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Zhao T, Jhangri GS, Dobson KS, Li JY, Premji SS, Tao F, Zhu B, Yamamoto SS. The impact of prenatal mental health on birth outcomes before and during the COVID-19 pandemic in Anhui, China. PLoS One 2024; 19:e0308327. [PMID: 39106266 DOI: 10.1371/journal.pone.0308327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 07/22/2024] [Indexed: 08/09/2024] Open
Abstract
Adverse birth outcomes remain challenging public health problems in China. Increasing evidence indicated that prenatal depression and anxiety are associated with adverse birth outcomes, highlighting the importance and severity of prenatal depression and anxiety in China. The COVID-19 pandemic is likely to further exacerbate prenatal mental health problems and increase the risk of adverse birth outcomes. The aim of this study is to assess and compare the impacts of prenatal mental health issues on birth outcomes before and during the COVID-19 pandemic in Ma'anshan, Anhui, China. Participants in this study were women who visited local maternal and child health hospitals in Ma'anshan, Anhui, China. Two independent sets of individual maternal data (npre-pamdemic = 1148; npandemic = 2249) were collected. Prenatal depression and anxiety were measured online using the Edinburgh Postnatal Depression Scale (EPDS) and the General Anxiety Disorder-7 (GAD-7). Adverse birth outcomes were determined using hospital-recorded infant birth weight and gestational age at delivery. In this study, we found that the pandemic cohort had lower mean EPDS and GAD-7 scores than the pre-pandemic cohort. The prevalence of prenatal depression (14.5%) and anxiety (26.7%) among the pandemic cohort were lower than the pre-pandemic cohort (18.6% and 36.3%). No significant difference was found in the prevalence of adverse birth outcomes comparing the two cohorts. Prenatal depression was associated with small gestational age only in the pandemic cohort (OR = 1.09, 95% CI 1.00-1.19, p = 0.042). Overall, this study highlighted an association between prenatal depression and small for gestational age in Anhui, China. Addressing prenatal depression may thus be key in improving birth outcomes. Future studies could focus on potential causal relationships.
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Affiliation(s)
- Tianqi Zhao
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Gian S Jhangri
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Keith S Dobson
- Faculty of Arts, Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Jessica Yijia Li
- Faculty of Social Sciences, Department of Psychology, University of Victoria, Victoria, BC, Canada
| | - Shahirose S Premji
- Faculty of Health Sciences, School of Nursing, Queen's University, Kingston, Ontario, Canada
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Beibei Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Shelby S Yamamoto
- School of Public Health, University of Alberta, Edmonton, AB, Canada
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Oros Ruiz M, Perejón López D, Serna Arnaiz C, Siscart Viladegut J, Àngel Baldó J, Sol J. Maternal and foetal complications of pregestational and gestational diabetes: a descriptive, retrospective cohort study. Sci Rep 2024; 14:9017. [PMID: 38641705 PMCID: PMC11031602 DOI: 10.1038/s41598-024-59465-x] [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: 12/11/2023] [Accepted: 04/11/2024] [Indexed: 04/21/2024] Open
Abstract
Gestational diabetes is characterized by hyperglycaemia diagnosed during pregnancy. Gestational and pregestational diabetes can have deleterious effects during pregnancy and perinatally. The baby's weight is frequently above average and might reach macrosomia (≥ 4 kg), which can reduce pregnancy time causing preterm births, and increase foetal-pelvic disproportion which often requires delivery by caesarean section. Foetal-pelvic disproportion due to the baby's weight can also cause foetal distress resulting in lower Apgar scores. To analyse the association between pregestational and gestational diabetes with maternal and foetal risk. We conducted a retrospective cohort study in women pregnant between 2012 and 2018 in the region of Lleida. Regression coefficients and 95% confidence intervals (CI) were used. The multivariate analysis showed statistically significant associations between pregestational diabetes and: prematurity (OR 2.4); caesarean section (OR 1.4); moderate (OR 1.3), high (OR 3.3) and very high (OR 1.7) risk pregnancies; and birth weight ≥ 4000 g (macrosomia) (OR 1.7). In getational diabetes the multivariate analysis show significant association with: caesarean section (OR 1.5); moderate (OR 1.7), high (OR 1.7) and very high (OR 1.8) risk pregnancies and lower 1-minuto Apgar score (OR 1.5). Pregestational and gestational diabetes increase: pregnancy risk, caesarean sections, prematurity, low Apgar scores, and macrosomia.
