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1.
BMC Pregnancy Childbirth ; 22(1): 833, 2022 Nov 11.
Article in English | MEDLINE | ID: covidwho-2121880

ABSTRACT

BACKGROUND: The coronavirus disease 2019 infection (COVID-19) pandemic is a new global outbreak disease. According to the Taiwan Centers for Diseases Control statement, hospitals had to change their corresponding measures to prevent the spread of COVID-19. The frequency of parental visits to the special care nursery was reduced from three times to once daily. Visiting was not permitted from April 4 to May 10, 2020, and rooming-in with healthy neonates was discontinued, which could increase maternal postpartum distress. Therefore, this study was conducted to determine whether COVID-19 prevention increased maternal psychological distress. METHODS: This prospective study used convenience sampling to enroll healthy mothers who had just delivered via normal spontaneous delivery. Based on the neonates' status and visiting times, mothers were grouped into no-rooming-in, rooming-in, no-visiting, and one-visit/day groups. Mothers' baseline characteristics were compared using the Chi-square or Fisher's exact test and t-test. Salivary cortisol levels and scores of Chinese versions of the Perceived Stress Scale (PSS) and State-Trait Anxiety Inventory were evaluated on postpartum days 1 and 3 and analyzed by one-way analysis of variance and a paired t-test. RESULTS: There were 16, 58, 28, and 47 women categorized as no-rooming-in, rooming-in, no-visit, and one-visit/day groups, respectively. No significant differences were found between groups in mothers' baseline characteristics and postpartum salivary cortisol levels. The PSS on day 3 was significantly higher than on day 1 in every group (p < 0.001). The PSS increasing trend in the no-rooming-in group was significantly greater than that in the no-visit group (p = 0.02) and significantly greater in the rooming-in group than that in the one-visit/day group (p = 0.001). CONCLUSION: Postpartum stress increased for all mothers and was an even more significant response to the COVID-19 pandemic than the stress associated with neonates' hospitalization.


Subject(s)
COVID-19 , Psychological Distress , Infant, Newborn , Female , Humans , Pandemics , COVID-19/epidemiology , Pilot Projects , Hydrocortisone/analysis , Prospective Studies , Postpartum Period/psychology , Mothers/psychology
2.
J Obstet Gynaecol Can ; 44(10): 1067-1075, 2022 10.
Article in English | MEDLINE | ID: covidwho-2076430

ABSTRACT

OBJECTIVES: To determine the psychological and behavioural effects of the COVID-19 pandemic on a Canadian cohort of individuals during pregnancy and the postpartum period. METHODS: In 2020, individuals between 20 weeks gestation and 3 months postpartum receiving maternity care from an urban Canadian clinic were invited to complete a questionnaire. The purpose-built questionnaire used validated scales including the Medical Outcomes Study Social Support Survey (MOS), Depression, Anxiety, and Stress Scale (DASS-21), Edinburgh Postnatal Depression Scale (EPDS), and questions from a SARS study. RESULTS: One hundred nine people completed the questionnaire (response rate, 55%) of whom 57% (n = 62) were postpartum. Most respondents (107, 98%) were married and had completed post-secondary education (104, 95%). Despite these protective factors, moderate to severe levels of depression (22%), anxiety (19%) and stress (27%), were recorded using the DASS-21, and 25% of participants (26) had depression (score ≥11) using the EPDS. Despite high social support in all MOS domains (median scores 84-100), a majority of participants reported loneliness (69, 67%) and were nearly or totally housebound (65, 64%). About half of participants worried about themselves (50, 46.3%) or their baby (59, 54%) contracting COVID-19, while the majority postponed (80, 74.1%) and cancelled (79, 73.2%) prenatal appointments. Being homebound or feeling lonely / lacking support were significant risk factors for psychological distress (P = 0.02) whereas exercise and strong social support were protective (P < 0.05). CONCLUSION: Pregnant and postpartum individuals experienced moderate to severe depression, anxiety, and stress during the COVID-19 pandemic. Exercise and strong social support were protective. Health care provider enquiry of home circumstances and activity may identify individuals needing enhanced supports.


Subject(s)
COVID-19 , Depression, Postpartum , Maternal Health Services , Psychological Distress , Anxiety/epidemiology , Anxiety/psychology , COVID-19/epidemiology , Canada/epidemiology , Depression/epidemiology , Depression, Postpartum/epidemiology , Depression, Postpartum/psychology , Female , Humans , Pandemics , Postpartum Period/psychology , Pregnancy , Stress, Psychological/epidemiology , Stress, Psychological/psychology
3.
J Affect Disord ; 302: 15-24, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1717750

