFO and EMBASE databases. A wide search criterion was used to ensure the inclusion of all pregnant women with existing gynaecological conditions. The Newcastle-Ottawa-Scale was used to assess the risk of bias for all included studies. Random effects model with restricted maximum-likelihood estimation method was applied for the meta-analysis and I-square statistic was used to evaluate heterogeneity across studies. The pooled prevalence rates of symptoms of anxiety, depression, PTSD, stress, and sleep disorders with 95% confidence interval (CI) were computed. RESULTS This systematic review identified 217 studies which included 638,889 pregnant women or women who had just given birth. There were no studies reporting the mental health impact due to MERS and SARS. Results showed that women who were pregnant or had just given birth displayed various symptoms of poor mental health including those relating to depression (24.9%), anxiety (32.8%), stress (29.44%), Post Traumatic Stress Disorder (PTSD) (27.93%), and sleep disorders (24.38%) during the COVID-19 pandemic. DISCUSSION It is important to note that studies included in this review used a range of outcome measures which does not allow for direct comparisons between findings. Most studies reported self-reported measure of symptoms without clinical diagnoses so conclusions can be made for symptom prevalence rather than of mental illness. The importance of managing mental health during pregnancy and after-delivery improves the quality of life and wellbeing of mothers hence developing an evidence-based approached as part of pandemic preparedness would improve mental health during challenging times. OTHER The work presented in this manuscript was not funded by any specific grants. A study protocol was developed and published in PROSPERO (CRD42021235356) to explore several key objectives.
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Affiliation(s)
- Gayathri Delanerolle
- Nuffield Department of Primary Health Care Sciences, Uuniversity of Oxford, Oxford, UK
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Mary McCauley
- Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Martin Hirsch
- University College London, London, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Yutian Zeng
- Southern University of Science and Technology, Shenzhen, China
| | - Xu Cong
- Southern University of Science and Technology, Shenzhen, China
| | - Heitor Cavalini
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Sana Sajid
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Ashish Shetty
- University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Shanaya Rathod
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Jian Qing Shi
- Southern University of Science and Technology, Shenzhen, China
- National Center for Applied Mathematics, Shenzhen, China
| | | | - Peter Phiri
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK.
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
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Manaka M, Sasano N, Chikazawa S, Sasaki A. Review of the Depression Rate among Pregnant Women during the COVID-19 Pandemic. Health (London) 2023. [DOI: 10.4236/health.2023.151003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Frontline Healthcare Professionals’ Views Regarding the Impact of COVID-19 on Ethical Decision-Making: A Multicentre Mixed-Methods Study from Estonia. Healthcare (Basel) 2022; 10:healthcare10040711. [PMID: 35455888 PMCID: PMC9032527 DOI: 10.3390/healthcare10040711] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/09/2022] [Accepted: 04/09/2022] [Indexed: 12/21/2022] Open
Abstract
Background: The objective of the study was to investigate frontline healthcare professionals’ experiences and attitudes in relation to the COVID-19 pandemic’s ethical and psychosocial aspects in Estonia. There were two research foci: first, ethical decision-making related to treating patients in the context of potential medical resource scarcity, and second, other psychosocial factors for healthcare professionals pertaining to coping, role conflicts, and the availability of institutional support. Methods: An online survey was conducted in the fall of 2020 amongst the frontline healthcare professionals working in the three most impacted hospitals; respondents were also drawn from two ambulance services. The focus of the survey was on the first wave of COVID-19 (spring 2020). A total of 215 respondents completed the quantitative survey and qualitative data were gathered from open comments. Results: Over half of the surveyed healthcare professionals in Estonia expressed confidence in their roles during the pandemic. More than half cited the complex ethical aspects related to their decisions as their main source of doubt and uncertainty. In response to this uncertainty, Estonian healthcare professionals drew on their previous training and experience, the policies and guidelines of their institution, and support from their colleagues, to aid their decision-making during the pandemic. Conclusions: Although frontline healthcare professionals faced difficult decisions during the first wave of the pandemic, overall, most agreed that experiencing the pandemic reconfirmed that their work mattered greatly.
