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1.
J Clin Psychiatry ; 82(4)2021 07 06.
Article in English | MEDLINE | ID: covidwho-1518675

ABSTRACT

Objective: The conditions created by the COVID-19 pandemic could negatively affect maternal mental health and the mother-infant relationship. The aim of this study is to determine the impact of the COVID-19 pandemic on depression, anxiety, and mother-infant bonding among women seeking treatment for postpartum depression (PPD).Methods: Baseline data collected in two separate randomized controlled trials of a psychoeducational intervention for PPD in the same geographic region, one prior to COVID-19 (March 2019-March 2020) and one during the COVID-19 pandemic (April-October 2020), were compared. Eligible participants had an Edinburgh Postnatal Depression Scale (EPDS) score of ≥ 10, were ≥ 18 years of age, had an infant < 12 months old, and were fluent in English. Outcomes included PPD (EPDS), anxiety (Generalized Anxiety Disorder-7 [GAD-7]), and mother-infant relationship (Postpartum Bonding Questionnaire [PBQ]). All were measured continuously and dichotomized at accepted clinical cutoffs.Results: Of the 603 participants (305 pre-COVID-19; 298 during COVID-19), mothers enrolled during the COVID-19 pandemic reported higher levels of symptoms of PPD (B = 1.35; 95% CI, 0.64 to 2.06; Cohen d = 0.31) and anxiety (B = 1.52; 95% CI, 0.72 to 2.32; Cohen d = 0.30). During COVID-19, women had 65% higher odds of clinically significant levels of depression symptoms (OR = 1.65; 95% CI, 1.13 to 2.31) and 46% higher odds of clinically relevant anxiety symptoms (OR = 1.46; 95% CI, 1.05 to 2.05). However, there were no statistically significant differences in mother-infant bonding.Conclusions: The findings of this study suggest that rates and severity of PPD and anxiety symptoms among women seeking treatment for PPD have worsened in Canada during the COVID-19 pandemic. However, treatment-seeking mothers have consistently maintained good relationships with their infants. Considering the difficulties women with PPD face when accessing treatment, it is important that strategies are developed and disseminated to safely identify and manage PPD to mitigate potential long-term adverse consequences for mothers and their families.Trial Registration: ClinicalTrials.gov identifiers: NCT03654261 and NCT04485000.


Subject(s)
Anxiety/etiology , COVID-19/psychology , Depression, Postpartum/etiology , Mother-Child Relations/psychology , Mothers/psychology , Object Attachment , Pandemics , Adolescent , Adult , Anxiety/diagnosis , Anxiety/epidemiology , Anxiety/psychology , COVID-19/epidemiology , Depression, Postpartum/epidemiology , Depression, Postpartum/psychology , Female , Humans , Infant , Infant, Newborn , Ontario/epidemiology , Risk Factors , Self Report , Severity of Illness Index , Young Adult
2.
Neonatal Netw ; 40(3): 161-174, 2021 May 01.
Article in English | MEDLINE | ID: covidwho-1259288

ABSTRACT

Early recommendations to separate mothers from their newborns during the coronavirus disease 2019 (COVID-19) pandemic have created a detrimental separation practice. This article presents a review of the latest information regarding the (1) 3 modes of transmission of the virus to the neonate; (2) incidence, clinical signs, and severity of COVID-19 in the neonate; (3) factors to be considered to balance risk and benefits of separation and skin-to-skin contact (SSC) when conducting shared decision making; and (4) compendium of published SSC guidelines; and concludes with recommendations for safe practice of SSC to prevent and/or restrict COVID-19 infection in neonates.


Subject(s)
COVID-19/psychology , Kangaroo-Mother Care Method/psychology , Kangaroo-Mother Care Method/standards , Mother-Child Relations/psychology , Mothers/psychology , Neonatal Nursing/standards , Practice Guidelines as Topic , Adult , Female , Humans , Infant, Newborn , Male , Pandemics , Pregnancy , SARS-CoV-2
3.
Neonatal Netw ; 40(3): 183-186, 2021 May 01.
Article in English | MEDLINE | ID: covidwho-1259285

ABSTRACT

COVID-19's first wave created chaos for new NICU families as they struggled to cope with the challenge of a fragile infant along with a pandemic. Safety was paramount due to a lack of understanding around how the virus transmits, but much has been learned since then. The next wave of the virus needs to have a rethink around family separation. World leader organization European Foundation for the Care of Newborn Infants (EFCNI) provides insight into the challenges with the first wave and suggests ideas around rethinking how families interact with their baby in the subsequent waves.