ABSTRACT

BACKGROUND: Postpartum depression(PPD) and anxiety(PPA) have become the one of major public health threats. However, the research evidence on PPD and PPA in Xinjiang is insufficient. This research reports the incidence of PPD and PPA in the past 4 years, and analyzes the impact of sociodemographic and obstetric factors on postpartum mental health. METHODS: The selected research objects are parturients who have undergone postpartum health check-ups in a tertiary hospital in Urumqi from January 2018 to September 2021. The study obtained the socio-demographic and obstetric information of the puerpera through general survey questionnaires, and used the PHQ-9 and GAD-7 scales to screen for PPD and PPA. Furthermore, after univariate analysis of related influencing factors of PPD and PPA, multiple binary logistic regression analysis was used to further explore the relationship between PPD and PPA and various influencing factors. RESULTS: A total of 7,703 parturients were included in this study. The incidence of PPD (PHQ-9 ≥ 10) was 9.7% in 2018, 11.1% in 2019, 13.3% in 2020, and 14.2% in 2021 (χ2 = 18.386, P < 0001). The incidence of PPA(GAD-7 ≥ 10) was 8.1% in 2018,8.6% in 2019, 11.4% in 2020, and 9.8% in 2021 (χ2 = 16.895, P = 0.001). The six factors that were statistically different after univariate analysis were included in the multivariate binary logistic regression analysis. The final results suggested that women who delivery in 2020 were 1.405 times (95%CI:1.145-1.723) more likely to suffer from depression than those who delivery in 2018 and 1.688 times (95%CI:1.237-2.303) than that in 2021. Compared with puerpera with formal jobs, the incidence of PPD among puerpera who were self-employed (AOR = 1.372,95%CI:1.085-1.735) or unemployed(AOR = 1.348,95%CI:1.137-1.599) was on the rise. Moreover, studies have shown that mixed feeding (AOR = 1.515,95%CI: 1.296-1.772) or artificial feeding (AOR = 1.736,95%CI: 1.299-2.321) 6 weeks postpartum was associated with a higher risk of depression, and puerpera who delivered female infants (AOR = 0.780, 95%CI: 0.626-0.971) were less likely to report depressive symptoms. Simultaneously, for PPA, women who delivered in 2020 were 1.418 times (95%CI: 1.065-1.887) more likely to suffer from anxiety than those who delivered in 2018. Women aged 18-29 years (AOR = 2.070,95%CI:1.229-3.487) were more likely to report PPA than those over the age of 29. Similarly, women who selected cesarean section delivery (AOR = 1.332,95%CI:1.087-1.632) were more likely to have PPA. Mixed feeding (AOR = 1.436,95%CI: (1.193-1.729) ) or artificial feeding (AOR = 1.742,95%CI: 1.243-2.441) at 6 weeks postpartum was associated with a higher risk of anxiety. While puerpera who delivered female infants (AOR = 0.746,95%CI: 0.567-0.982) were less likely to report anxiety symptoms. CONCLUSION: This study shows that in Xinjiang, the incidence of postpartum depression and anxiety was on the rise from 2018 to 2020, and although there was a slight decline in 2021, it was still higher than in 2019. Simultaneously, the proportion of overweight or obese, cesarean section, and non-breastfeeding women had increased year by year. Factors such as maternal age, occupation, mode of delivery, feeding pattern and neonatal gender may help to identify high-risk patients. Therefore, primary, secondary, and tertiary prevention should be given priority to reduce the incidence of postpartum depression and anxiety in high-risk groups.


Subject(s)
Depression, Postpartum , Adolescent , Adult , Anxiety/psychology , Cesarean Section/psychology , Cross-Sectional Studies , Depression, Postpartum/psychology , Female , Humans , Incidence , Infant, Newborn , Postpartum Period/psychology , Pregnancy , Risk Factors , Young Adult
4.
J Midwifery Womens Health ; 67(5): 626-634, 2022 09.
Article in English | MEDLINE | ID: covidwho-2038070

ABSTRACT

INTRODUCTION: Coronavirus disease 2019 (COVID-19) pandemic-related stressors (eg, exposure, infection worry, self-quarantining) can result in heightened levels of distress and symptoms of postpartum posttraumatic stress disorder (PTSD). METHODS: Using a cross-sectional descriptive design, we collected survey data from a convenience sample of 670 postpartum persons who gave birth to a newborn during the first 6 months of the COVID-19 pandemic in the United States. The presence of PTSD symptoms was measured using the 21-item Birth Memories And Recall Questionnaire (BirthMARQ) and defined as an affirmative rating for each item (score of 5 to 7 on a 1 to 7 agreement scale). Symptoms counts were computed for each of the 6 BirthMARQ domains, 2 symptom clusters (intrusive; mood and cognition alterations), and the total number of symptoms. Symptom counts were analyzed using descriptive statistics. We explored associations among COVID-19 experiences (self-quarantine behaviors, infection worry, exposure) and counts of PTSD symptoms using negative binomial regression models while controlling for postpartum depression screening scores, neonatal intensive care unit admissions, number of weeks postpartum, race, and marital status. RESULTS: Almost 99% of participants reported experiencing at least one of 21 PTSD symptoms (mean, 8.32; SD, 3.63). Exposure to COVID-19 was associated with a 34% greater risk for experiencing intrusive symptoms, specifically, symptoms of reliving the birthing experience as if it were happening now (47% greater risk). Worry surrounding COVID-19 infection was associated with a 26% increased risk for experiencing intrusive recall symptoms in which birth memories came up unexpectantly. COVID-19 quarantining behaviors were not significantly related to increasing PTSD symptoms. Many of the demographic variables included were associated with increasing PTSD symptoms. DISCUSSION: Screening perinatal persons for PTSD is critically important, especially during public health crises like the COVID-19 pandemic. The integration of comprehensive mental health screening, including specific screening for trauma and symptoms of PTSD, across health care settings can help improve delivery of quality, patient-centered care to postpartum persons.


Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Infant, Newborn , Pandemics , Postpartum Period/psychology , Pregnancy , Stress Disorders, Post-Traumatic/psychology , United States/epidemiology
5.
J Affect Disord ; 319: 99-111, 2022 Dec 15.
Article in English | MEDLINE | ID: covidwho-2007795

ABSTRACT

BACKGROUND: This systematic review and meta-analysis pooled the prevalence of psychological symptoms during the COVID-19 pandemic and examined the effects of the pandemic on psychological health in postpartum women. METHODS: A systematic literature search and identification were performed in PubMed, EMBASE, Web of Science, and PsycINFO databases until June 16th, 2021. The fixed or random effect models to estimate the pooled prevalence of postpartum psychological symptoms during the COVID-19 pandemic and the odds ratio (OR) of COVID-19 for psychological symptoms. RESULTS: A total of 29 articles including 20,225 postpartum women during the COVID-19 pandemic and 8312 before the COVID-19 pandemic were identified. During the COVID-19 pandemic, the prevalence of postpartum depressive, anxiety, stress, and post-traumatic stress disorder symptoms were 26.7 % (95 % CI: 22.0-31.9 %), 33.8 % (95 % CI: 21.1-49.4 %), 55.0 % (95%CI: 27.9-79.5 %), and 33.7 % (95%CI: 19.6-51.5 %), respectively. The ORs of COVID-19 pandemic for postpartum depressive and anxiety symptoms were 1.54 (95 % CI: 1.00-2.36) and 2.56 (95%CI: 1.62-4.04). Subgroup analyses revealed that women with >6 weeks after delivery, younger than 35 years old, low income, less education and without breastfeeding experienced a higher risk of depressive or anxiety symptoms after delivery. LIMITATIONS: Only a few of prospective studies were included, and significant but inevitable heterogeneities were found in some analyses. CONCLUSION: A significantly higher proportion of postpartum women were suffered from psychological symptoms during COVID-19 pandemic, particularly in those with >6 weeks after delivery, younger than 35 years old, low income, less education and formula feeding.


Subject(s)
COVID-19 , Female , Humans , Adult , COVID-19/epidemiology , Pandemics , Prospective Studies , Postpartum Period/psychology , Anxiety/epidemiology , Prevalence , Health Status , Depression/epidemiology
6.
PLoS One ; 17(8): e0273176, 2022.
Article in English | MEDLINE | ID: covidwho-1993516

ABSTRACT

INTRODUCTION: Vulnerability for depression, anxiety and posttraumatic stress disorder symptoms due to perceived traumatic birth increase during the postpartum period. Traumatic birth has been defined as an event occurring during labour and birth that may be a serious threat to the life and safety of the mother and/or child. However, the comorbidity and multimorbidity of depression, anxiety and PTSD with their direct and indirect predictors is not well investigated in the postpartum period. In addition, the longitudinal directional association of depression, anxiety and PTSD with their comorbidities is not studied in Ethiopia. OBJECTIVE: The aim of this study was to assess prevalence of postnatal comorbid and multimorbid anxiety, depression and PTSD. It also aimed to determine the directional association of postnatal anxiety, depression and PTSD with the comorbidity and multimorbidity of these mental health problems over time and to explore the factors that are directly or indirectly associated with comorbidity and multimorbidity of anxiety, depression and PTSD. METHODS: A total of 775 women were included at the first, second and third follow-up of the study (6th, 12th and 18th week of postpartum period) during October, 2020 -March, 2021. A cross-lagged autoregressive path analysis was carried out using Stata 16.0 software in order to determine the autoregressive and cross-lagged effects of depression, anxiety and PTSD with their comorbidities. In addition, a linear structural equation modelling was also carried out to determine the direct and indirect effects of independent variables on the comorbidities of depression, anxiety and PTSD. RESULTS: Comorbidity of anxiety with depression was the most common (14.5%, 12.1% and 8.1%) at the 6th, 12th and 18th week of postnatal period respectively. With regard to the direction of association, comorbidity of PTSD (due to perceived traumatic birth) with depression, PTSD with anxiety, depression with anxiety and triple comorbidity predicted depression and anxiety in subsequent waves of measurement. Direct and indirect maternal morbidity, fear of childbirth and perceived traumatic childbirth were found to have a direct and indirect positive association with comorbidities of depression, anxiety and PTSD. In contrast, higher parity, higher family size and higher social support had a direct and indirect negative association with these mental health disorders. CONCLUSION: Postnatal mental health screening, early diagnosis and treatment of maternal morbidities, developing encouraging strategies for social support and providing adequate information about birth procedures and response to mothers' needs during childbirth are essential to avert comorbidity of anxiety, depression and PTSD in the postpartum period.


