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Salm Ward TC, Abu Zahra T, Payjapoh C, Oladebo T. Experiences of birthing people during the COVID-19 pandemic: Analysis of comments from the 2020 Wisconsin Pregnancy Risk Assessment Monitoring System (PRAMS). Birth 2024. [PMID: 38798170 DOI: 10.1111/birt.12836] [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: 09/14/2023] [Revised: 01/08/2024] [Accepted: 05/02/2024] [Indexed: 05/29/2024]
Abstract
BACKGROUND The COVID-19 pandemic has taken a significant toll on the US population, with birthing people having special clinical needs. The Pregnancy Risk Assessment Monitoring System (PRAMS) is a population-based surveillance system for monitoring birthing people's experiences. Comment data from the PRAMS survey can provide further insight into birthing people's experiences. This study aims to use PRAMS data to describe pandemic-related experiences in a representative sample of birthing people in Wisconsin to help inform future emergency preparedness planning. METHODS This study analyzed 2020 Wisconsin PRAMS data for births in March or later. Content analysis of pandemic-related comment data was conducted, and quantitative data on demographic characteristics and pandemic-related experiences were examined. RESULTS Findings from 1406 respondents indicated that many birthing people were affected by the pandemic, including changes in healthcare visits and employment. One hundred respondents commented on pandemic-related experiences; four interrelated themes emerged from content analysis: changed nature and quality of healthcare, limited social support, increased anxiety, stress, or fear, and employment or financial burden. Most comments discussed negative impacts; some expressed positive aspects. DISCUSSION Findings suggest opportunities for improving support for birthing people during public health emergencies, for example, through developing healthcare policies and public health guidelines that prioritize the protective mechanisms of social support for birthing people, identifying additional and immediately accessible policy protections to support birthing and postpartum people (e.g., insurance and paid leave) during public health emergencies, and implementing additional screening and support to help address increased mental health needs during public health emergencies.
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Affiliation(s)
- Trina C Salm Ward
- Helen Bader School of Social Welfare, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Tuleen Abu Zahra
- School of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Chuthamas Payjapoh
- School of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
| | - Tinuola Oladebo
- School of Nursing, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, USA
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WANG J, HU L, ZHANG T, LIU J, YU C, ZHAO N, QI J, LIU L. Prevalence and predictors of prenatal depression during the COVID-19 pandemic: A multistage observational study in Beijing, China. PLoS One 2024; 19:e0298314. [PMID: 38662750 PMCID: PMC11045078 DOI: 10.1371/journal.pone.0298314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/19/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVE While growing psychological health issues among pregnant women during the COVID-19 pandemic have been clearly validated, most research was conducted in countries with relatively lax quarantine measures. This study aimed to compare the prevalence of prenatal depression among pre-, peak-, and post-COVID-19 in Beijing, the region with a stringent response policy in China. We also explore predictors of prenatal depression throughout the outbreak. METHODS We investigated prenatal depression among 742 pregnant women who received antenatal checkups in Beijing from March 28, 2019 to May 07, 2021 using the Edinburgh Postnatal Depression Scale and associative demographic, pregnancy-related, and psychosocial characteristics were measured. The phase was divided into pre-, peak-, and post-COVID-19 in light of the trajectory of COVID-19. Pearson's Chi-square test was used after the examination of confounders homogeneity. The bivariable and multivariable logistic regression was conducted to explore predictors. RESULTS The pooled prevalence of prenatal depression was 11.9% throughout the COVID-19 pandemic. Rates at different phases were 10.6%, 15.2%, and 11.1% respectively and no significant difference was observed. Multivariable logistic regression revealed that history of mental illness, number of boy-preference from both pregnant women and husband's family, social support, occupation, and living space were independent predictors of prenatal depression in Beijing. CONCLUSION Our data suggested that the impact of this pandemic on prenatal depression in Beijing appears to be not significant, which will strengthen confidence in adhering to current policy for decision-makers and provide important guidance for the development of major outbreak control and management policies in the future. Our findings may also provide a more efficient measure to identify high-risk pregnant women for professionals and help raise gender equity awareness of pregnant women and their husbands' families. Future studies should focus on the value of targeted care and family relations on the mental health of pregnant women.
