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Hwang YM, Roper RT, Piekos SN, Enquobahrie DA, Hebert MF, Paquette AG, Baloni P, Price ND, Hood L, Hadlock JJ. Timing of selective serotonin reuptake inhibitor use and risk for preterm birth and related adverse events: with a consideration of the COVID-19 pandemic period. J Matern Fetal Neonatal Med 2024; 37:2313364. [PMID: 38342572 PMCID: PMC11033706 DOI: 10.1080/14767058.2024.2313364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/29/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVE There is uncertainty around the safety of SSRIs for treating depression during pregnancy. Nevertheless, the use of SSRIs has been gradually increasing, especially during the COVID-19 pandemic period. We aimed to (1) characterize maternal depression rate and use of SSRIs in a recent 10-year period, (2) address confounding by indication, as well as socioeconomic and environmental factors, and (3) evaluate associations of the timing of SSRI exposure in pregnancy with risk for preterm birth (PTB), low birthweight (LBW), and small for gestational age (SGA) infants among women with depression before pregnancy. METHODS We conducted propensity score-adjusted regression to calculate odds ratios (ORs) of PTB, LBW, and SGA. We accounted for maternal/pregnancy characteristics, comorbidity, depression severity, time of delivery, social vulnerability, and rural residence. RESULTS There were 50.3% and 40.3% increases in the prevalence rate of prenatal depression and prenatal SSRI prescription rate during the pandemic. We identified women with depression ≤180 days before pregnancy (n = 8406). Women with no SSRI order during pregnancy (n = 3760) constituted the unexposed group. The late SSRI exposure group consisted of women with an SSRI order after the first trimester (n = 3759). The early-only SSRI exposure group consisted of women with SSRI orders only in the first trimester (n = 887). The late SSRI exposure group had an increased risk of PTB of OR = 1.5 ([1.2,1.8]) and LBW of OR = 1.5 ([1.2,2.0]), relative to the unexposed group. Associations between late SSRI exposure and risk of PTB/LBW were similar among a subsample of patients who delivered during the pandemic. CONCLUSIONS These findings suggest an association between PTB/LBW and SSRI exposure is dependent on exposure timing during pregnancy. Small for gestational age is not associated with SSRI exposure.
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Affiliation(s)
- Yeon Mi Hwang
- Institute for Systems Biology; 401 Terry Ave N, Seattle, Washington, USA 98109
- Molecular Engineering and Sciences Institute, University of Washington; Seattle, Washington, USA
| | - Ryan T. Roper
- Institute for Systems Biology; 401 Terry Ave N, Seattle, Washington, USA 98109
| | - Samantha N. Piekos
- Institute for Systems Biology; 401 Terry Ave N, Seattle, Washington, USA 98109
| | - Daniel A. Enquobahrie
- Department of Epidemiology, School of Public Health, University of Washington; Seattle, Washington, USA
| | - Mary F. Hebert
- Department of Pharmacy, School of Pharmacy, University of Washington; Seattle, Washington, USA
| | - Alison G. Paquette
- Department of Pediatrics, School of Medicine, University of Washington; Seattle, Washington USA
- Center for Developmental Biology and Regenerative Medicine, Seattle Children’s Research Institute; Seattle, Washington USA
| | - Priyanka Baloni
- School of Health Sciences, Purdue University, West Lafayette, Indiana USA
| | - Nathan D. Price
- Institute for Systems Biology; 401 Terry Ave N, Seattle, Washington, USA 98109
- Thorne HealthTech, New York, New York, USA
| | - Leroy Hood
- Institute for Systems Biology; 401 Terry Ave N, Seattle, Washington, USA 98109
- Providence St. Joseph Health; Renton, Washington, USA
| | - Jennifer J. Hadlock
- Institute for Systems Biology; 401 Terry Ave N, Seattle, Washington, USA 98109
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Mattera JA, Erickson NL, Barbosa-Leiker C, Gartstein MA. COVID-19 pandemic effects: Examining prenatal internalizing symptoms and infant temperament. INFANCY 2024; 29:386-411. [PMID: 38244202 DOI: 10.1111/infa.12583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 11/06/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024]
Abstract
For pregnant women, the COVID-19 pandemic has resulted in unprecedented stressors, including uncertainty regarding prenatal care and the long-term consequences of perinatal infection. However, few studies have examined the role of this adverse event on maternal wellbeing and infant socioemotional development following the initial wave of the pandemic when less stringent public health restrictions were in place. The current study addressed these gaps in the literature by first comparing prenatal internalizing symptoms and infant temperament collected after the first wave of the pandemic to equivalent measures in a pre-pandemic sample. Second, associations between prenatal pandemic-related stress and infant temperament were examined. Women who were pregnant during the COVID-19 pandemic endorsed higher pregnancy-specific anxiety relative to the pre-pandemic sample. They also reported greater infant negative emotionality and lower positive affectivity and regulatory capacity at 2 months postpartum. Prenatal infection stress directly predicted infant negative affect. Both prenatal infection and preparedness stress were indirectly related to infant negative emotionality through depression symptoms during pregnancy and at 2 months postpartum. These results have implications for prenatal mental health screening procedures during the pandemic and the development of early intervention programs for infants born to mothers during this adverse event.
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Affiliation(s)
- Jennifer A Mattera
- Department of Psychology, Washington State University, Pullman, Washington, USA
| | - Nora L Erickson
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Maria A Gartstein
- Department of Psychology, Washington State University, Pullman, Washington, USA
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Chan JK, Marzuki AA, Vafa S, Thanaraju A, Yap J, Chan XW, Harris HA, Todi K, Schaefer A. A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain. BMC Psychol 2024; 12:237. [PMID: 38671542 PMCID: PMC11046828 DOI: 10.1186/s40359-024-01715-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders. METHODS Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health. RESULTS Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst. CONCLUSIONS This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.
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Affiliation(s)
- Jee Kei Chan
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia.
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia.