Subject(s)
Anxiety/epidemiology , Depression, Postpartum/epidemiology , Stress Disorders, Post-Traumatic/epidemiology , Anxiety/etiology , Anxiety/psychology , Comorbidity , Depression, Postpartum/etiology , Depression, Postpartum/psychology , Ethiopia/epidemiology , Female , Humans , Infant, Newborn , Longitudinal Studies , Parturition/psychology , Postpartum Period/psychology , Pregnancy , Prevalence , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/psychology
7.
J Affect Disord ; 316: 245-253, 2022 11 01.
Article in English | MEDLINE | ID: covidwho-1983300

ABSTRACT

BACKGROUND: The COVID-19 pandemic was a significant threat to perinatal mental health. This study examined differences in clinically significant depression, anxiety, and co-morbid symptoms among pregnant and postpartum women across several countries and compared prevalence of perinatal depression and anxiety before and during the pandemic in each participating country. METHODS: Participants were 3326 pregnant and 3939 postpartum women (up to six months postpartum) living in Brazil, Chile, Cyprus, Greece, Israel, Portugal, Spain, Turkey, and the United Kingdom. An online survey was completed between June 7th and October 31st 2020, and included the Edinburgh Postnatal Depression Scale (EPDS) and the Generalized Anxiety Disorder Screener (GAD-7). The pre-pandemic studies were identified through literature review. RESULTS: Prevalence of clinically significant depression (EPDS≥13), anxiety (GAD-7 ≥ 10), and co-morbid (EPDS≥13 and GAD-7 ≥ 10) symptoms was 26.7 %, 20 % and 15.2 %, in pregnant women, and 32.7 %, 26.6 % and 20.3 %, in postpartum women, respectively. Significant between-country differences were found in all mental health indicators in both perinatal periods. Higher levels of symptoms were observed during (versus before) the pandemic, especially among postpartum women. LIMITATIONS: Participants were mostly highly educated and cohabiting with a partner. The online nature of the survey may have limited the participation of women from vulnerable socio-economically backgrounds. CONCLUSIONS: Our findings expand previous literature on the negative impact of the COVID-19 pandemic on perinatal mental health, by highlighting that this may be influenced by country of residence. Mental health care policies and interventions should consider the unique needs of perinatal women in different parts of the world.


Subject(s)
COVID-19 , Depression, Postpartum , Anxiety/epidemiology , COVID-19/epidemiology , Depression/epidemiology , Depression, Postpartum/psychology , Female , Humans , Pandemics , Parturition , Postpartum Period/psychology , Pregnancy , Pregnant Women/psychology
8.
BMC Pregnancy Childbirth ; 22(1): 537, 2022 Jul 04.
Article in English | MEDLINE | ID: covidwho-1974121

ABSTRACT

BACKGROUND: The COVID-19 pandemic has posed profound challenges for pregnant patients and their families. Studies conducted early in the pandemic found that pregnant individuals reported increased mental health concerns in response to pandemic-related stress. Many obstetric practices changed their healthcare delivery models, further impacting the experiences of pregnant patients. We conducted a survey study to explore the ways in which COVID-19 impacted the lives of pregnant and newly postpartum people. METHODS: A mixed-methods survey was distributed to all patients ≥18 years old who were pregnant between January 1st, 2020 - April 28, 2021 in a large Midwest health system. Open-ended survey responses were analyzed for common themes using standard qualitative methodology. RESULTS: Among the 1182 survey respondents, 647 women provided an open-ended response. Of these, 77% were in the postpartum period. The majority of respondents identified as white, were partnered or married, and owned their own home. Respondents reported feeling greater uncertainty, social isolation, as though they had limited social and practical support, and negative mental health effects as a result of the pandemic. Many cited sudden or arbitrary changes to their medical care as a contributing factor. Though in the minority, some respondents also reported benefits from the changes to daily life, including perceived improvements to medical care, better work-life balance, and opportunities for new perspectives. CONCLUSIONS: This large qualitative dataset provides insight into how healthcare policy and lifestyle changes impacted pregnant and postpartum people. Respondents expressed similar levels of uncertainty and mental health concerns compared to other cohorts but less overall positivity. Our findings suggest greater attention be given to the impact of pandemic-related stress on pregnant and postpartum women. As the pandemic continues, these data identify areas where investment in additional support may have the greatest impact.


Subject(s)
COVID-19 , Adolescent , COVID-19/epidemiology , Female , Humans , Menopause , Mental Health , Pandemics , Postpartum Period/psychology , Pregnancy
9.
BMC Pregnancy Childbirth ; 22(1): 114, 2022 Feb 11.
Article in English | MEDLINE | ID: covidwho-1962771

ABSTRACT

BACKGROUND: Peripartum depression in and after pregnancy are common, reported by 11.9% of women worldwide, and the proportion was even higher during the outbreak of coronavirus disease 2019 (COVID-19). We aimed to investigate the prevalence and risk factors of peripartum depression under the influence of COVID-19 in China. METHODS: Using a cross-sectional design, 2026 pregnant and postpartum women residing in Beijing, Wuhan, and Lanzhou of China were recruited from February 28 to April 9, 2020. The Patient Health Questionnaire-9 was used to assess their depressive symptoms. The women were divided into four subgroups based on pregnancy stage, and a binary logistic regression analysis was conducted on each subgroup. RESULTS: Under the influence of COVID-19, the prevalence rate of peripartum depression among Chinese women was 9.7%. It was 13.6, 10.8, 7.9 and 7.3% in the first, second, third trimester and puerperium, respectively. Regression analysis showed that the influence of current pregnancy status on movement (Mild vs. No, aORs were 3.89, P < 0.001, 2.92, P = 0.003, 1.58, P = 0.150 in the three trimesters, respectively; Severe vs. No, aORs were 13.00, 20.45, 5.38 in the three trimesters, respectively, all P < 0.05), and worries and fears about childbirth (aORs were 2.46, 2.96, 2.50 in the three trimesters, respectively, all P < 0.05) were associated with depression throughout pregnancy. CONCLUSIONS: The prevalence rate of peripartum depression during the COVID-19 outbreak in China was not higher than usual. The influence of current pregnancy status on movement, as well as worries and fears about childbirth were independent risk factors for peripartum depression throughout pregnancy during COVID-19. The stage of pregnancy should be considered when implementing interventions.