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Gorgui J, Tchuente V, Pages N, Fareh T, King S, Elgbeili G, Bérard A. The impact of prenatal maternal mental health during the COVID-19 pandemic on birth outcomes: two nested case-control studies within the CONCEPTION cohort. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:755-773. [PMID: 37668893 PMCID: PMC10485209 DOI: 10.17269/s41997-023-00814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 07/19/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE Assess the association between prenatal mental health during the COVID-19 pandemic and preterm birth (PTB; delivery < 37 weeks gestation) and low birth weight (LBW; < 2500 g). METHODS Pregnant individuals, > 18 years, were recruited in Canada and provided data through a web-based questionnaire. We analyzed data on persons recruited between 06/2020 and 08/2021 who completed questionnaires while pregnant and 2 months post-partum. Data on maternal sociodemographics, comorbidities, medication use, mental health (Edinburgh Postnatal Depression Scale, General Anxiety Disorder-7, stress), pandemic hardship (CONCEPTION-Assessment of Stress from COVID-19), and on gestational age at delivery and birth weight were self-reported. Crude and adjusted odds ratios (aOR) with 95% confidence interval (95%CI) were calculated to quantify the association between PTB/LBW and maternal mental health. RESULTS A total of 1265 and 1233 participants were included in the analyses of PTB and LBW, respectively. No associations were observed between PTB and prenatal mental health (depression [aOR 1.01, 95%CI 0.91-1.11], anxiety [aOR 1.04, 95%CI 0.93-1.17], stress [aOR 0.88, 95%CI 0.71-1.10], or hardship [aOR 1.00, 95%CI 0.96-1.04]) after adjusting for potential confounders. The risk of PTB was increased with non-white ethnicity/race (aOR 3.85, 95%CI 1.35-11.00), consistent with the literature. Similar findings were observed for LBW (depression [aOR 1.03, 95%CI 0.96-1.13], anxiety [aOR 1.05, 95%CI 0.95-1.17], COVID stress [aOR 0.92, 95%CI 0.77-1.09], or overall hardship [aOR 0.97, 95%CI 0.94-1.01]). CONCLUSION No association was found between prenatal mental health nor hardship during the COVID-19 pandemic and the risk of PTB or LBW. However, it is imperative to continue the follow-up of mothers and their offspring to detect long-term health problems early.
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Affiliation(s)
- Jessica Gorgui
- Research Centre, Centre Hospitalier Universitaire Ste-Justine, Montréal, Québec, Canada
- Faculty of Pharmacy, University of Montreal, Montréal, Québec, Canada
| | - Vanina Tchuente
- Research Centre, Centre Hospitalier Universitaire Ste-Justine, Montréal, Québec, Canada
| | - Nicolas Pages
- Research Centre, Centre Hospitalier Universitaire Ste-Justine, Montréal, Québec, Canada
- Faculty of Medicine, Université Claude Bernard Lyon 1, Lyon, France
| | - Tasnim Fareh
- Research Centre, Centre Hospitalier Universitaire Ste-Justine, Montréal, Québec, Canada
- Faculty of Medicine, Université Claude Bernard Lyon 1, Lyon, France
| | - Suzanne King
- Faculty of Medicine, McGill University, Montréal, Québec, Canada
| | | | - Anick Bérard
- Research Centre, Centre Hospitalier Universitaire Ste-Justine, Montréal, Québec, Canada.
- Faculty of Pharmacy, University of Montreal, Montréal, Québec, Canada.
- Faculty of Medicine, Université Claude Bernard Lyon 1, Lyon, France.
