Impact of COVID-19 pandemic on mental health during pregnancy and postpartum: A cross-sectional study (preprint)

ABSTRACT

Objective: - To determine the prevalence of peripartum depression (PPD) and anxiety during the COVID-19 pandemic, any differences between COVID-infected and non-infected mothers and its risk factors. Study design- Cross-sectional study. Setting- Tertiary care maternity hospital Population- Pregnant and postpartum women Methods- Questionnaire based direct interview. EPDS (Edinburgh postnatal depression scale) score, COVID-19 anxiety scale (CAS) was used. Outcome measures- Possible PPD (EPDS13), Probable PPD (EPDS14), Peripartum anxiety (EPDS anxiety sub score4), COVID-19 related anxiety and risk factors of PPD. Results- Out of 842 eligible subjects, 142 were confirmed COVID-19 positive and 670 patients were without the infection. The mean age was 25±3.9 years and 571 (67.8%) subjects were postpartum. Among the subjects, 383 (45.5%) had possible depression, 317 (37.6%) had probable depression. Peripartum anxiety was observed among 763(90.6%) subjects and the median CAS score was 15(8-28). While there was no significant difference in the prevalence of PPD, peripartum anxiety was higher among COVID non-infected subjects (91.6% vs 86.6%, p=0.04). The CAS score was higher among COVID-19 infected compared to the non-infected [17(10-28) vs 15(8-25), p=0.00]. In multivariate analysis, history of psychiatric illness [OR- 4.2(95% CI- 1.82-9.93), p=0.001], domestic violence [OR-2.4(95% CI-1.16-5.10), p=0.019] and past obstetric complications [OR-1.5(95%CI-1.01-2.27), p=0.042] were significant risk factors for PPD. Conclusion- High prevalence of PPD was observed during COVID-19 pandemic without any significant difference between COVID-19 infected and non-infected subjects. COVID-19 infected patients had higher COVID related anxiety. Funding- None taken Keywords- peripartum depression; EPDS; COVID-19 anxiety scale.