Subject(s)
COVID-19/psychology , Depression/epidemiology , Peripartum Period/psychology , China/epidemiology , Cross-Sectional Studies , Female , Humans , Patient Health Questionnaire , Postpartum Period/psychology , Pregnancy , Pregnancy Trimesters/psychology , Prevalence , Risk Factors , SARS-CoV-2
10.
BMC Pregnancy Childbirth ; 22(1): 92, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1962767

ABSTRACT

BACKGROUND: Pregnancy and early motherhood are sensitive times where epidemic disease outbreaks can affect mental health negatively. Countries and health care systems handled the pandemic and lockdowns differently and knowledge about how the COVID-19 pandemic affected the mental well-being of pregnant women and new mothers is limited and points in different directions. AIM: To investigate symptoms of anxiety and depression in a population of pregnant women and new mothers in various stages of infection pressure and lockdown during the first 15 months of the COVID-19 pandemic in Denmark. METHODS: The study population was nested an inception cohort of women recruited in their first trimester of pregnancy. Data about mental health of the woman were obtained in relation to pregnancy and child development (first trimester, 8 weeks postpartum and 5 months postpartum), and data were analysed cross-sectionally according to calendar time (periods defined by infection rate and lock-down during the COVID-19 pandemic). RESULTS: No differences in reported levels of depressive symptoms between the six examined time periods of the pandemic were observed. Specifically, symptoms remained unchanged after the first lock-down. No major changes in anxiety symptoms were observed in relation to increased infection pressure or lockdowns, but a small increase was observed during the second lockdown in women 8 weeks postpartum. CONCLUSION: No clear change in mood among pregnant women was seen between during the stages of COVID-19 pandemic in Denmark.


Subject(s)
Anxiety/epidemiology , COVID-19/psychology , Depression/epidemiology , Mothers/psychology , Postpartum Period/psychology , Pregnant Women/psychology , Quarantine/psychology , Adult , Cross-Sectional Studies , Denmark/epidemiology , Female , Humans , Mental Health , Pregnancy , SARS-CoV-2
11.
BMC Pregnancy Childbirth ; 22(1): 468, 2022 Jun 04.
Article in English | MEDLINE | ID: covidwho-1951117

ABSTRACT

BACKGROUND: There are very few developed countries where physical isolation and low community transmission has been reported for COVID-19 but this has been the experience of Australia. The impact of physical isolation combined with low disease transmission on the mental health of pregnant women is currently unknown and there have been no studies examining the psychological experience for partners of pregnant women during lockdown. The aim of the current study was to examine the impact of the first COVID-19 lockdown in March 2020 and post lockdown from August 2020 on the mental health of pregnant women or postpartum women and their partners. METHODS: Pregnant women and their partners were prospectively recruited to the study before 24 weeks gestation and completed various questionnaires related to mental health and general wellbeing at 24 weeks gestation and then again at 6 weeks postpartum. The Depression, Anxiety and Stress Scale (DASS-21) and the Edinburgh Postnatal Depression Scale (EPDS) were used as outcome measures for the assessment of mental health in women and DASS-21 was administered to their partners. This analysis encompasses 3 time points where families were recruited; before the pandemic (Aug 2018-Feb 2020), during lockdown (Mar-Aug 2020) and after the first lockdown was over (Sept-Dec 2020). RESULTS: There was no significant effect of COVID-19 lockdown and post lockdown on depression or postnatal depression in women when compared to a pre-COVID-19 subgroup. The odds of pregnant women or postpartum women experiencing severe anxiety was more than halved in women during lockdown relative to women in the pre-COVID-19 period (OR = 0.47; 95%CI: 0.27-0.81; P = 0.006). Following lockdown severe anxiety was comparable to the pre-COVID-19 women. Lockdown did not have any substantial effects on stress scores for pregnant and postpartum women. However, a substantial decrease of over 70% in the odds of severe stress was observed post-lockdown relative to pre-COVID-19 levels. Partner's depression, anxiety and stress did not change significantly with lockdown or post lockdown. CONCLUSION: A reproductive age population appear to be able to manage the impact of lockdown and the pandemic with some benefits related to reduced anxiety.