- Sunway University Malaysia, Room: 4-4-11, Jalan Lagoon Selatan, Bandar Sunway, Petaling Jaya, 47500, Selangor, Malaysia.
| | - Aleya A Marzuki
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Samira Vafa
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Arjun Thanaraju
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Jie Yap
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Xiou Wen Chan
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Hanis Atasha Harris
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Khushi Todi
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Alexandre Schaefer
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
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WANG J, HU L, ZHANG T, LIU J, YU C, ZHAO N, QI J, LIU L. Prevalence and predictors of prenatal depression during the COVID-19 pandemic: A multistage observational study in Beijing, China. PLoS One 2024; 19:e0298314. [PMID: 38662750 PMCID: PMC11045078 DOI: 10.1371/journal.pone.0298314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 01/19/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVE While growing psychological health issues among pregnant women during the COVID-19 pandemic have been clearly validated, most research was conducted in countries with relatively lax quarantine measures. This study aimed to compare the prevalence of prenatal depression among pre-, peak-, and post-COVID-19 in Beijing, the region with a stringent response policy in China. We also explore predictors of prenatal depression throughout the outbreak. METHODS We investigated prenatal depression among 742 pregnant women who received antenatal checkups in Beijing from March 28, 2019 to May 07, 2021 using the Edinburgh Postnatal Depression Scale and associative demographic, pregnancy-related, and psychosocial characteristics were measured. The phase was divided into pre-, peak-, and post-COVID-19 in light of the trajectory of COVID-19. Pearson's Chi-square test was used after the examination of confounders homogeneity. The bivariable and multivariable logistic regression was conducted to explore predictors. RESULTS The pooled prevalence of prenatal depression was 11.9% throughout the COVID-19 pandemic. Rates at different phases were 10.6%, 15.2%, and 11.1% respectively and no significant difference was observed. Multivariable logistic regression revealed that history of mental illness, number of boy-preference from both pregnant women and husband's family, social support, occupation, and living space were independent predictors of prenatal depression in Beijing. CONCLUSION Our data suggested that the impact of this pandemic on prenatal depression in Beijing appears to be not significant, which will strengthen confidence in adhering to current policy for decision-makers and provide important guidance for the development of major outbreak control and management policies in the future. Our findings may also provide a more efficient measure to identify high-risk pregnant women for professionals and help raise gender equity awareness of pregnant women and their husbands' families. Future studies should focus on the value of targeted care and family relations on the mental health of pregnant women.
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Affiliation(s)
- Jin WANG
- Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China
- Department of Aviation Psychology, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Libin HU
- Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China
| | - Tianyi ZHANG
- Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China
| | - Jiajia LIU
- Department of Aviation Psychology, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Chuan YU
- Department of Aviation Psychology, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Ningxin ZHAO
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jianlin QI
- Department of Aviation Psychology, Air Force Medical Center, Air Force Medical University, Beijing, China
| | - Lihua LIU
- Institution of Hospital Management, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing, China
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Bernier E, Brien ME, Girard S. Pregnant individuals with uncomplicated pregnancies display pro-inflammatory immune changes when exposed to the COVID-19 pandemic. Am J Reprod Immunol 2024; 91:e13828. [PMID: 38374807 DOI: 10.1111/aji.13828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/04/2023] [Accepted: 02/06/2024] [Indexed: 02/21/2024] Open
Abstract
PROBLEM The COVID-19 pandemic has been shown to have a detrimental impact on the mental health of pregnant individuals, and chronic stress can alter the immune profile. However, the effects of the COVID-19 pandemic on the immune system in pregnancy are still poorly understood. We aimed to evaluate the impact of pandemic exposure on the maternal immune profile in uncomplicated pregnancies. METHOD OF STUDY We collected blood and placenta samples from pregnant individuals exposed and unexposed to the pandemic to compare their immune and inflammatory profiles. We performed co-culture with circulating maternal immune cells and endothelial cells to assess endothelial activation. Statistical analysis was performed using unpaired t-test, Mann-Whitney, or Fisher's exact test as appropriate. RESULTS In exposed individuals, we observed a decreased proportion of Th2 cells (p < .0001) and Treg/Th17 ratio (p < .05), as well as an increased Th1/Th2 ratio (p < .0001). Levels of IL-1β (p < .01) and IL-18 (p < .01) were increased in the circulation of exposed participants, whilst other mediators were significantly decreased (IFNγ, IL-8, MCP-1, amongst others). Furthermore, we observed increased production of ICAM, hallmark of endothelial activation, when we co-cultured endothelial cells with immune cells from exposed individuals. Vaccination status impacted the cellular profile with increased proportions of Th1 and B cells in vaccinated participants. CONCLUSION Overall, we observed a pro-inflammatory bias in the circulation of pregnant individuals exposed to the COVID-19 pandemic, with otherwise uncomplicated pregnancies. Our work also supports an association between the increased risk of endothelial activation/hypertension and SARS-CoV2 infection, which might be driven in part by exposure to the pandemic and associated stressors.
