Anxiety, stress, and depression in Australian pregnant women during the COVID-19 pandemic: A cross sectional study.

BACKGROUND: The COVID-19 pandemic necessitated rapid responses by health services to suppress transmission of the virus. AIM: This study aimed to investigate predictors of anxiety, stress and depression in Australian pregnant women during the COVID-19 pandemic including continuity of carer and the role of social support. METHODS: Women aged 18 years and over in their third trimester of pregnancy were invited to complete an online survey between July 2020 and January 2021. The survey included validated tools for anxiety, stress, and depression. Regression modelling was used to identify associations between a range of factors including continuity of carer, and mental health measures. FINDINGS: 1668 women completed the survey. One quarter screened positive for depression, 19% for moderate or higher range anxiety, and 15.5% for stress. The most significant contribution to higher anxiety, stress, and depression scores was a pre-existing mental health condition, followed by financial strain and a current complex pregnancy. Protective factors included age, social support, and parity. DISCUSSION: Maternity care strategies to reduce COVID-19 transmission restricted women's access to their customary pregnancy supports and increased their psychological morbidity. CONCLUSION: Factors associated with anxiety, stress and depression scores during the COVID-19 pandemic were identified. Maternity care during the pandemic compromised pregnant women's support systems.

ASSOCIATION OF CONTINUITY OF CARER AND WOMEN'S EXPERIENCES OF MATERNITY CARE DURING THE COVID-19 PANDEMIC: A CROSSSECTIONAL SURVEY

Background: Recent research highlights the impact of the COVID-19 pandemic on maternity services, although none to date have asked women how they feel about the changes to care or analysed the association between continuity of carer and women's experiences. Aim: The aim of our research was to discover pregnant women's self-reported changes to their planned care and associations between continuity of carer and how women felt about changes to their planned care. Methods: A cross-sectional online survey of pregnant women aged over 18 years in their final trimester of pregnancy in Australia was undertaken. Results: 1668 women completed the survey. Most women reported at least one change to pregnancy care and birthing plans. Women receiving full continuity of carer (from an obstetrician or midwife) were more likely to rate the changes to care as positive (p < 0.001) when compared with women who received partial or no continuity. Conclusions: Pregnant women experienced many changes to their planned pregnancy and birth care during the COVID-19 pandemic. Women who perceived they were experiencing full continuity of carer had fewer changes to care and were more likely to feel positive about the changes than women who did not report they received full continuity of carer. Our study demonstrates that women are better together through continuity of carer models.

Implementing a National Approach to Research Ethics Review during a Pandemic - the Irish Experience

The surge of coronavirus disease 2019 (COVID-19) research studies involving human participants in response to the pandemic has meant that research ethics committees across the world have been challenged to adapt their processes to meet demand while retaining high standards of review. Ethics review during this pandemic remains essential to ensure the safety, dignity and well-being of research participants, however research ethics committees are now faced with new, and often complex, ethics considerations and logistical challenges. This Open Letter looks specifically at the Irish experience of establishing a national approach to research ethics review amidst a global pandemic. This represents Ireland's first National Research Ethics Committee, which provided the research community with an expedited and 'single national opinion' for ethics review for COVID-related research. The insights gleaned and lessons learned from the Irish experience may inform emergency responses to future pandemics or public health emergencies.