The effectiveness of an internet-based support program on maternal self-efficacy, postpartum depression and social support for primiparous women during the COVID-19 pandemic: Randomized controlled trial.

Background: Many primiparous women usually encounter various parenting and mental health issues after childbirth. The effects of intervention based on internet platform on parenting and mental health outcomes for Chinese first-time mothers remain unknown during the COVID-19 pandemic. Therefore, our research aimed to evaluate the effectiveness of an internet-based support program (ISP) on maternal self-efficacy (MSE), postpartum depression (PPD) and social support for primiparous women amid the pandemic. Methods: A multicenter randomized controlled trial (RCT) was conducted. From May 2020 to March 2021, 242 primiparous women were recruited in the maternity wards of two hospitals in Shenzhen City, China and randomly assigned to the intervention group and the control group. Women in control group (n = 118) received the routine postpartum care, and women in intervention group (n = 118) accessed to the ISP intervention (expert education and peer support) and routine postpartum care. Intervention outcomes were measured at baseline before randomization (T0), post-intervention (T1), and three-month follow up (T2) through questionnaires. The chi-square (χ2), the independent sample t-test and the repeated measures multivariate analysis of covariance were performed, and the two-tailed p-value <0.05 was regarded as statistically significant. Results: In comparison with women in the control group, women in the intervention group had a significantly higher score of MSE at T1 (mean: 73.53, standard deviation [SD]: 6.21) and at T2 (mean: 72.90, SD: 6.73); and a lower score of PPD at T1(mean: 6.03, SD: 2.50) and T2 (mean: 5.70, SD: 2.23); and a higher score of social support at T1 (mean: 45.70, SD: 3.73), but no significant difference at T2 (mean: 42.90, SD: 3.29). Conclusions: The effect of ISP was evaluated to significantly increase the levels of MSE, social support, and to alleviate PPD symptoms for Chinese first-time mothers. As an effective and easily accessible intervention, ISP could become a significant source for health professionals to support primiparous women on parenting and mental health during the COVID-19 pandemic. Trial registration: The trial is registered at the Chinese Clinical Trials Registry (ChiCTR2000033154).

The cross-sectional survey on COVID-19 vaccine hesitancy and it predictors among Chinese parents of 3-17 years aged children in Shenzhen City.

INTRODUCTION AND OBJECTIVE: Vaccinations programs on 3-17 years aged children in China have been launched in some cities since July 2021; and comparative evaluations are important to push the programs forward. Therefore, this study is conducted to explore the COVID-19 vaccine hesitancy and it predictors among Chinese parents of 3-17 years aged children; and their willingness to vaccinate their child/children. MATERIAL AND METHODS: A cross-sectional study was conducted based on the online survey; and 3484 participants were recruited in health centers of Shenzhen, China. RESULTS: The prevalence of COVID-19 vaccine hesitancy was 20.7% among Chinese parents of 3-17 years aged children; and 2976 participants (89.0%) were reported to be willing or very willing to accept a COVID-19 vaccine for their child/children. Perceived trust degree of a COVID-19 vaccine (OR: 0.766), and perceived effectiveness of a COVID-19 vaccine (OR: 0.455) were negatively associated with vaccine hesitancy. Perceived risk degree of a COVID-19 vaccine (OR: 1.485) positively predicted vaccine hesitancy. Parents with a higher educational level (OR: 0.518) and working in public institution (OR: 0.741) had a lower level of vaccine hesitancy; whereas, parents with liberal professionals had a higher level of vaccine hesitancy (OR: 1.378). CONCLUSIONS: These findings indicated that Chinese parents of 3-17 years aged children in Shenzhen City had a higher level of COVID-19 vaccine acceptability, compared with adults in Western counties. The significant factors of perceived trust degree, effectiveness, and risk degree of a COVID-19 vaccine, parents' educational level and occupation could predict COVID-19 vaccine hesitancy. The research results can be useful in supporting the development of effective and targeted children COVID-19 vaccination campaigns in China and worldwide.

Prevalence and Risk Factors Associated with Postpartum Depression during the COVID-19 Pandemic: A Literature Review and Meta-Analysis.

BACKGROUND: Owing to the high prevalence and detrimental consequences, postpartum depression (PPD) has been identified as one of the severe global public health issues in the last decade. Prior research found that during disasters or events, the prevalence rates of mental disorders among postpartum women are significantly high. However, the effect of the coronavirus disease 2019 (COVID-19) pandemic on PPD and its risk factors remained unclear for postpartum women. Therefore, the present systematic review and meta-analysis aimed to estimate the influence of the COVID-19 pandemic on the prevalence of PPD and to summarize risk factors for PPD during the COVID-19 pandemic. METHODS: Three electronic databases of MEDLINE, EMBASE, and Cochrane library databases were systematically searched for articles from their commencements until 1 November 2021. Quality assessment of included studies, random-effects meta-analysis, and sensitivity analysis were performed. RESULTS: A total of eight studies with 6480 postpartum women during the COVID-19 pandemic were included, and most studies were conducted in developed countries. The pooled prevalence of PPD was 34% (95% CI: 21-46%) during the COVID-19 pandemic, much higher than the incident of previous research during the non-pandemic period. Risk factors for PPD during the COVID-19 pandemic were defined as socio-demographic and clinical characteristics, stress and anxiety, lack of various supports, and the COVID-19 related factors. CONCLUSION: The research findings indicated that the COVID-19 pandemic could make detrimental effects on maternal mental wellbeing among women after childbirth. Investigating the prevalence and risk factors of PPD among postpartum women could shed some light on their mental and emotional states; so that support measures and tailored interventions from health professionals and policymakers could be offered to improve the maternal and infant outcomes, especially during the COVID-19 pandemic. Much more research on maternal psychological wellbeing during the COVID-19 pandemic was strongly recommended to undertake in the middle and low-income countries.