Parental and Other Caregiver Loss Due to COVID-19 in the United States: Prevalence by Race, State, Relationship, and Child Age.

The more than one million COVID-19 deaths in the United States include parents, grandparents, and other caregivers for children. These losses can disrupt the social, emotional, and economic well-being of children, their families, and their communities, and understanding the number and characteristics of affected children is a critical step in responding. We estimate the number of children who lost a parent or other co-residing caregiver to COVID-19 in the U.S. and identify racial, ethnic, and geographic disparities by aligning COVID-19 death counts through mid-May 2022 with household information from a representative sample of individuals. We estimate that 216,617 children lost a co-residing caregiver to COVID-19; 77,283 lost a parent and more than 17,000 children lost the only caregiver with whom they lived. Non-White children were more than twice as likely as White children to experience caregiver loss, and children under 14 years old experienced 70% of caregiver loss. These losses are a salient threat to the functioning of families and the communities in which COVID-19 deaths are concentrated, compounding additional challenges to physical and mental health and economic stability disproportionately imposed by the pandemic on historically disadvantaged populations. Policymakers and systems should take steps to ensure access to appropriate supports.

Experience of COVID-19 and Postpartum Mental Health

Background: Early reports show pregnant and postpartum women have increased rates of anxiety and depression during the COVID-19 pandemic. These elevations could be related to fear of contracting COVID or mitigation strategies, such as social distancing and stay-at-home orders. First-time mothers may be uniquely vulnerable to these stressors. We examined whether 1) exposure to potentially stressful COVID-19 events, perceived impact of COVID-19, and COVID-19 distress are related to anxiety and depression symptoms reported by first-time mothers, and 2) whether the relationship between COVID-19 related stressors and anxiety and depression is stronger for mothers reporting less social support. Methods: We interviewed 125 first-time mothers of infants less than 3 months old from four pediatric primary care offices in Pennsylvania and Delaware (June 2020 - February 2021). Mothers completed a self-report interview asking about social support, COVID-19 experiences, and anxiety and depression symptoms (EPDS Total, Anxiety, Depression). The COVID-19 measure yielded three variables: 1) number of potentially stressful COVID-19 pandemic-related events (Event Exposure), 2) perceived impact of the COVID-19 pandemic on family (Family Impact), and 3) overall perceived distress related to the pandemic (Distress). Results: Participants (mean age = 29.18, SD: 5.50) were racially representative of the recruitment clinics (40.8% White;37.6% Black;11.2% Asian/Asian American;6.4% Latina). Hierarchical linear regression found COVID-19 Event Exposure was unrelated to Depression (β = 0.03, n.s.) and Anxiety (β = 0.04, n.s.). Controlling for Event Exposure, Family Impact was associated with higher EPDS Total (β = 0.32, p = 0.001), Depression (β = 0.29, p =.003), and Anxiety (β = 0.23, p = 0.02). Distress was significantly associated with higher EPDS Total (β = 0.21, p = 0.04) and Depression (β = 0.26, p = 00.01) but not Anxiety (β = 0.08, n.s.). Mothers reporting less social support had higher Depression scores (r = 0.26, p =.003), but social support was unrelated to Anxiety (r = 0.08, p = 0.41). The interaction of Family Impact and social support produced a nonsignificant trend (p = 0.09, Figure). Conclusion: While experience of more COVID-19 related events was unrelated to maternal anxiety and depression symptoms, maternal report of impact of COVID-19 on the family was associated with both anxiety and depression symptoms. Additionally, higher maternal distress reports and less perceived social supports were related to increased maternal depression symptoms. Therefore, future work should explore how to mitigate impact of COVID-19 families and connect mothers to social support to support maternal mental health.

Postpartum Mental Health and Infant Development During the COVID-19 Pandemic

Background: Infection mitigation strategies implemented during the COVID-19 pandemic influenced social experiences for new mothers and their infants, with potential to negatively impact infant development. Early reports during the pandemic show postpartum women have increased rates of anxiety and depression which are known risk factors for developmental delay. Additionally, stay-at-home orders, social distancing, and use of face masks may alter visual input (facial expressions and oral motor movements) infants receive with the potential to negatively impact social-emotional and communication development. Thus, there is need to examine the developmental trajectory of infants born during the COVID-19 pandemic. We hypothesized that higher COVID impact and maternal symptoms of anxiety and depression would be linked to greater risk for developmental delay. Methods: We recruited 125 first-time mothers of infants less than 3 months of age from four pediatric primary care offices in Pennsylvania and Delaware (June 2020 - February 2021). Mothers completed a self-report interview when their infants were less than 3 months of age (baseline) and again at 6 months of age (follow-up), asking about COVID-19 family impact, anxiety and depression symptoms (EPDS Total, Anxiety, Depression), infant development (ASQ-3 at 3 months and 6 months and ASQ-SE at 6 months), and items inquiring about the frequency of mother-child caretaking activities across a range of behaviors. Results: Bivariate correlations found that while perceived family impact from COVID-19 was related to maternal self-report of postpartum depression symptoms at baseline (r = .32, p = .001), it was not related to the frequency of mother-child caretaking activities or infant development in the first 6 months of life. However, hierarchical linear regression found when controlling for COVID-19 family impact, baseline postpartum depression symptoms were related to fewer concurrent motherchild caretaking activities (β =.24, p = .007) and predicted poorer infant social-emotional development at 6 months of age (β = .23, p = .013). Conclusion: Consistent with prior literature, maternal postpartum depression symptoms were related to fewer concurrent mother-child caretaking activities and poorer infant social-emotional development at 6 months of age. However, despite anecdotal maternal concern, there was not a relationship between the effect of COVID-19 on the family unit and infant development. It is possible that COVID-19 pandemic effects will play a more prominent role as infants' complex language and social skills emerge. However, the current findings do not support a direct effect of pandemic family impact on infant development during the first six months of life, instead underscoring the importance of maternal wellbeing and functioning for infant social-emotional development.

Adaptive systems for student resilience in the context of COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic is a disaster, defined as an event that suspends normal activities and threatens or causes severe, community-wide damage (Masten & Motti-Stefanidi, 2020). While all school children and their families have been impacted by COVID-19 to some degree, the burdens are disproportionately being borne by children experiencing poverty and children from minority racial and ethnic groups. In this article, we consider resilience and risk in the context of the COVID-19 pandemic by focusing on children's developing adaptive systems. When adaptive systems are functioning well, most children will demonstrate resilience to disaster. The capacity of children's adaptive systems to function well depends upon their developmental histories and the social and community resources available to them. We discuss how these factors contribute to children's adaptation and close with recommendations for communities looking to support resilience to the varied adversities of COVID-19. (PsycInfo Database Record (c) 2021 APA, all rights reserved).