Postpartum Depressive Symptoms, Perceived Social Support and Their Associations of Women Under Different COVID-19 Pandemic Severities: Analysis of A Chinese Nationwide Multicenter Study (preprint)

Background The evidence for associations of mental health with COVID-19 pandemic severity is scarce in postpartum women. We aimed to investigate the associations of postpartum depressive symptoms (PDS), perceived social support (PSS) with COVID-19 pandemic severity, respectively, and to explore the associations between PSS and PDS under different pandemic severities.Methods This was a nationwide multicenter study. An online survey was launched from January 23 through February 29, 2020 in mainland China. Participants’ PDS and PSS were measured by Edinburgh Postnatal Depression Scale and Multidimensional Scale of Perceived Social Support, respectively.Results The final sample consisted of 452 participants from 19 hospitals in 19 provinces/municipalities of mainland China. After covariate adjustment, women in Hubei Province experienced higher PDS levels than those in moderate (β coefficient = − 3.883, p = 0.001) and high (β coefficient = − 3.760, p = 0.005) pandemic severity; women in moderate pandemic severity reported higher PSS levels not only than those in high (β coefficient = − 4.947, p = 0.008) pandemic severity and Hubei Province (β coefficient = − 6.480, p = 0.049), but also than low (β coefficient = − 7.428, p = 0.005) pandemic severity. Also, no significant associations were found between PSS and pandemic severity for women with moderate-to-severe PDS (p > 0.05). There were significantly negative associations between PSS and PDS for women under low (OR = 0.837, p = 0.039), moderate (OR = 0.919, p < 0.001), and high (OR = 0.951, p = 0.012) pandemic severity, and no significant association between PSS and PDS was observed in Hubei Province after covariate adjustment (p > 0.05).Conclusion Women in Hubei Province experienced higher PDS levels than those in moderate and high pandemic severity. Women in moderate pandemic severity reported higher PSS levels not only than those in high pandemic severity and Hubei Province, but also than low pandemic severity, and no associations were found between PSS and pandemic severity for women with moderate-to-severe PDS. There were negative associations between PSS and PDS for women in low, moderate and high pandemic severity, but no association between PSS and PDS of women in Hubei Province.

Characteristics of online medical care consultation for pregnant women during the COVID-19 outbreak: a cross-sectional study (preprint)

Background During the Coronavirus Disease 2019 (COVID-19) outbreak, emergency traffic bans limited accessibility of some medical resource for pregnant women. Fear of viral transmission also prevented pregnant women from seeking routine antenatal care (ANC). This study described the needs of pregnant women and the contents of online obstetric consultation in representative areas with various severity of the epidemic in China. Methods From February 10 th to 23 rd , we collected data on online obstetric consultations and women’s satisfaction in mild, moderate and severe epidemic areas through an e-health provider’s platform. Information on women’s needs, contents of the consultation and satisfaction were collected and compared by epidemic areas. Results A total of 2599 pregnant women participated in this study, of whom 448, 1322 and 819 women were from the mild, moderate and severe epidemic areas, respectively. The distributions of the amount of online consultation were significantly different not only in different areas, but also in different trimesters. The more severe the epidemic was and the more advanced the pregnancy was, the higher the amount of second category (changed their schedules of ANC and/or delivery as well as method of delivery) was. 957 participants completed a satisfaction survey. For most of the participants, it’s their first time to use the e-health, and nearly 90% participants were completely or mostly satisfied with the online consultation. Conclusions Our study found that during the outbreak, many pregnant women had changed their scheduled ANC visits without authorization, and the more serious the epidemic was, the more common it occurred. The needs for online consultation was substantial. In order to prevent irreversible obstetric adverse events, an appropriate ANC contingency plan with e-health services is highly recommended during the Public Health Emergency of International Concern (PHEIC).