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Affiliation(s)
- Jin WANG
- Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China
- Department of Aviation Psychology, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Libin HU
- Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China
| | - Tianyi ZHANG
- Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China
| | - Jiajia LIU
- Department of Aviation Psychology, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Chuan YU
- Department of Aviation Psychology, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Ningxin ZHAO
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jianlin QI
- Department of Aviation Psychology, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Lihua LIU
- Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China
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Wiley KS, Fox MM, Gildner TE, Thayer ZM. A longitudinal study of how women's prenatal and postnatal concerns related to the COVID-19 pandemic predicts their infants' social-emotional development. Child Dev 2023; 94:1356-1367. [PMID: 37068183 PMCID: PMC10524379 DOI: 10.1111/cdev.13934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 01/19/2023] [Accepted: 02/23/2023] [Indexed: 04/19/2023]
Abstract
Infant social-emotional development may be impacted by the COVID-19 pandemic. This study investigated associations between maternal pre- and postnatal pandemic-related concerns and social-emotional developmental risk. Data, collected in 2020-2021, came from 220 mothers (87% white, 6% Hispanic, 1% Black, 3% Asian, 1% American Indian, Mage = 32.46 years), and infants (53.18% male, Mage = 12.98 months) in the United States. Maternal postnatal pandemic-related concerns were associated with total risk scores (B = 6.09, p-value <.001) and offspring risk of scoring positive for problems related to inflexibility (B = 4.07, p-value = .006). The total score association was moderated by self-reported social support. Infants may be detrimentally impacted by the pandemic via maternal pandemic-related concerns. Maternal social support may buffer infants.
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Affiliation(s)
- Kyle S. Wiley
- Department of Anthropology, University of California, Los
Angeles, Los Angeles, California, USA
| | - Molly M. Fox
- Department of Anthropology, University of California, Los
Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, Los Angeles, California, USA
| | - Theresa E. Gildner
- Department of Anthropology, Washington University in St.
Louis, St. Louis, Missouri, USA
| | - Zaneta M. Thayer
- Department of Anthropology, Dartmouth College, Hanover, New
Hampshire, USA
- Ecology, Evolution, Environment & Society Program,
Dartmouth College, Hanover, New Hampshire, USA
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Khoury JE, Jambon M, Giles L, Atkinson L, Gonzalez A. Trajectories of distress from pregnancy to 15-months post-partum during the COVID-19 pandemic. Front Psychol 2023; 14:1104386. [PMID: 37063573 PMCID: PMC10102331 DOI: 10.3389/fpsyg.2023.1104386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/15/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundThe COVID-19 pandemic has particularly burdened pregnant and postpartum women. It remains unclear how distress levels of pregnant and postpartum people have changed (or persisted) as the pandemic continues on and which factors may contribute to these trajectories of distress.MethodsThis longitudinal study included 304 pregnant people, who were followed during pregnancy, 6-weeks, 6-months and 15-months postpartum. At each time point, a latent “distress” factor was estimated using self-reported depressive symptoms, anxiety symptoms, and stress. Reported negative impact of COVID-19 and social support were assessed during pregnancy as risk and protective factors related to distress. Second-order latent growth curve modeling with a piecewise growth function was used to estimate initial levels and changes in distress over time.ResultsMean distress was relatively stable from the pregnancy to 6-weeks postpartum and then declined from 6-weeks to 15-months postpartum. Higher education, greater social support, and lower negative impact of COVID-19 were associated with a lower distress during pregnancy. Unexpectedly, negative impact of COVID-19 was associated with a faster decrease in distress and more social support was associated with a greater increase in distress from pregnancy to 6-weeks postpartum. However, these effects became non-significant after controlling for distress during pregnancy.ConclusionFindings indicate high but declining levels of distress from pregnancy to the postpartum period. Changes in distress are related to social support and the negative impact of the pandemic in pregnancy. Findings highlight the continued impact of COVID-19 on perinatal mental health and the need for support to limit the burden of this pandemic on pregnant people and families.