Subject(s)
COVID-19/psychology , Intensive Care Units, Neonatal/standards , Intensive Care, Neonatal/psychology , Intensive Care, Neonatal/standards , Mother-Child Relations/psychology , Practice Guidelines as Topic , Adult , Family Separation , Female , Humans , Infant, Newborn , Infant, Premature , Male , SARS-CoV-2
5.
J Clin Psychol ; 77(9): 1997-2010, 2021 09.
Article in English | MEDLINE | ID: covidwho-1168880

ABSTRACT

BACKGROUND: Millions of people worldwide have been diagnosed with coronavirus disease 2019 (COVID-19), which has impacted maternal mental health and mother-infant relationships during the postpartum period. OBJECTIVES: To explore how mothers' anxious and depressive symptoms, parenting stress, mindful parenting, and mother-infant bonding vary as a function of the moment of the baby's birth (pre-COVID-19 or post-COVID-19) and to examine the contribution of those variables to mother-infant bonding. METHODS: The sample was recruited online and comprises 567 mothers (18-46 years) with an infant aged between 0 and 12 months old. RESULTS: Approximately 27.5% of the mothers presented clinically significant levels of anxious and depressive symptoms. Mothers who gave birth during the COVID-19 pandemic presented lower levels of Emotional Awareness of the Child and a more impaired mother-infant bonding than mothers who gave birth before the pandemic started. Approximately 49% of the mother-infant bonding variance was explained by parenting stress and by several dimensions of mindful parenting. CONCLUSION: Our findings provide important insights into the impact of COVID-19 on maternal mental health and parenting.


Subject(s)
COVID-19 , Mental Health/statistics & numerical data , Mindfulness , Mother-Child Relations/psychology , Mothers/psychology , Pandemics , Parenting/psychology , Postpartum Period/psychology , COVID-19/epidemiology , Female , Humans , Infant , Infant, Newborn , Male , Portugal/epidemiology
8.
Matern Child Nutr ; 16(4): e13033, 2020 10.
Article in English | MEDLINE | ID: covidwho-378015

ABSTRACT

The World Health Organization (WHO) has provided detailed guidance on the care of infants of women who are persons under investigation (PUI) or confirmed to have COVID-19. The guidance supports immediate post-partum mother-infant contact and breastfeeding with appropriate respiratory precautions. Although many countries have followed WHO guidance, others have implemented infection prevention and control (IPC) policies that impose varying levels of post-partum separation and discourage or prohibit breastfeeding or provision of expressed breast milk. These policies aim to protect infants from the potential harm of infection from their mothers, yet they may fail to fully account for the impact of separation. Global COVID-19 data are suggestive of potentially lower susceptibility and a typically milder course of disease among children, although the potential for severe disease in infancy remains. Separation causes cumulative harms, including disrupting breastfeeding and limiting its protection against infectious disease, which has disproportionate impacts on vulnerable infants. Separation also presumes the replaceability of breastfeeding-a risk that is magnified in emergencies. Moreover, separation does not ensure lower viral exposure during hospitalizations and post-discharge, and contributes to the burden on overwhelmed health systems. Finally, separation magnifies maternal health consequences of insufficient breastfeeding and compounds trauma in communities who have experienced long-standing inequities and violence, including family separation. Taken together, separating PUI/confirmed SARS-CoV-2-positive mothers and their infants may lead to excess preventable illnesses and deaths among infants and women around the world. Health services must consider the short-andlong-term impacts of separating mothers and infants in their policies.


Subject(s)
Breast Feeding , COVID-19/prevention & control , COVID-19/transmission , Infectious Disease Transmission, Vertical/prevention & control , Patient Isolation , SARS-CoV-2 , Breast Feeding/adverse effects , Breast Feeding/psychology , Female , Humans , Infant , Infant, Newborn , Milk, Human , Mother-Child Relations/psychology , Mothers , Patient Isolation/psychology , World Health Organization
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