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Andrei AM, Webb R, Enea V. Health anxiety, death anxiety and coronaphobia: Predictors of postpartum depression symptomatology during the COVID-19 pandemic. Midwifery 2023; 124:103747. [PMID: 37276749 PMCID: PMC10229209 DOI: 10.1016/j.midw.2023.103747] [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: 02/02/2022] [Revised: 03/07/2023] [Accepted: 05/26/2023] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To determine levels of postpartum depression symptoms and possible relevant predictors, such as death anxiety, health anxiety, and coronavirus-related anxiety. DESIGN Cross-sectional web-based survey using quantitative methods. SETTING Exclusively online recruiting via social media and unpaid cross-posting conducted during the third wave of the COVID-19 pandemic in Romania. PARTICIPANTS Women were eligible to take part in the study if they were mothers over the age of 18 and had a baby aged between 4 weeks - 12 months of age; 1024 women were included in the final sample. MEASUREMENTS AND FINDINGS Health anxiety, death anxiety, coronavirus-related anxiety, and postpartum depression symptoms were measured using validated instruments. Current depression symptomatology was 67.6%, 26.7% scored above the cut-off for high health anxiety, 1% for coronavirus-related anxiety, and 62.7% for death anxiety. Significant predictors for depressive symptomatology were breastfeeding, history of depression, family income, number of children, health anxiety, death anxiety, and coronavirus anxiety. Further, hierarchical multiple regression analysis indicated that death anxiety, health anxiety, and coronavirus anxiety predicted postpartum depression symptoms over and above socio-demographic factors. KEY CONCLUSIONS Supported by previous studies, our results suggest that postpartum depression symptomatology levels during the COVID-19 pandemic are high and that they are predicted by health and death anxiety, which are also increased during the pandemic. IMPLICATION FOR PRACTICE The findings provide information to identify the risk for depression symptoms in postpartum mothers during acute public health situations.
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Affiliation(s)
- Ana-Maria Andrei
- Department of Psychology, Alexandru Ioan Cuza University, Iaşi, Romania
| | | | - Violeta Enea
- Department of Psychology, Alexandru Ioan Cuza University, Iaşi, Romania.
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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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Zhao T, Zuo H, Campbell SM, Jhangri GS, Dobson KS, Li JY, Premji SS, Tao F, Zhu B, Yamamoto SS. The Impacts of Prenatal Mental Health Issues on Birth Outcomes during the COVID-19 Pandemic: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137670. [PMID: 35805327 PMCID: PMC9265353 DOI: 10.3390/ijerph19137670] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 02/04/2023]
Abstract
Background: The severity of the COVID-19 pandemic is likely to exacerbate mental health problems during the prenatal period and increase the risk of adverse birth outcomes. This review assessed the published literature related to the impacts of prenatal mental health issues on birth outcomes during the COVID-19 pandemic. Methods: This scoping review was conducted using PROSPERO, Cochrane Library, OVID Medline, Ovid EMBASE, OVID PsycInfo, EBSCO CINAHL, and SCOPUS. The search was conducted using controlled vocabulary and keywords representing the concepts “COVID19”, “mental health” and “birth outcomes”. The main inclusion criteria were peer-reviewed published articles from late 2019 to the end of July 2021. Results and Discussion: After removing duplicates, 642 articles were identified, of which two full texts were included for analysis. Both articles highlighted that pregnant women have experienced increasing prenatal mental health issues during the COVID-19 pandemic and, further, increased the risk of developing adverse births. This scoping review highlighted that there is a lack of research on the impact of prenatal mental health issues on birth outcomes during the pandemic. Conclusion: Given the severity of the COVID-19 pandemic and the burdens of prenatal mental health issues and adverse birth outcomes, there is an urgent need to conduct further research.
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Affiliation(s)
- Tianqi Zhao
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (H.Z.); (S.M.C.); (G.S.J.); (S.S.Y.)
- Correspondence:
| | - Hanxiao Zuo
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (H.Z.); (S.M.C.); (G.S.J.); (S.S.Y.)
| | - Sandra M. Campbell
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (H.Z.); (S.M.C.); (G.S.J.); (S.S.Y.)
| | - Gian S. Jhangri
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (H.Z.); (S.M.C.); (G.S.J.); (S.S.Y.)
| | - Keith S. Dobson
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB T2N 1N4, Canada; (K.S.D.); (J.Y.L.)
| | - Jessica Yijia Li
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, AB T2N 1N4, Canada; (K.S.D.); (J.Y.L.)
| | - Shahirose S. Premji
- School of Nursing, Faculty of Health, York University, Toronto, ON M3J 1P3, Canada;
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230038, China; (F.T.); (B.Z.)
| | - Beibei Zhu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei 230038, China; (F.T.); (B.Z.)
| | - Shelby S. Yamamoto
- School of Public Health, University of Alberta, Edmonton, AB T6G 1C9, Canada; (H.Z.); (S.M.C.); (G.S.J.); (S.S.Y.)
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