Subject(s)
COVID-19 , Anxiety/epidemiology , COVID-19/epidemiology , COVID-19/prevention & control , Communicable Disease Control , Depression/epidemiology , Female , Humans , Mental Health , Postpartum Period/psychology , Pregnancy , Pregnant Women/psychology , Prospective Studies , Queensland/epidemiology , SARS-CoV-2
12.
J Prim Care Community Health ; 13: 21501319221110421, 2022.
Article in English | MEDLINE | ID: covidwho-1933052

ABSTRACT

BACKGROUND: The fast spread of COVID-19 can cause some psychological disorders for men. One of the psychological disorders is paternal postpartum depression (PPD). The aim of the present research was to review studies that have investigated paternal postpartum depression during the COVID-19 pandemic. MATERIALS AND METHODS: For this narrative review, databases such as Google Scholar, Scientific Information Databases (SID), Magiran, PubMed, Web of Science, and Scopus were searched for the full texts of published studies in the Persian and English languages in the period of 2019 to 2021. Finally, 3 articles were selected and reviewed in this study. RESULTS: The results of this review study were classified into 3 main categories such as (1) The psychological status of men during the COVID-19 pandemic, (2) The effect of paternal PPD on children's development and family psychological status during the COVID-19 pandemic, and (3) The role of healthcare providers in the management of paternal PPD. The findings of the studies showed that paternal PPD increases the rate of child maltreatment, maternal depression, and domestic violence. The promotion of the interpersonal skills of healthcare providers with fathers suffering from depression or psychological problems is the determinant factor of successful results. CONCLUSIONS: The results showed that paternal PPD has a wide range of consequences in this pandemic. Therefore, it would be recommended that healthcare staff have close contact with families and screen fathers for paternal PPD during the COVID-19 pandemic.


Subject(s)
COVID-19 , Depression, Postpartum , COVID-19/epidemiology , Child , Depression/epidemiology , Depression, Postpartum/epidemiology , Depression, Postpartum/psychology , Fathers/psychology , Female , Health Personnel , Humans , Male , Pandemics , Postpartum Period/psychology , Risk Factors , Tuberculin
13.
BMC Pregnancy Childbirth ; 21(1): 625, 2021 Sep 17.
Article in English | MEDLINE | ID: covidwho-1923520

ABSTRACT

BACKGROUND: COVID-19 has placed additional stressors on mothers during an already vulnerable lifecourse transition. Initial social distancing restrictions (Timepoint 1; T1) and initial changes to those social distancing restrictions (Timepoint 2; T2) have disrupted postpartum access to practical and emotional support. This qualitative study explores the postpartum psychological experiences of UK women during different phases of the COVID-19 pandemic and associated 'lockdowns'. METHODS: Semi-structured interviews were conducted with 12 women, approximately 30 days after initial social distancing guidelines were imposed in the UK (22 April 2020). A separate 12 women were interviewed approximately 30 days after the initial easing of social distancing restrictions (10 June 2020). Data were transcribed verbatim, uploaded into NVivo for management and analysis, which followed a recurrent cross-sectional approach to thematic analysis. RESULTS: Two main themes were identified for T1: 'Motherhood is Much Like Lockdown' and 'A Self-Contained Family Unit'. Each main T1 theme contained two sub-themes. Two main themes were also identified for T2: 'Incongruously Held Views of COVID-19' and 'Mothering Amidst the Pandemic'. Each main T2 theme contained three sub-themes. Comparisons between data gathered at each timepoint identified increased emotional distress over time. Current findings call for the improvement of postpartum care by improving accessibility to social support, and prioritising the re-opening of schools, and face-to-face healthcare appointments and visitation. CONCLUSION: Social distancing restrictions associated with COVID-19 have had a cumulative, negative effect on postpartum mental health. Recommendations such as: Allowing mothers to 'bubble' with a primary support provider even at their healthcare appointments; allowing one support partner to attend all necessary healthcare appointments; and providing tailored informational resources, may help to support postpartum emotional wellbeing during this, and similar health crises in the future.


Subject(s)
Burnout, Psychological , COVID-19/psychology , Mothers/psychology , Psychological Distress , Social Support , Adult , Communicable Disease Control/methods , Cross-Sectional Studies , Female , Humans , Interviews as Topic , Mental Health Services , Postnatal Care/methods , Postpartum Period/psychology , Qualitative Research
14.
Int J Environ Res Public Health ; 19(13)2022 06 26.
Article in English | MEDLINE | ID: covidwho-1911370

ABSTRACT

BACKGROUND: Women in the postpartum period may be particularly vulnerable to the psychological effects of the COVID-19 pandemic. The aim of our study was to evaluate the impact of the coronavirus pandemic on postpartum depression and anxiety levels and the role of the fear of COVID-19 in its development. METHODS: Women who delivered at the Bissaya Barreto Maternity Hospital, between 16 March and 16 June 2020 (Group 1: Birth in COVID-19 period, n = 207), recruited in the postpartum period, filled in a set of self-reported validated questionnaires: Perinatal Depression Screening Scale, Perinatal Anxiety Screening Scale, Profile of Mood States, Perseverative Thinking Questionnaire, Dysfunctional Beliefs Towards Maternity Scale, and the Fear of COVID-19 Scale. Levels of depressive and anxious symptomatology, negative affect, negative repetitive thinking, and the dysfunctional beliefs towards motherhood of these women were compared with data from samples of previous studies that included women whose delivery had occurred at the same Maternity Hospital before the COVID-19 pandemic period (Group 2: Birth before the COVID-19 period, n = 212). RESULTS: Based on the cutoff points of the screening scales, the prevalence of clinically relevant depressive and anxious symptoms in Group 1 was 40.1% and 36.2%, respectively. Women in Group 1 had significantly higher levels of anxious and depressive symptoms, negative affect, negative repetitive thinking, and dysfunctional beliefs towards motherhood than women in Group 2 (p < 0.05). Fear of COVID-19 in the postpartum period was a predictor of depressive (ß = 0.262) and anxious (ß = 0.371) symptoms, explaining 6.9% and 13.7% of their variability, respectively (p < 0.001). CONCLUSION: During the COVID-19 pandemic, women in the postpartum period present greater depressive and anxious symptomatology, as well as increased risk factors.