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Affiliation(s)
- Elsa Bernier
- Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
- Department of Microbiology, Infectiology and Immunology, Université de Montréal, Montreal, Quebec, Canada
- Department of Obstetrics and Gynecology, Department of Immunology, Mayo Clinic, Rochester, Minnesota, USA
| | - Marie-Eve Brien
- Sainte-Justine Hospital Research Center, Montreal, Quebec, Canada
| | - Sylvie Girard
- Department of Obstetrics and Gynecology, Department of Immunology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Obstetrics and Gynecology, Université de Montréal, Montreal, Quebec, Canada
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Xiao W, Yang Y, Xiao H, Huang P, Wei D, Wu Y, Yu J, He JR, Qiu X. Impact of closed-off management due to COVID-19 rebound on maternal depression during pregnancy. BMC Pregnancy Childbirth 2024; 24:88. [PMID: 38287284 PMCID: PMC10823603 DOI: 10.1186/s12884-024-06285-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 01/21/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND This study aimed to assess the impacts of closed-off measures with different strictness levels (lockdown, partial lockdown and non-lockdown) and geographic proximity to patients with coronavirus disease 2019 (COVID-19) on prenatal depression during an epidemic rebound of COVID-19. METHODS This was a cross-sectional web-based survey including 880 pregnant women. Depressive symptoms were measured by Self-Rating Depression Scale (SDS) and geographic proximity was calculated using Geographic Information Systems. Linear and logistic regression were used to assess the associations of closed-off measures and geographic proximity with SDS scores and depressive symptoms. Restricted cubic splines were used to model non-linear associations between geographic proximity and depression symptoms. RESULTS Compared with those living in non-lockdown areas, women in lockdown areas had higher SDS scores (adjusted β: 3.51, 95% CI: 1.80, 5.21) and greater risk of depressive symptoms (adjusted OR: 4.00, 95% CI: 2.18, 7.35), but evidence for partial lockdown was not obvious. A progressive increase in the risk of depressive symptoms was found with decreasing distance to COVID-19 patients when geographic proximity was <8 kilometers. Compared to those in the 5th quintile of geographic proximity, women in the first, second and third quintiles had at least 6 times higher risk of depressive symptoms. CONCLUSIONS Pregnant women under strict closed-off management during COVID-19 epidemic have high risk of depression. A specific range around the residences of reported COVID-19 patients should be underlined as potential clustering of high prenatal depression levels. Our findings highlight the importance of enhancing mental health management during the COVID-19 epidemic for pregnant women.
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Affiliation(s)
- Wanqing Xiao
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Yuting Yang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
| | - Huiyun Xiao
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Peiyuan Huang
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
| | - Dongmei Wei
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Yingfang Wu
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Jia Yu
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China
| | - Jian-Rong He
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China.
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
| | - Xiu Qiu
- Division of Birth Cohort Study, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No. 9 Jinsui Rd., Tianhe District, Guangzhou, 510623, Guangdong, China.
- Department of Women's Health, Guangdong Provincial Key Clinical Specialty of Woman and Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
- Guangdong Provincial Clinical Research Center for Child Health, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, China.
- Provincial Key Laboratory of Research in Structure Birth Defect Disease and Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510623, Guangdong, China.
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Blendermann M, Ebalu TI, Obisie-Orlu IC, Fried EI, Hallion LS. A narrative systematic review of changes in mental health symptoms from before to during the COVID-19 pandemic. Psychol Med 2024; 54:43-66. [PMID: 37615061 DOI: 10.1017/s0033291723002295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
The onset of the COVID-19 pandemic raised concerns regarding population-wide impacts on mental health. Existing work on the psychological impacts of disaster has identified the potential for multiple response trajectories, with resilience as likely as the development of chronic psychopathology. Early reviews of mental health during the pandemic suggested elevated prevalence rates of multiple forms of psychopathology, but were limited by largely cross-sectional approaches. We conducted a systematic review of studies that prospectively assessed pre- to peri-pandemic changes in symptoms of psychopathology to investigate potential mental health changes associated with the onset of the pandemic (PROSPERO #CRD42021255042). A total of 97 studies were included, covering symptom clusters including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), fear, anxiety, depression, and general distress. Changes in psychopathology symptoms varied by symptom dimension and sample characteristics. OCD, anxiety, depression, and general distress symptoms tended to increase from pre- to peri-pandemic. An increase in fear was limited to medically vulnerable participants, and findings for PTSD were mixed. Pre-existing mental health diagnoses unexpectedly were not associated with symptom exacerbation, except in the case of OCD. Young people generally showed the most marked symptom increases, although this pattern was reversed in some samples. Women in middle adulthood in particular demonstrated a considerable increase in anxiety and depression. We conclude that mental health responding during the pandemic varied as a function of both symptom cluster and sample characteristics. Variability in responding should therefore be a key consideration guiding future research and intervention.
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Affiliation(s)
- Mary Blendermann
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tracie I Ebalu
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Eiko I Fried
- Department of Psychology, Leiden University, Leiden, The Netherlands
| | - Lauren S Hallion
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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Sprengeler MK, Mattheß J, Galeris MG, Eckert M, Koch G, Reinhold T, Berghöfer A, Fricke J, Roll S, Keil T, Ludwig-Körner C, Kuchinke L, von Klitzing K, White LO, Schlensog-Schuster F. Being an Infant in a Pandemic: Influences of the COVID-19 Pandemic on Infants, Toddlers and Their Mothers in a Clinical Population. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1885. [PMID: 38136087 PMCID: PMC10742006 DOI: 10.3390/children10121885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
The COVID-19 pandemic and the ongoing lockdowns might have had a strong impact on mental health of mothers and their infants/toddlers. For example, families had to deal with health issues and social isolation, which might have affected mental health and parent-child interactions. The aim of this study is to evaluate differences in (1) infantile regulatory disorders, (2) maternal mental health, (3) the impact of maternal mental health on infantile regulatory disorders, and (4) alterations in the mother-child interaction for participants recruited before versus after the onset of the first German lockdown. For this reason, mother-child dyads have been divided into two groups and were compared by analyzing clinical interviews on psychopathology of mother and child (M.I.N.I. & DC:05) and mother-child-interactions (Emotional Availability Scales). Results showed that (1) differences in infantile sleeping disorders emerged (phi = 0.243; p = 0.016) compared to the pre-lockdown group, while (2) the occurrence of maternal panic and anxiety increased in the post-lockdown group (phi = 0.229; p = 0.022). Moreover, there was (3) an association for maternal panic and child's sleep disorder, and (4) specific associations with maternal non-hostility in the mother-child-interaction. In conclusion, the present study highlights the differences of maternal mental health occurrences and infants' regulatory problems, as well as the possible effects of the COVID-19 pandemic for infants. In the pre-lockdown group, maternal non-hostility might have acted as a promotive factor against regulatory disorders, while this mechanism was mitigated in the post-lockdown group.
