Postpartum Depression after Maternal Isolation during the COVID-19 Pandemic: The MUMI-19 Study (Mothers Undergoing Mental Impact of COVID-19 Pandemic).

ABSTRACT

BACKGROUND: The COVID-19 pandemic has shaken the world by imposing unprecedented health measures, including in the postpartum period. OBJECTIVES: We aim to assess the impact of maternal isolation in the immediate postpartum period on the rate of postpartum depression (PPD) in a tertiary center. STUDY DESIGN: We conducted a prospective cohort study, between 22 April and 29 October 2020, using anonymous questionnaires on 265 participants (129 during lockdown and 135 outside). The Edinburgh Postnatal Depression Scale (EPDS) was used as screening for PPD. We used a univariate logistic regression model to analyze the association between risk factors and PPD. RESULTS: There was no difference between the two groups for PPD assessed by an EPDS score >10.5 on day 30 and/or day 60 (23.1% vs. 29.3%, p = 0.661) but on day 3 it was higher (31% vs. 17.8%, p = 0.015) during the lockdown period and partners were more impacted psychologically (48.3% vs. 10.5%, p < 0.001). Parity ≥1 was a protective factor for PPD (OR = 0.2, 95% CI [0.1-0.6], p = 0.003). Risk factors of PPD were history of psychological abuses (OR = 6.4, CI 95% [1.1-37.6], p = 0.04), stressful life event (OR = 4.5, CI 95% [1.6-12.6], p = 0.004), and bad birth experience (OR = 5.1, CI 95% [1.4-17.8], p = 0.012). CONCLUSION: Maternal isolation in the immediate postpartum period is associated with an increased rate of moderate to severe symptoms of postpartum blues. The well-known long-term consequences of PPD must be balanced against the expected benefits of partner's restrictive access to maternity ward.