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Housing environment and mental health of Europeans during the COVID-19 pandemic: a cross-country comparison. Sci Rep 2022; 12:5612. [PMID: 35379838 PMCID: PMC8978496 DOI: 10.1038/s41598-022-09316-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/21/2022] [Indexed: 01/01/2023] Open
Abstract
AbstractMany studies have investigated the impact of the COVID-19 pandemic on mental health. Throughout the pandemic, time spent at home increased to a great extent due to restrictive measures. Here we set out to investigate the relationship between housing conditions and the mental health of populations across European countries. We analyzed survey data collected during spring 2020 from 69,136 individuals from four cohorts from Denmark, France, and the UK. The investigated housing conditions included household density, composition, and crowding, access to outdoor facilities, dwelling type, and urbanicity. The outcomes were loneliness, anxiety, and life satisfaction. Logistic regression models were used, and results were pooled using random-effects meta-analysis. In the meta-analysis, living alone was associated with higher levels of loneliness (OR = 3.08, 95% CI 1.87–5.07), and lower life satisfaction (OR = 1.27, 95% CI 1.05–0.55), compared to living with others. Not having access to an outdoor space and household crowding were suggestively associated with worse outcomes. Living in crowded households, living alone, or lacking access to outdoor facilities may be particularly important in contributing to poor mental health during a lockdown. Addressing the observed fundamental issues related to housing conditions within society will likely have positive effects in reducing social inequalities, as well as improving preparedness for future pandemics.
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Overbeck G, Rasmussen IS, Siersma V, Kragstrup J, Ertmann RK, Wilson P. Mental well-being during stages of COVID-19 lockdown among pregnant women and new mothers. BMC Pregnancy Childbirth 2022; 22:92. [PMID: 35105334 PMCID: PMC8804668 DOI: 10.1186/s12884-021-04374-4] [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] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/30/2021] [Indexed: 01/04/2023] Open
Abstract
Background Pregnancy and early motherhood are sensitive times where epidemic disease outbreaks can affect mental health negatively. Countries and health care systems handled the pandemic and lockdowns differently and knowledge about how the COVID-19 pandemic affected the mental well-being of pregnant women and new mothers is limited and points in different directions. Aim To investigate symptoms of anxiety and depression in a population of pregnant women and new mothers in various stages of infection pressure and lockdown during the first 15 months of the COVID-19 pandemic in Denmark. Methods The study population was nested an inception cohort of women recruited in their first trimester of pregnancy. Data about mental health of the woman were obtained in relation to pregnancy and child development (first trimester, 8 weeks postpartum and 5 months postpartum), and data were analysed cross-sectionally according to calendar time (periods defined by infection rate and lock-down during the COVID-19 pandemic). Results No differences in reported levels of depressive symptoms between the six examined time periods of the pandemic were observed. Specifically, symptoms remained unchanged after the first lock-down. No major changes in anxiety symptoms were observed in relation to increased infection pressure or lockdowns, but a small increase was observed during the second lockdown in women 8 weeks postpartum. Conclusion No clear change in mood among pregnant women was seen between during the stages of COVID-19 pandemic in Denmark.