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Affiliation(s)
- Mona Katharina Sprengeler
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
| | - Janna Mattheß
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
- International Psychoanalytic University, 10555 Berlin, Germany; (M.E.); (G.K.); (C.L.-K.); (L.K.)
| | - Mirijam-Griseldis Galeris
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
| | - Melanie Eckert
- International Psychoanalytic University, 10555 Berlin, Germany; (M.E.); (G.K.); (C.L.-K.); (L.K.)
| | - Gabriele Koch
- International Psychoanalytic University, 10555 Berlin, Germany; (M.E.); (G.K.); (C.L.-K.); (L.K.)
| | - Thomas Reinhold
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.R.); (J.F.); (S.R.); (T.K.)
| | - Anne Berghöfer
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.R.); (J.F.); (S.R.); (T.K.)
| | - Julia Fricke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.R.); (J.F.); (S.R.); (T.K.)
| | - Stephanie Roll
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.R.); (J.F.); (S.R.); (T.K.)
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité—Universitätsmedizin Berlin, 10117 Berlin, Germany; (T.R.); (J.F.); (S.R.); (T.K.)
- Institute of Clinical Epidemiology and Biometry, University of Wuerzburg, 97080 Wuerzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, 97688 Bad Kissingen, Germany
| | - Christiane Ludwig-Körner
- International Psychoanalytic University, 10555 Berlin, Germany; (M.E.); (G.K.); (C.L.-K.); (L.K.)
| | - Lars Kuchinke
- International Psychoanalytic University, 10555 Berlin, Germany; (M.E.); (G.K.); (C.L.-K.); (L.K.)
| | - Kai von Klitzing
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
| | - Lars Otto White
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
| | - Franziska Schlensog-Schuster
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University of Leipzig, 04103 Leipzig, Germany; (M.K.S.); (M.-G.G.); (K.v.K.); (L.O.W.); (F.S.-S.)
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, 3000 Bern, Switzerland
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Kim ME, Jung HN. Prevalence and associated factors of prenatal depression in pregnant Korean women during the COVID-19 pandemic: a cross-sectional study. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2023; 29:274-290. [PMID: 38204388 PMCID: PMC10788393 DOI: 10.4069/kjwhn.2023.11.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 06/22/2023] [Accepted: 11/22/2023] [Indexed: 01/12/2024] Open
Abstract
PURPOSE This study investigated the effects of prenatal education characteristics, pandemic-related pregnancy stress, and health behaviors during pregnancy on prenatal depression in pregnant women during the coronavirus disease 2019 (COVID-19) pandemic. METHODS The participants were 180 pregnant Korean women, recruited from internet communities for pregnancy preparation, childbirth, and childcare, from July 5 to 15, 2022. The collected data were analyzed using the t-test, analysis of variance, the Mann-Whitney U-test, the Kruskal-Wallis test, and multiple regression analysis. RESULTS The scores for pandemic-related pregnancy stress (24.50±6.37) and health behaviors during pregnancy (67.07±9.20) were high. Nearly half of the participants (n=89, 49.4%) presented with prenatal depression, with scores of 10 or greater. Prenatal depression had a positive correlation with gestational age (r=.18, p=.019) and pandemic-related pregnancy stress (r=.27, p<.001), and a negative correlation with health behaviors during pregnancy (r=-.42, p<.001). The factors associated with prenatal depression were pandemic-related pregnancy stress (t=4.70, p<.001), marital satisfaction (dissatisfied) (t=3.66, p<.001), pregnancy healthcare practice behaviors (t=-3.31, p=.001), family type (weekend couple) (t=2.84, p=.005), and gestational age (t=2.32, p=.022). The explanatory power of these variables was 38.2%. CONCLUSION Since participants had a high level of prenatal depression during the pandemic, and infectious diseases such as COVID-19 may recur, strategies should be developed to improve pregnant women's mental health with consideration of the unique variables that are relevant in a pandemic. It is also necessary to develop efficient online prenatal education programs that can be implemented even in special circumstances such as social distancing, and to evaluate their effectiveness.
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Affiliation(s)
- Mi-Eun Kim
- Department of Nursing Science, Jeonju University, Jeonju, Korea
| | - Ha-Neul Jung
- Department of Nursing Science, Jeonju University, Jeonju, Korea
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10
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Fingar KR, Weiss AJ, Roemer M, Agniel D, Reid LD. Effects of the COVID-19 early pandemic on delivery outcomes among women with and without COVID-19 at birth. Birth 2023; 50:996-1008. [PMID: 37530067 DOI: 10.1111/birt.12753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 07/06/2023] [Accepted: 07/17/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND The COVID-19 pandemic may influence delivery outcomes through direct effects of infection or indirect effects of disruptions in prenatal care. We examined early pandemic-related changes in birth outcomes for pregnant women with and without a COVID-19 diagnosis at delivery. METHODS We compared four delivery outcomes-preterm delivery (PTD), severe maternal morbidity (SMM), stillbirth, and cesarean birth-between 2017 and 2019 (prepandemic) and between April and December 2020 (early-pandemic) using interrupted time series models on 11.8 million deliveries, stratified by COVID-19 infection status at birth with entropy weighting for historical controls, from the Healthcare Cost and Utilization Project across 43 states and the District of Columbia. RESULTS Relative to 2017-2019, women without COVID-19 at delivery in 2020 had lower odds of PTD (OR = 0.93; 95% CI = 0.92-0.94) and SMM (OR = 0.88; 95% CI = 0.85-0.91) but increased odds of stillbirth (OR = 1.04; 95% CI = 1.01-1.08). Absolute effects were small across race/ethnicity groups. Deliveries with COVID-19 had an excess of each outcome, by factors of 1.07-1.46 for outcomes except SMM at 4.21. The effect for SMM was more pronounced for Asian/Pacific Islander non-Hispanic (API; OR = 10.51; 95% CI = 5.49-20.14) and Hispanic (OR = 5.09; 95% CI = 4.29-6.03) pregnant women than for White non-Hispanic (OR = 3.28; 95% CI = 2.65-4.06) women. DISCUSSION Decreasing rates of PTD and SMM and increasing rates of stillbirth among deliveries without COVID-19 were small but suggest indirect effects of the pandemic on maternal outcomes. Among pregnant women with COVID-19 at delivery, adverse effects, particularly SMM for API and Hispanic women, underscore the importance of addressing health disparities.