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Affiliation(s)
- Jennifer E. Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
- *Correspondence: Jennifer E. Khoury,
| | - Marc Jambon
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Lauren Giles
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Leslie Atkinson
- Department of Psychology, Metropolitan Toronto University, Toronto ON, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
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He J, Yang W, He Q, Tang Y, Wang Y, Wang G, Jiang X, Ren J. Chinese pregnant women's knowledge, attitude, and practice of self-protection against coronavirus disease 2019 during the post-pandemic period: A structural equation modeling-based survey. INTERNATIONAL JOURNAL OF DISASTER RISK REDUCTION : IJDRR 2023; 87:103559. [PMID: 36714184 PMCID: PMC9869621 DOI: 10.1016/j.ijdrr.2023.103559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 01/03/2023] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to investigate the Chinese pregnant women's levels of knowledge, attitude, and practice (KAP) of self-protection against coronavirus disease 2019 (COVID-19) during the post-pandemic period, to aid the development of targeted health education. An online questionnaire was conducted for 2156 Chinese pregnant women from October 1, 2021, to December 31, 2021, to collect socio-demographic and KAP information. Structural equation modeling (SEM) was used to determine self-protection-related factors. The mean age of the participants was 30 ± 4.1 years. SEM indicated that pregnant women's level of knowledge can directly and indirectly affect the practice of self-protection (r = 0.23) through their belief, with a correlation coefficient of 0.56 and 0.46 between knowledge and belief and belief and practice, respectively. The "basic protection" and "hospital visits after infection" exerted the greatest impact on knowledge formation, with correlation coefficients of 0.85 and 0.89, respectively. Attitude had a direct effect on practice with a correlation coefficient of 0.46. "Awareness of prevention and control" and "family and social support" had the greatest impact on belief formation, with correlation coefficients of 0.77 and 0.73, respectively. Pregnant Chinese women were generally familiar with COVID-19 knowledge, and their levels of knowledge and beliefs particularly affect the practice of self-protection. Health education aimed at improving pregnant women's knowledge and belief toward self-protection against COVID-19 may be an effective way to guide them toward positive practices and promote their health and that of their babies.
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Key Words
- AGFI, adjusted goodness of fit index
- BMI, body mass index
- CFI, comparative fix index
- CMIN/DF, Chi-square fit statistics/degree of freedom
- COVID-19
- COVID-19, coronavirus disease 2019
- GFI, goodness-of-fit index
- I-CVI, individual-item content validity index
- IFI, incremental fix index
- KAP theory
- KAP, knowledge attitude and practice
- MERS, Middle eastern respiratory syndrome
- Post-pandemic period
- Pregnant women
- RMSEA, root mean square error of approximation
- S-CVI, scale-content validity index
- SARS, severe acute respiratory syndrome
- SEM, structural equation modeling
- Self-protection
- TLI, Tucker-Lewis index
- UA, universal agreement
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Affiliation(s)
- Jingjing He
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Wenqian Yang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Qiuyang He
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Yuxin Tang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Yonghong Wang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Guoyu Wang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan , SC 28/610000, China
| | - Xiaolian Jiang
- West China School of Nursing, Sichuan University / West China School of Medicine, Sichuan University / West China Hospital, Sichuan University, No. 37, Guoxue Lane, Wuhou District, Chengdu, Sichuan, SC 28/610000, China
| | - Jianhua Ren
- Department of nursing, West China Second University Hospital / West China School of Nursing, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), No. 20, Section 3, Renmin Road South, Chengdu, Sichuan, SC 28/610000, China
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Cluxton-Keller F, Olson A. A Family-Based Collaborative Care Model for Treatment of Depressive and Anxiety Symptoms in Perinatal Women: Results from a Pilot Study (Preprint). JMIR Pediatr Parent 2023; 6:e45616. [PMID: 37052997 PMCID: PMC10141279 DOI: 10.2196/45616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/06/2023] [Accepted: 02/07/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Untreated perinatal depression and anxiety can have detrimental consequences on family function. Logistical barriers prevent many perinatal women from accessing treatment, and these barriers are compounded for women residing in rural areas. This paper describes a Family-Based Collaborative Care Model (FBCCM) that is designed to bypass barriers to increase access to care for depressed and anxious perinatal women in rural regions of the United States. The FBCCM includes the following two components: (1) a 10-session video-delivered family therapy treatment for perinatal depression and anxiety and (2) a video-delivered infant care provider training on addressing the parenting needs of depressed and anxious mothers. OBJECTIVE This paper describes the feasibility of implementing the FBCCM with families and infant care providers. Findings are presented on the preliminary effectiveness of the video-delivered family therapy treatment in reducing maternal depressive and anxiety symptoms, and family conflict. METHODS This pilot study was carried out using an implementation-effectiveness hybrid trial design without a comparison group. Changes in maternal depressive symptoms, maternal anxiety symptoms, and family conflict were measured at posttreatment, 3 months, and 6 months later. RESULTS On average, mothers (n=24) attended 9.79 (SD 1.02) sessions. On average, their family members (n=24) attended 9.42 (SD 1.28) sessions. A total of 31 infant care providers attended the training on addressing the parenting needs of depressed and anxious mothers. Mothers reported a significant reduction in depressive symptoms (P<.001) and anxiety symptoms (P<.001) from baseline to the 6-month follow-up. Mothers reported a significant reduction in conflict (P<.001), and their family members also reported a significant reduction in conflict (P=.007) from baseline to the 6-month follow-up. CONCLUSIONS The findings from this study provide support for the feasibility and preliminary effectiveness of the FBCCM. The findings will be used to inform a larger study of the FBCCM.
