Association between SARS-CoV-2 infection during pregnancy and postpartum depressive and anxiety symptoms: finding from the International Registry of Coronavirus Exposure in Pregnancy (IRCEP) study.

While there has been concern over the perinatal mental health implications of the COVID-19 outbreak, evidence on the risk of postpartum depression and anxiety following SARS-CoV-2 infection is limited. We studied this question using the International Registry of Coronavirus Exposure in Pregnancy, which included both a prospective and retrospective cohort. Study participants were required to have been tested for SARS-CoV-2 between the date of last menstrual period and delivery. The exposure of interest was SARS-CoV-2 infection during pregnancy, as well as COVID-19 severity (severe, moderate, mild, and asymptomatic). The outcome was postpartum depression and anxiety symptoms, assessed by the 4-item Patient Health Questionnaire. The final analytic cohort consisted of 3819 participants (COVID-19 positive: 771; COVID-19 negative: 3048). After adjusting for confounding by socio-demographics, prior obstetric and maternal health comorbidities, mothers with severe COVID-19 had an increased risk of depressive (aRR: 1.72; 95%CI: 1.18-2.52) and anxiety (aRR: 1.40; 0.98-2.00) symptoms. The strength of the association was attenuated for women with moderate COVID-19 (aRR = 1.12; 0.86-1.44 for depressive symptoms; aRR = 1.18; 0.96-1.44 for anxiety symptoms). No increased risk was observed for mild or asymptomatic illness. The findings can inform targeted interventions to minimize the risk of adverse COVID-19-related mental health outcomes for pregnant women.

Feelings of Culpability: Just Following Orders Versus Making the Decision Oneself.

In five experiments (N = 1,490), participants were asked to imagine themselves as programmers of self-driving cars who had to decide how to program the car to respond in a potential accident: spare the driver or spare pedestrians. Alternatively, participants imagined that they were a mayor grappling with difficult moral dilemmas concerning COVID-19. Either they, themselves, had to decide how to program the car or which COVID-19 policy to implement (high-agency condition) or they were told by their superior how to act (low-agency condition). After learning that a tragic outcome occurred because of their action, participants reported their felt culpability. Although we expected people to feel less culpable about the outcome if they acted in accordance with their superior's injunction than if they made the decision themselves, participants actually felt more culpable when they followed their superior's order. Some possible reasons for this counterintuitive finding are discussed.