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Affiliation(s)
| | | | - Marc Roemer
- Agency for Healthcare Research and Quality, Rockville, Maryland, USA
| | | | - Lawrence D Reid
- Agency for Healthcare Research and Quality, Rockville, Maryland, USA
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11
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De Genna NM, Hossain F, Dwarakanath M, Balascio PM, Moore MM, Hill AV. Pandemic stressors and vaccine hesitancy among young, pregnant Black people: A qualitative study of health disparities during a global pandemic. Birth Defects Res 2023; 115:1912-1922. [PMID: 37807480 PMCID: PMC11061795 DOI: 10.1002/bdr2.2262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND The novel coronavirus 2019 (COVID-19) pandemic exacerbated existing health inequities in the United States, but no studies have focused on the lived experiences of younger Black birthing people. The goal of this qualitative study was to center the experiences of younger pregnant and birthing Black and Biracial people during the pandemic. METHODS We recruited 25 Black and Biracial pregnant and birthing people ages 16-23 for individual semi-structured interviews. Participants were asked about experiences with the healthcare system during the pandemic, and interviews were transcribed verbatim and coded for qualitative analysis using nVivo. We adhered to the Consolidated Criteria for Reporting Qualitative Research guidelines. RESULTS Participants identified pandemic-related stressors such as fears about infection, lack of support, and pressure to get vaccinated. Reasons for vaccine hesitancy included mistrust in the government and racism experienced during reproductive healthcare. Provider appeals highlighting patient autonomy and science were more effective in encouraging vaccine uptake than emotional appeals that made participants feel guilty about potentially infecting loved ones. CONCLUSIONS Restrictions on children and support people created barriers to timely prenatal care and reduced tangible support for young Black and Biracial birthing people during the pandemic. Their vaccine hesitancy was related to mistrust, concerns that the vaccines had not been tested enough prior to roll-out, and possible side effects of the vaccine including infection with the virus and pregnancy loss. Obstetric providers need to understand and recognize the ongoing impact of obstetric and scientific racism on health communication with younger Black and Biracial patients.
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Affiliation(s)
- Natacha M. De Genna
- Department of Psychiatry and Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Fahmida Hossain
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Megana Dwarakanath
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Phoebe Ms. Balascio
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Mikaela Ms. Moore
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Ashley V. Hill
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, Pennsylvania, USA
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12
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Blackwell CK, Sherlock P, Jackson KL, Hofheimer JA, Cella D, Algermissen MA, Alshawabkeh AN, Avalos LA, Bastain T, Blair C, Enlow MB, Brennan PA, Breton C, Bush NR, Chandran A, Collazo S, Conradt E, Crowell SE, Deoni S, Elliott AJ, Frazier JA, Ganiban JM, Gold DR, Herbstman JB, Joseph C, Karagas MR, Lester B, Lasky-Su JA, Leve LD, LeWinn KZ, Mason WA, McGowan EC, McKee KS, Miller RL, Neiderhiser JM, O’Connor TG, Oken E, O’Shea TM, Pagliaccio D, Schmidt RJ, Singh AM, Stanford JB, Trasande L, Wright RJ, Duarte CS, Margolis AE. Development and psychometric validation of the Pandemic-Related Traumatic Stress Scale for children and adults. Psychol Assess 2023; 35:1054-1067. [PMID: 37902671 PMCID: PMC10773574 DOI: 10.1037/pas0001211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
To assess the public health impact of the COVID-19 pandemic on mental health, investigators from the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) research program developed the Pandemic-Related Traumatic Stress Scale (PTSS). Based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) acute stress disorder symptom criteria, the PTSS is designed for adolescent (13-21 years) and adult self-report and caregiver-report on 3-12-year-olds. To evaluate psychometric properties, we used PTSS data collected between April 2020 and August 2021 from non-pregnant adult caregivers (n = 11,483), pregnant/postpartum individuals (n = 1,656), adolescents (n = 1,795), and caregivers reporting on 3-12-year-olds (n = 2,896). We used Mokken scale analysis to examine unidimensionality and reliability, Pearson correlations to evaluate relationships with other relevant variables, and analyses of variance to identify regional, age, and sex differences. Mokken analysis resulted in a moderately strong, unidimensional scale that retained nine of the original 10 items. We detected small to moderate positive associations with depression, anxiety, and general stress, and negative associations with life satisfaction. Adult caregivers had the highest PTSS scores, followed by adolescents, pregnant/postpartum individuals, and children. Caregivers of younger children, females, and older youth had higher PTSS scores compared to caregivers of older children, males, and younger youth, respectively. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Courtney K. Blackwell
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Phillip Sherlock
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Kathryn L. Jackson
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | - Julie A. Hofheimer
- Department of Pediatrics, University of North Carolina School of Medicine
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
| | | | - Akram N. Alshawabkeh
- Department of Civil and Environmental Engineering, College of Engineering, Northeastern University
| | - Lyndsay A. Avalos
- Kaiser Permanente North California, Division of Research, Oakland, California, United States
| | - Tracy Bastain
- Clinical Population and Public Health Sciences, Keck School of Medicine of the University of Southern California
| | - Clancy Blair
- New York University Grossman School of Medicine
- Department of Population Health, New York University Grossman School of Medicine
| | - Michelle Bosquet Enlow
- Boston Children’s Hospital, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
| | | | - Carrie Breton
- Clinical Population and Public Health Sciences, Keck School of Medicine of the University of Southern California
| | - Nicole R. Bush
- Department of Psychiatry, University of California, San Francisco
| | - Aruna Chandran
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health
| | - Shaina Collazo
- Icahn School of Medicine at Mount Sinai
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai
| | | | | | - Sean Deoni
- Bill and Melinda Gates Foundation, Seattle, Washington, United States
| | - Amy J. Elliott
- Avera Research Institute, Sioux Falls, South Dakota, United States