Subject(s)
COVID-19 , Depression, Postpartum , Anxiety/epidemiology , Anxiety/psychology , COVID-19/epidemiology , Depression/epidemiology , Depression/psychology , Depression, Postpartum/diagnosis , Female , Humans , Pandemics , Postpartum Period/psychology , Pregnancy
15.
J Affect Disord ; 314: 68-77, 2022 10 01.
Article in English | MEDLINE | ID: covidwho-1907232

ABSTRACT

BACKGROUND: While there have been reports of increased perinatal anxiety during the COVID-19 pandemic (Stepowicz et al., 2020), there has been a lack of research on the relative importance of objective hardship and subjective distress. In this study, we explored the extent to which resilience, tolerance of uncertainty, and cognitive appraisal of the pandemic's consequences moderate the effect of prenatal objective hardship and subjective distress due to the pandemic on 2-month postpartum anxiety. METHODS: Data were collected as part of the Birth in the Time of COVID (BITTOC) study. We measured objective hardship and subjective distress, mental health, and potential psychological moderators in 419 pregnant women residing in Australia, and at two months postpartum. Hierarchical multiple regressions were used. RESULTS: Objective hardship and subjective distress independently predicted postpartum anxiety. All three psychological factors moderated the effect of objective hardship on anxiety. For women with low/neutral resilience, or low/moderate tolerance of uncertainty, or a negative cognitive appraisal, greater objective hardship predicted higher postpartum anxiety. Conversely, for women with high resilience, or high tolerance of uncertainty, or neutral/positive cognitive appraisal, there was no association. Only a neutral/positive cognitive appraisal significantly buffered the effect of subjective distress on anxiety. LIMITATIONS: Participants self-selected themselves into the study. The generalizability of our results could be restricted to women of higher socio-economic status. CONCLUSIONS: These findings help us better understand options for intervention and assessment of vulnerable women during times of stress, along with the mechanisms by which COVID-related stress during pregnancy contributes to postpartum anxiety.


Subject(s)
COVID-19 , Pandemics , Anxiety/epidemiology , Anxiety/psychology , Australia/epidemiology , COVID-19/epidemiology , Depression , Female , Humans , Postpartum Period/psychology , Pregnancy , Stress, Psychological/epidemiology , Stress, Psychological/psychology
16.
Rev Esc Enferm USP ; 56: e20210556, 2022.
Article in English, Portuguese | MEDLINE | ID: covidwho-1902718

ABSTRACT

OBJECTIVE: to identify how the COVID-19 pandemic has influenced postpartum women in breastfeeding. METHOD: a scoping review, with a search in seven databases. Studies available in full, in English, Portuguese or Spanish, published from December/2019-April/2021 were included. The analysis was carried out by categorizing common themes. RESULTS: 25 studies were included, grouped into five categories, presenting the influence of the pandemic: in the routine of breastfeeding care, evidencing preventive measures against COVID-19; in breastfeeding rates, highlighting changes in dietary practices; in the support network for breastfeeding, indicating a lack of service care; in the postpartum women's emotions, with predominance of concern and stress; in the use of technology to support breastfeeding, with teleservice facilitating care. CONCLUSION: the COVID-19 pandemic has influenced new forms of care, in the offer and duration of breastfeeding, in emotional health and in the support network fragility. It is expected to contribute so that health professionals provide care with greater assertiveness in the face of this new situation.


Subject(s)
Breast Feeding , COVID-19 , Breast Feeding/psychology , Emotions , Female , Humans , Pandemics/prevention & control , Postpartum Period/psychology
17.
J Womens Health (Larchmt) ; 31(6): 772-778, 2022 06.
Article in English | MEDLINE | ID: covidwho-1901041

