COVID-19: Aspetti materni, fetali, neonatali e organizzativi inviato DA Prof Anna Locatelli

ABSTRACT

INTRODUCTION Depression is common in pregnant and postpartum women and is associated with adverse outcomes for the mother, the developing child, the mother-infant relationship and the intimate partner relationship. Depression screening using the Edinburgh Postnatal Depression Scale (EPDS, a self-report depression symptom questionnaire) is the most common screening tool in perinatal care and could potentially improve detection and management of perinatal depression. Two studies showed that pandemia of COVID-19 negatively influenced EPDS results and depression diagnosis. Our objective was to evaluate the efficacy of perinatal depression screening started in 2017 in ASST-Brianza and the effect of pandemia on this diagnosis. METHODS In this longitudinal study we administered EPDS in three-point times to each woman, first between 28 and 32 weeks pregnancy, second two days after delivery and last measurement at 3 months after childbirth. The cut-off value adopted to identify the women who might have depression is >/= 12. All women within this cut-off value were called by a psychologist in order to offer a clinical psychological interview. The interview could end with a low, medium or high depression diagnosis. In case of mild or medium depression a psychological therapy was offered;while in case of high depression a psychiatric assessment was proposed. The database collection started in June 2018. RESULTS From 1st June 2018 to 30th December 2020 we administered 8228 questionnaires to 6441 women. The cutoff value was >/= 12 in 531 (6.4%) cases but only 202 (38%) accepted the clinical psychological interview. The results of the diagnostic assessment were mild-moderate or high depression in 65 (32%) of cases;negative in 57 (28%) and unknown in 80 (40)%. The overall prevalence of depression identified was 1% (Table 1). Then we compared the results from 1st march 2019 to 29 February 2020, before COVID-19 pandemia, to the period o of COVID-19 pandemia (from 1st march 2020 to 28 February 2021). The questionnaires administered were 3417 before and 2752 during pandemia. The questionnaires with value >/=12 were 204 (5.9 %) before COVID-19 and 173 (6.2%) during COVID-19 period. The psychological interview was accepted by 67 (29 %) women before COVID-19 and by 50 (29%) women during COVID-19. The depression diagnoses were respectively 32 (48%) before COVID-19 and 29 (58%) after pandemic start. The overall prevalence of depression was 0.93% before and 1.05% after the pandemic started. CONCLUSIONS In our study the overall prevalence of perinatal depression is low and we did not detect any difference in pandemic period regarding questionnaire results and overall diagnosis. EPDS does not seem the right tool to evaluate anxiety due to the pandemic but a specific tool to evaluate depression.