- Department of Pediatrics, University of South Dakota School of Medicine
| | - Jean A. Frazier
- Department of Psychiatry, University of Massachusetts Chan Medical School
| | - Jody M. Ganiban
- Department of Clinical/Developmental Psychology, George Washington University
| | - Diane R. Gold
- Department of Psychiatry, Harvard Medical School
- Department of Medicine, Harvard Medical School
- Harvard University T.H. Chan School of Public Health
- Department of Environmental Health, Harvard University T.H. Chan School of Public Health
- Brigham and Women’s Hospital, Boston, Massachusetts, United States
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health
| | | | | | - Barry Lester
- Women & Infants Hospital, Providence, Rhode Island, United States
- Department of Psychiatry and Human Behavior, Brown University
- Department of Pediatrics, Brown University
| | - Jessica A. Lasky-Su
- Department of Psychiatry, Harvard Medical School
- Department of Medicine, Harvard Medical School
- Brigham and Women’s Hospital, Boston, Massachusetts, United States
| | - Leslie D. Leve
- Department of Counseling Psychology and Human Services, University of Oregon College of Education
| | - Kaja Z. LeWinn
- Department of Psychiatry, University of California, San Francisco
| | - W. Alex Mason
- Department of Child, Youth, and Family Studies, College of Education and Human Sciences, University of Nebraska—Lincoln
| | - Elisabeth C. McGowan
- Women & Infants Hospital, Providence, Rhode Island, United States
- Department of Pediatrics, Brown University
| | - Kimberly S. McKee
- Department of Family Medicine, University of Michigan Medical School
| | - Rachel L. Miller
- Icahn School of Medicine at Mount Sinai
- Department of Medicine, Icahn School of Medicine at Mount Sinai
| | | | | | - Emily Oken
- Department of Psychiatry, Harvard Medical School
- Harvard University T.H. Chan School of Public Health
- Brigham and Women’s Hospital, Boston, Massachusetts, United States
- Department of Population Medicine, Harvard Medical School
- Department of Nutrition, Harvard University T.H. Chan School of Public Health
- Harvard Pilgrim Health Care Institute, Boston, Massachusetts, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina School of Medicine
| | - David Pagliaccio
- Columbia University Irving Medical Center
- New York State Psychiatric Institute, New York, New York, United States
| | - Rebecca J. Schmidt
- Department of Public Health Services, University of California—Davis School of Medicine
| | - Anne Marie Singh
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health
| | - Joseph B. Stanford
- Department of Family and Preventative Medicine, University of Utah School of Medicine
| | - Leonardo Trasande
- New York University Grossman School of Medicine
- Department of Pediatrics, New York University Grossman School of Medicine
| | - Rosalind J. Wright
- Icahn School of Medicine at Mount Sinai
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai
| | - Cristiane S. Duarte
- Columbia University Irving Medical Center
- Department of Psychiatry, Columbia University
| | - Amy E. Margolis
- Columbia University Irving Medical Center
- Department of Psychiatry, Columbia University
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13
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Wiley KS, Fox MM, Gildner TE, Thayer ZM. A longitudinal study of how women's prenatal and postnatal concerns related to the COVID-19 pandemic predicts their infants' social-emotional development. Child Dev 2023; 94:1356-1367. [PMID: 37068183 PMCID: PMC10524379 DOI: 10.1111/cdev.13934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 01/19/2023] [Accepted: 02/23/2023] [Indexed: 04/19/2023]
Abstract
Infant social-emotional development may be impacted by the COVID-19 pandemic. This study investigated associations between maternal pre- and postnatal pandemic-related concerns and social-emotional developmental risk. Data, collected in 2020-2021, came from 220 mothers (87% white, 6% Hispanic, 1% Black, 3% Asian, 1% American Indian, Mage = 32.46 years), and infants (53.18% male, Mage = 12.98 months) in the United States. Maternal postnatal pandemic-related concerns were associated with total risk scores (B = 6.09, p-value <.001) and offspring risk of scoring positive for problems related to inflexibility (B = 4.07, p-value = .006). The total score association was moderated by self-reported social support. Infants may be detrimentally impacted by the pandemic via maternal pandemic-related concerns. Maternal social support may buffer infants.
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Affiliation(s)
- Kyle S. Wiley
- Department of Anthropology, University of California, Los
Angeles, Los Angeles, California, USA
| | - Molly M. Fox
- Department of Anthropology, University of California, Los
Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, Los Angeles, California, USA
| | - Theresa E. Gildner
- Department of Anthropology, Washington University in St.
Louis, St. Louis, Missouri, USA
| | - Zaneta M. Thayer
- Department of Anthropology, Dartmouth College, Hanover, New
Hampshire, USA
- Ecology, Evolution, Environment & Society Program,
Dartmouth College, Hanover, New Hampshire, USA
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14
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Wagner E, Bień K, Łomża A, Grunwald A, Kimber-Trojnar Ż, Libera A, Leszczyńska-Gorzelak B. Stress of Prematurity in the Experience of the COVID-19 Pandemic-Current State of Knowledge. Life (Basel) 2023; 13:1757. [PMID: 37629614 PMCID: PMC10455823 DOI: 10.3390/life13081757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/10/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Stress is a process that triggers various physiological, hormonal and psychological mechanisms in response to a threat, which significantly affects the health of an individual. The COVID-19 pandemic introduced a lot of social changes that required constant adaptation to unfavorable conditions. The aim of the study was to assess the impact of stress related to this pandemic on pregnant women, mothers of premature infants and their families, and on obstetric complications, particularly preterm birth. A comprehensive literature review was performed using electronic databases such as Pubmed, Science Direct and Google Scholar. Keywords such as: "prematurity"; "pregnancy"; "stress"; "COVID-19" and various combinations of the above were used. Maternal stress and anxiety increase the levels of corticotropin-releasing hormone (CRH) in the placenta, which in turn affects the incidence of preterm birth and many other related maternal and neonatal complications. In addition, it was found that SARS-CoV-2 infection may increase the risk of this phenomenon. The COVID-19 pandemic has adversely affected preterm birth rates and the mental health of mothers of preterm infants, exacerbating their negative experience of having a premature baby. More research is needed to demonstrate the long-term effects of COVID-19 stress on prematurity.
