Experience of COVID-19 and Postpartum Mental Health

ABSTRACT

Background: Early reports show pregnant and postpartum women have increased rates of anxiety and depression during the COVID-19 pandemic. These elevations could be related to fear of contracting COVID or mitigation strategies, such as social distancing and stay-at-home orders. First-time mothers may be uniquely vulnerable to these stressors. We examined whether 1) exposure to potentially stressful COVID-19 events, perceived impact of COVID-19, and COVID-19 distress are related to anxiety and depression symptoms reported by first-time mothers, and 2) whether the relationship between COVID-19 related stressors and anxiety and depression is stronger for mothers reporting less social support. Methods: We interviewed 125 first-time mothers of infants less than 3 months old from four pediatric primary care offices in Pennsylvania and Delaware (June 2020 - February 2021). Mothers completed a self-report interview asking about social support, COVID-19 experiences, and anxiety and depression symptoms (EPDS Total, Anxiety, Depression). The COVID-19 measure yielded three variables 1) number of potentially stressful COVID-19 pandemic-related events (Event Exposure), 2) perceived impact of the COVID-19 pandemic on family (Family Impact), and 3) overall perceived distress related to the pandemic (Distress). Results: Participants (mean age = 29.18, SD 5.50) were racially representative of the recruitment clinics (40.8% White;37.6% Black;11.2% Asian/Asian American;6.4% Latina). Hierarchical linear regression found COVID-19 Event Exposure was unrelated to Depression (β = 0.03, n.s.) and Anxiety (β = 0.04, n.s.). Controlling for Event Exposure, Family Impact was associated with higher EPDS Total (β = 0.32, p = 0.001), Depression (β = 0.29, p =.003), and Anxiety (β = 0.23, p = 0.02). Distress was significantly associated with higher EPDS Total (β = 0.21, p = 0.04) and Depression (β = 0.26, p = 00.01) but not Anxiety (β = 0.08, n.s.). Mothers reporting less social support had higher Depression scores (r = 0.26, p =.003), but social support was unrelated to Anxiety (r = 0.08, p = 0.41). The interaction of Family Impact and social support produced a nonsignificant trend (p = 0.09, Figure). Conclusion: While experience of more COVID-19 related events was unrelated to maternal anxiety and depression symptoms, maternal report of impact of COVID-19 on the family was associated with both anxiety and depression symptoms. Additionally, higher maternal distress reports and less perceived social supports were related to increased maternal depression symptoms. Therefore, future work should explore how to mitigate impact of COVID-19 families and connect mothers to social support to support maternal mental health.