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.

Clinical characteristics of pregnant women infected with Coronavirus Disease 2019 in China: a nationwide case-control study (preprint)

OBJECTIVETo formally compare the clinical course of Coronavirus disease 2019 (COVID-19) in pregnant women with their nonpregnant counterparts. METHODSClinical data of pregnant women with confirmed COVID-19 in the designated hospitals of mainland China were retrieved up to April 12, 2020 through an epidemic reporting system maintained at the National Health Commission of the Peoples Republic China. Each pregnant patient was randomly matched to a nonpregnant woman with confirmed COVID-19 in the same hospital as control, then their clinical courses were formally compared. RESULTS138 pregnant women had been identified as confirmed COVID-19 cases. Among them, 17 severe cases and 1 maternal death were recorded, which was less than their nonpregnant peers (23 severe cases and 3 death). 57.2% had been infected with SARS-CoV-2 during the third trimester, including 13 severe cases and 1 maternal death. 7.3% of pregnant patients had diarrhea and 3.6% had nausea or vomiting, compared with related proportion as 15.2% (OR: 0.38, 95%CI: 0.15, 0.96) and 10.1% (OR: 0.25, 95%CI: 0.07, 0.89) in nonpregnant patients. Pregnant patients infected with SARS-CoV-2 in early pregnancy presented similar laboratory tests with their nonpregnant peers, however, with pregnancy progresses, increased inflammation, coagulation and hepatic injury markers happened more and more frequently (p<0.001) in pregnant patients. CONCLUSIONSBeing pregnant did not represent a risk for severe condition when compared with their nonpregnant peers. Patients infected with SARS-CoV-2 in early pregnancy were even at lower risk of severe illness than those infected in late pregnancy. What are the novel findings of this work?Compared with non-pregnant COVID-19 patients, pregnant patients tend to present less symptom, had unique laboratory findings, and tend to at lower risk of COVID-19-related death. Patients infected with SARS-CoV-2 in the early pregnancy tend to be in the less severe condition of illness than those infected in late pregnancy. What are the clinical implications of this work?Vital comparisons of the clinical course upon COVID-19 between pregnant and nonpregnant women in childbearing age are, unfortunately, lacking. Through formally comparisons between the two groups, the present study provides more reliable evidence towards the management of pregnant women with COVID-19.