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Affiliation(s)
| | | | | | | | - Żaneta Kimber-Trojnar
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, 20-090 Lublin, Poland; (E.W.); (K.B.); (A.Ł.); (A.G.); (A.L.); (B.L.-G.)
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15
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Khoury JE, Jambon M, Giles L, Atkinson L, Gonzalez A. Trajectories of distress from pregnancy to 15-months post-partum during the COVID-19 pandemic. Front Psychol 2023; 14:1104386. [PMID: 37063573 PMCID: PMC10102331 DOI: 10.3389/fpsyg.2023.1104386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/15/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundThe COVID-19 pandemic has particularly burdened pregnant and postpartum women. It remains unclear how distress levels of pregnant and postpartum people have changed (or persisted) as the pandemic continues on and which factors may contribute to these trajectories of distress.MethodsThis longitudinal study included 304 pregnant people, who were followed during pregnancy, 6-weeks, 6-months and 15-months postpartum. At each time point, a latent “distress” factor was estimated using self-reported depressive symptoms, anxiety symptoms, and stress. Reported negative impact of COVID-19 and social support were assessed during pregnancy as risk and protective factors related to distress. Second-order latent growth curve modeling with a piecewise growth function was used to estimate initial levels and changes in distress over time.ResultsMean distress was relatively stable from the pregnancy to 6-weeks postpartum and then declined from 6-weeks to 15-months postpartum. Higher education, greater social support, and lower negative impact of COVID-19 were associated with a lower distress during pregnancy. Unexpectedly, negative impact of COVID-19 was associated with a faster decrease in distress and more social support was associated with a greater increase in distress from pregnancy to 6-weeks postpartum. However, these effects became non-significant after controlling for distress during pregnancy.ConclusionFindings indicate high but declining levels of distress from pregnancy to the postpartum period. Changes in distress are related to social support and the negative impact of the pandemic in pregnancy. Findings highlight the continued impact of COVID-19 on perinatal mental health and the need for support to limit the burden of this pandemic on pregnant people and families.
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Affiliation(s)
- Jennifer E. Khoury
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
- *Correspondence: Jennifer E. Khoury,
| | - Marc Jambon
- Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Lauren Giles
- Department of Psychology, Mount Saint Vincent University, Halifax, NS, Canada
| | - Leslie Atkinson
- Department of Psychology, Metropolitan Toronto University, Toronto ON, Canada
| | - Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Offord Centre for Child Studies, McMaster University, Hamilton, ON, Canada
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16
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Developmental screening of full-term infants at 16 to 18 months of age after in-utero exposure to maternal SARS-CoV-2 infection. J Perinatol 2023; 43:659-663. [PMID: 36932135 PMCID: PMC10020764 DOI: 10.1038/s41372-023-01642-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 02/07/2023] [Accepted: 02/24/2023] [Indexed: 03/18/2023]
Abstract
OBJECTIVE To screen for neurodevelopmental delays in a cohort of full-term infants born to mothers with SARS-CoV-2. STUDY DESIGN This was a prospective, descriptive cohort study of full-term infants born to mothers with SARS-CoV-2 during pregnancy. Subjects underwent neurodevelopmental screening using the Ages and Stages Questionnaires®-Third Edition (ASQ®-3) at 16 to 18 months age. RESULTS Of 51 subjects, twelve (24%) were below cutoff, and twenty-seven (53%) were either below or close to the cutoff in at least one developmental domain. Communication (29%), fine motor (31%), and problem-solving (24%) were the most affected domains. There were no differences in outcomes between infants born to asymptomatic and mildly symptomatic mothers. CONCLUSION We observed increased risk of neurodevelopmental delays during screening of infants born at full-term to mothers with SARS-CoV-2 at 16 to 18 months age. These results highlight the urgent need for follow-up studies of infants born to mothers with SARS-CoV-2.
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17
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Delanerolle G, McCauley M, Hirsch M, Zeng Y, Cong X, Cavalini H, Sajid S, Shetty A, Rathod S, Shi JQ, Hapangama DK, Phiri P. The prevalence of mental ill-health in women during pregnancy and after childbirth during the Covid-19 pandemic: a systematic review and Meta-analysis. BMC Pregnancy Childbirth 2023; 23:76. [PMID: 36709255 PMCID: PMC9883834 DOI: 10.1186/s12884-022-05243-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 11/24/2022] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND This systematic review aims to explore the prevalence of the impact of the COVID-19, MERS, and SARS pandemics on the mental health of pregnant women. METHODS All COVID-19, SARS and MERS studies that evaluated the mental health of pregnant women with/without gynaecological conditions that were reported in English between December 2000 - July 2021 were included. The search criteria were developed based upon the research question using PubMed, Science Direct, Ovid PsycINFO and EMBASE databases. A wide search criterion was used to ensure the inclusion of all pregnant women with existing gynaecological conditions. The Newcastle-Ottawa-Scale was used to assess the risk of bias for all included studies. Random effects model with restricted maximum-likelihood estimation method was applied for the meta-analysis and I-square statistic was used to evaluate heterogeneity across studies. The pooled prevalence rates of symptoms of anxiety, depression, PTSD, stress, and sleep disorders with 95% confidence interval (CI) were computed. RESULTS This systematic review identified 217 studies which included 638,889 pregnant women or women who had just given birth. There were no studies reporting the mental health impact due to MERS and SARS. Results showed that women who were pregnant or had just given birth displayed various symptoms of poor mental health including those relating to depression (24.9%), anxiety (32.8%), stress (29.44%), Post Traumatic Stress Disorder (PTSD) (27.93%), and sleep disorders (24.38%) during the COVID-19 pandemic. DISCUSSION It is important to note that studies included in this review used a range of outcome measures which does not allow for direct comparisons between findings. Most studies reported self-reported measure of symptoms without clinical diagnoses so conclusions can be made for symptom prevalence rather than of mental illness. The importance of managing mental health during pregnancy and after-delivery improves the quality of life and wellbeing of mothers hence developing an evidence-based approached as part of pandemic preparedness would improve mental health during challenging times. OTHER The work presented in this manuscript was not funded by any specific grants. A study protocol was developed and published in PROSPERO (CRD42021235356) to explore several key objectives.