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Affiliation(s)
- Gritt Overbeck
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Ida Scheel Rasmussen
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jakob Kragstrup
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ruth Kirk Ertmann
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Philip Wilson
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Centre for Rural Health, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, Scotland
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Broberg L, Rom AL, de Wolff MG, Høgh S, Nathan NO, Paarlberg LD, Christensen KB, Damm P, Hegaard HK. Psychological well-being and worries among pregnant women in the first trimester during the early phase of the COVID-19 pandemic in Denmark compared with a historical group: A hospital-based cross-sectional study. Acta Obstet Gynecol Scand 2021; 101:232-240. [PMID: 34904223 DOI: 10.1111/aogs.14303] [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] [Received: 05/27/2021] [Revised: 11/02/2021] [Accepted: 12/01/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION A pandemic may negatively influence psychological well-being in the individual. We aimed to assess the potential influence of the first national lockdown in Denmark (March to June 2020) due to the COVID-19 pandemic on psychological well-being and the content and degree of worries among pregnant women in early pregnancy. MATERIAL AND METHODS In this hospital-based cross-sectional study based on self-reported data we compared psychological well-being and worries among women who were pregnant during the first phase of the pandemic (COVID-19 group) (n = 685), with women who were pregnant the year before (Historical group) (n = 787). Psychological well-being was measured by the five-item World Health Organization Well-being Index (WHO-5), using a score ≤50 as indicator of reduced psychological well-being. Differences in WHO-5 mean scores and in the prevalence of women with score ≤50 were assessed using general linear and log-binomial regression analyses. The Cambridge Worry Scale was used to measure the content and degree of major worries. To detect differences between groups, Pearson's Chi-square test was used. RESULTS We found no differences in mean WHO-5 score between groups (mean difference) 0.1 (95% CI -1.5 to 1.6) or in the prevalence of women with WHO-5 score ≤50 (prevalence ratio 1.04, 95% CI 0.83-1.29) in adjusted analyses. A larger proportion of women in the COVID-19 group reported major worries about Relationship with husband/partner compared with the Historical group (3% [n = 19] vs 1% [n = 6], p = 0.04), and 9.2% in the COVID-19 group worried about the possible negative influence of the COVID-19 restrictions. CONCLUSIONS Our findings indicate that national restrictions due to the COVID-19 pandemic did not influence the psychological well-being or the content and degree of major worries among pregnant women. However, a larger proportion of women in the COVID-19 group reported major worries concerning Relationship with husband/partner compared with the Historical group and 9.2% in the COVID-19 group worried about the possible negative influence of the COVID-19 restrictions.
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Affiliation(s)
- Lotte Broberg
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,The Research Unit for Women's and Children's Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Ane L Rom
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,The Research Unit for Women's and Children's Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Research Unit of Gynecology and Obstetrics, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Mie G de Wolff
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,The Research Unit for Women's and Children's Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Stinne Høgh
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,The Research Unit for Women's and Children's Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Neurobiology Research Unit, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Nina O Nathan
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,The Research Unit for Women's and Children's Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Louise D Paarlberg
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,The Research Unit for Women's and Children's Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Karl B Christensen
- Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Peter Damm
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Hanne Kristine Hegaard
- Department of Obstetrics, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.,The Research Unit for Women's and Children's Health, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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Related Psychosocial Factors and Delivery Mode of Depression and Anxiety in Primipara in Late Pregnancy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:3254707. [PMID: 34646324 PMCID: PMC8505059 DOI: 10.1155/2021/3254707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/24/2021] [Indexed: 11/17/2022]
Abstract
Studies in recent years show that the delivery process, the choice of delivery mode, and the delivery outcome of primiparas are affected by their mental state. With the transformation of the medical model from the single biomedical model to the biopsychosocial medical model, the influence of social psychological factors on maternal psychological state has aroused heated discussion among clinical scholars. In this study, 480 cases of normal primiparas who had regular prenatal examination and delivered in hospital were selected as the research object. The Hospital Anxiety and Depression Scale (HAD) was used to record the depressive anxiety state of all study subjects in the third trimester, and we analyzed the effects of age, education background of pregnant women and their spouses, the nature of jobs, family income, prenatal and pregnancy health status, medical insurance status, attend pregnant women's school, and accompanying status of family member on their depressive anxiety state. The influence of depression and anxiety on delivery mode was analyzed. The result showed that the age, health status during prenatal and pregnancy, accompanying status of family members, and attend pregnant women's school are the independent risk factors affecting depression and anxiety status of primiparas during late pregnancy. Antenatal depression and anxiety have certain influence on the choice of the delivery mode of pregnant women. Targeted psychological intervention for primiparas with high-risk factors is helpful to improve their psychological state and reduce the rate of cesarean section.
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