ABSTRACT

Objective: Studies examining the impact of natural disasters noted that in the setting of stable rates of depression, postpartum depression (PPD) increased in vulnerable subgroups. Coronavirus disease 2019 (COVID-19) may similarly impact maternal health. This study aimed to characterize the effect of COVID-19 on the incidence of PPD and to identify vulnerable subgroups. Methods: Retrospective chart review of maternal-newborn dyads was conducted over two epochs: pre-COVID-19 (January 1-June 1, 2019) and during-COVID-19 (January 1-June 1, 2020). PPD was defined as an Edinburgh Postnatal Depression Scale score of ≧ 10 at any postnatal appointment. Prevalence of depression and anxiety was recorded. Data were analyzed using chi-square, Mann-Whitney, and t-tests. Results: Among 1061 dyads (557 in the 2019 epoch, 504 in the 2020 epoch), the epochs had similar clinical and demographic characteristics. Incidence proportion of PPD was similar (16.9% to 18.1%, p = 0.67). In subgroup analyses, this outcome was also similar among primiparous mothers (17.4% to 22.2%, p = 0.22) and publicly insured mothers (23.9% to 25.9%, p = 0.78). The 2020 epoch exhibited higher prevalence of current depression (9.9% to 14.3%, p = 0.03) and anxiety (10.1% to 18.7%, p < 0.001). However, incidence proportion of PPD decreased among women with current mental health diagnoses (41.5% to 31.3%, p = 0.19). Conclusions: A stable PPD incidence despite increased prevalence of current mood disorders highlights the complexity of the biopsychosocial milieu contributing to PPD. Further study of psychiatric care access and treatment is an important next step in understanding relationships between current mood disorders and PPD during the pandemic.


Subject(s)
COVID-19 , Depression, Postpartum , COVID-19/epidemiology , Depression, Postpartum/diagnosis , Female , Humans , Infant, Newborn , Mothers/psychology , Pandemics , Postpartum Period/psychology , Retrospective Studies , Risk Factors , Tuberculin
18.
MCN Am J Matern Child Nurs ; 46(1): 30-35, 2021.
Article in English | MEDLINE | ID: covidwho-1878846

ABSTRACT

For new families giving birth in a hospital setting, the COVID-19 pandemic has presented numerous challenges to their birth, breastfeeding, and postpartum experiences. We present experiences of three first-time, healthy mothers and their babies, as they gave birth in the hospital and were breastfeeding during the start of the pandemic in Philadelphia, PA. Each case is framed in the mother's prenatal goals, infant feeding intentions, birth, breastfeeding, and postpartum experiences. Shared concerns and experiences among the three participants are described in five key areas: 1) Recommendations changing every day, 2) Guilt, concern, and stress, 3) In-person versus telehealth visits, 4) Missing time with family and friends, and 5) Silver linings. Through these mothers' experiences, nurses and other health care providers can learn from their perceptions and events and proactively work to ensure we provide sound anticipatory guidance, enhance our communication, and improve provision of evidence-based lactation care and support.


Subject(s)
Breast Feeding/psychology , COVID-19/psychology , Postnatal Care/psychology , Postpartum Period/psychology , Adult , Anxiety/psychology , Female , Humans , Infant, Newborn , Labor, Obstetric , Pregnancy , Self Concept
19.
MCN Am J Matern Child Nurs ; 46(2): 103-109, 2021.
Article in English | MEDLINE | ID: covidwho-1816330

ABSTRACT

ABSTRACT: The COVID-19 pandemic led to several states mandating social distancing and sheltering in place along with a shift in health care delivery, unprecedented unemployment rates, financial stress, and emotional concerns. For pregnant and postpartum women, limited social support and social isolation with social distancing and fear of COVID-19 exposure or infection for themselves, their fetus, or their newborn infants, have implications for maternal mental health. An overview of the potential impact of COVID-19 on mental health risk for pregnant and postpartum women is presented with implications for nursing practice to promote maternal-infant wellbeing.


Subject(s)
COVID-19/epidemiology , Mental Health , Postpartum Period/psychology , Pregnant Women/psychology , Women's Health , Adult , Female , Humans , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/virology , SARS-CoV-2 , Social Support
20.
J Affect Disord ; 307: 206-214, 2022 06 15.
Article in English | MEDLINE | ID: covidwho-1814606

ABSTRACT

BACKGROUND: This study focused on postpartum women, who are one of the most vulnerable populations during the COVID-19 pandemic, aiming to reveal mental health consequences of social restrictions, loss of social support, and loss of autonomy. METHODS: We conducted a cross-sectional study for postpartum women in October 2020 in Japan (N = 600). The Edinburgh Postpartum Depression Scale (EPDS) was used to measure postpartum depression. The prevalence ratios were estimated by log-binomial regression models, adjusting for age, education, household income, residential area, parity, the timing of delivery, and a prior history of depression. RESULTS: The prevalence of postpartum depression was 28.7% (EPDS ≥9, which is frequently used in Japan), 18.6% (≥11), and 13.1% (≥13). Social restrictions, including cancellation of home visits by healthcare professionals and cancellation of infant checkups or vaccinations, loss of support during pregnancy or after delivery, including loss of opportunities to consult with healthcare professionals or friends and cancellation of parents or other family members' visits to support, and loss of autonomy about delivery or breastfeeding, were associated with postnatal depression. CONCLUSIONS: At least 13% of women who delivered and raised babies during the COVID-19 pandemic had postpartum depressive symptoms. COVID-19 related social restrictions and loss of social support from healthcare professionals, families, and friends were significantly associated with postpartum depression. In addition, loss of maternal autonomy in delivery and breastfeeding was associated with postpartum depression. The results indicate that both formal and informal support should not be limited to preventing postpartum depression during a pandemic.


Subject(s)
COVID-19 , Depression, Postpartum , COVID-19/epidemiology , Cross-Sectional Studies , Depression , Depression, Postpartum/psychology , Family , Female , Humans , Infant , Pandemics/prevention & control , Postpartum Period/psychology , Pregnancy , Social Support
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