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Affiliation(s)
- Fallon Cluxton-Keller
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
| | - Ardis Olson
- Department of Pediatrics, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Lebanon, NH, United States
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Potharst ES, Schaeffer MA, Gunning C, de Lara MC, Boekhorst MGBM, Hulsbosch LP, Pop VJM, Duijff SN. Implementing "Online Communities" for pregnant women in times of COVID-19 for the promotion of maternal well-being and mother-to-infant bonding: a pretest-posttest study. BMC Pregnancy Childbirth 2022; 22:415. [PMID: 35585565 PMCID: PMC9116067 DOI: 10.1186/s12884-022-04729-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 04/26/2022] [Indexed: 12/17/2022] Open
Abstract
Background The Coronavirus Disease 2019 (COVID-19) pandemic elevated the risk for mental health problems in pregnant women, thereby increasing the risk for long-term negative consequences for mother and child well-being. There was an immediate need for easily accessible interventions for pregnant women experiencing elevated levels of pandemic related stress. Methods A three-session intervention “Online Communities” (OC) was developed at the beginning of the Dutch lockdown, and implemented by a team of midwives and psychologists specialized in Infant Mental Health. Pretest (N = 34) and posttest (N = 17) measurements of depressive symptoms, worries about COVID-19 and worries in general, and mother-to-infant bonding were administered, as well as a posttest evaluation. Results At pretest, the OC group was compared to two reference groups of pregnant women from an ongoing pregnancy cohort study: a COVID-19 (N = 209) and pre-COVID-19 reference group (N = 297). OC participants had significantly more depressive symptoms than both reference groups, and less positive feelings of bonding than the COVID-19 but not the pre-COVID-19 reference group. Compared to pretest, significant decreases in depressive symptoms (with significantly less participants scoring above cut-off) and worries about COVID-19 (large effect sizes) and worries in general (moderate to large effect size) were found at posttest for the OC participants. No significant improvement was found in bonding. Participants rated the intervention positively. Conclusions The current study provides initial evidence supporting the idea that OC is a promising and readily accessible intervention for pregnant women experiencing stress due to the COVID-19 pandemic, and possibly also applicable to other stressors. Trial registration This intervention was registered in the Netherlands Trial Registration (registration number Trial NL8842, registration date 18/08/2020).
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Affiliation(s)
- Eva S Potharst
- Research Institute of Child Development and Education, University of Amsterdam, Gebouw D, Roeterseilandcomplex, Nieuwe Achtergracht 127, 1018 WS, Amsterdam, the Netherlands. .,UvA Minds, Academic Outpatient (child and adolescent) Treatment Center of the University of Amsterdam, Banstraat 29, 1071 JW, Amsterdam, the Netherlands.
| | - Mirla A Schaeffer
- UvA Minds, Academic Outpatient (child and adolescent) Treatment Center of the University of Amsterdam, Banstraat 29, 1071 JW, Amsterdam, the Netherlands.,Amsterdam Law and Behaviour Institute (A-LAB), Vrije Universiteit Amsterdam, De Boelelaan 1077a, 1081 HV, Amsterdam, the Netherlands.,Netherlands Institute for the Study of Crime and Law Enforcement, De Boelelaan 1077, 1081 HV, Amsterdam, the Netherlands
| | - Cecile Gunning
- Infant Mental Health Expertise Centre OuderKindLijn, Javastraat 155, 1095 CC, Amsterdam, The Netherlands
| | - Merith Cohen de Lara
- Outpatient Maternal Mental Health Practice Psyche en Zwangerschap, Cornelis Anthoniszstraat 28, 1071 VV, Amsterdam, The Netherlands
| | - Myrthe G B M Boekhorst
- Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders (CoRPS), Tilburg University, Gebouw TIAS, Warandelaan 2, 5037 AB, Tilburg, the Netherlands
| | - Lianne P Hulsbosch
- Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders (CoRPS), Tilburg University, Gebouw TIAS, Warandelaan 2, 5037 AB, Tilburg, the Netherlands
| | - Victor J M Pop
- Department of Medical and Clinical Psychology, Center of Research On Psychological and Somatic Disorders (CoRPS), Tilburg University, Gebouw TIAS, Warandelaan 2, 5037 AB, Tilburg, the Netherlands
| | - Sasja N Duijff
- Infant Mental Health Expertise Centre OuderKindLijn, Javastraat 155, 1095 CC, Amsterdam, The Netherlands.,Clinical Child, Family and Education Studies, University of Utrecht, Heidelberglaan 1, Postbus 80140, 3508 TC, Utrecht, The Netherlands
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