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Affiliation(s)
- Gayathri Delanerolle
- Nuffield Department of Primary Health Care Sciences, Uuniversity of Oxford, Oxford, UK
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Mary McCauley
- Liverpool Women's NHS Foundation Trust, Liverpool, UK
| | - Martin Hirsch
- University College London, London, UK
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Yutian Zeng
- Southern University of Science and Technology, Shenzhen, China
| | - Xu Cong
- Southern University of Science and Technology, Shenzhen, China
| | - Heitor Cavalini
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Sana Sajid
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Ashish Shetty
- University College London, London, UK
- University College London Hospitals NHS Foundation Trust, London, UK
| | - Shanaya Rathod
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK
| | - Jian Qing Shi
- Southern University of Science and Technology, Shenzhen, China
- National Center for Applied Mathematics, Shenzhen, China
| | | | - Peter Phiri
- Southern Health NHS Foundation Trust, Research and Innovation Department, Clinical Trials Facility, Tom Rudd Unit Moorgreen Hospital, Botley Road, West End, Southampton, SO30 3JB, UK.
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
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18
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Galanis P, Vraka I, Katsiroumpa A, Siskou O, Konstantakopoulou O, Zogaki E, Kaitelidou D. Psychosocial Predictors of COVID-19 Vaccine Uptake among Pregnant Women: A Cross-Sectional Study in Greece. Vaccines (Basel) 2023; 11:269. [PMID: 36851147 PMCID: PMC9967309 DOI: 10.3390/vaccines11020269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 01/28/2023] Open
Abstract
An understanding of the factors associated with the COVID-19 vaccine uptake in pregnant women is paramount to persuade women to get vaccinated against COVID-19. We estimated the vaccination rate of pregnant women against COVID-19 and evaluated psychosocial factors associated with vaccine uptake among them. We conducted a cross-sectional study with a convenience sample. In particular, we investigated socio-demographic data of pregnant women (e.g., age, marital status, and educational level), COVID-19 related variables (e.g., previous COVID-19 diagnosis and worry about the side effects of COVID-19 vaccines), and stress due to COVID-19 (e.g., danger and contamination fears, fears about economic consequences, xenophobia, compulsive checking and reassurance seeking, and traumatic stress symptoms about COVID-19) as possible predictors of COVID-19 vaccine uptake. Among pregnant women, 58.6% had received a COVID-19 vaccine. The most important reasons that pregnant women were not vaccinated were doubts about the safety and effectiveness of the COVID-19 vaccines (31.4%), fear that COVID-19 vaccines could be harmful to the fetus (29.4%), and fear of adverse side effects of COVID-19 vaccines (29.4%). Increased danger and contamination fears, increased fears about economic consequences, and higher levels of trust in COVID-19 vaccines were related with vaccine uptake. On the other hand, increased compulsive checking and reassurance seeking and increased worry about the adverse side effects of COVID-19 vaccines reduced the likelihood of pregnant women being vaccinated. An understanding of the psychosocial factors associated with increased COVID-19 vaccine uptake in pregnant women could be helpful for policy makers and healthcare professionals in their efforts to persuade women to get vaccinated against COVID-19. There is a need for targeted educational campaigns to increase knowledge about COVID-19 vaccines and reduce vaccine hesitancy in pregnancy.
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Affiliation(s)
- Petros Galanis
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Irene Vraka
- Department of Radiology, P. & A. Kyriakou Children’s Hospital, 11527 Athens, Greece
| | - Aglaia Katsiroumpa
- Clinical Epidemiology Laboratory, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Olga Siskou
- Department of Tourism Studies, University of Piraeus, 18534 Piraeus, Greece
| | - Olympia Konstantakopoulou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Eleftheria Zogaki
- Faculty of Midwifery, University of West Attica, West Attica, 12243 Aigaleo, Greece
| | - Daphne Kaitelidou
- Center for Health Services Management and Evaluation, Faculty of Nursing, National and Kapodistrian University of Athens, 11527 Athens, Greece
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19
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Somerville K, Rowell T, Stadulis R, Bell D, Neal-Barnett A. An evaluation of the feasibility and acceptability of sister circles as an anxiety intervention for pregnant Black women. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231185405. [PMID: 37480300 PMCID: PMC10363880 DOI: 10.1177/17455057231185405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 05/10/2023] [Accepted: 06/14/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Black women and their infants face heightened health risks during pregnancy, labor, and delivery that, for many, cost them their lives. Such health risks during this critical period are linked to increased rates of anxiety among Black pregnant and postpartum women. Black women also endure racism when seeking support from mental health and healthcare providers, which further contributes to pregnancy and postpartum-related anxiety. Evidence on sister circles has demonstrated that this indigenous form of healing may provide Black pregnant and postpartum women with the support and skills needed to cope with stressors associated with mental and physical health concerns and racism. OBJECTIVE Our study aimed to evaluate the feasibility and acceptability of the Birthing Beautiful Babies Sisters Offering Support, a sister circle cognitive behavioral therapy-based stress and anxiety intervention for Black pregnant and postpartum women. DESIGN Our study employed a mixed-methods framework. METHODS Descriptive analyses, paired samples t-test, and open and selective coding were conducted. We utilized the following measures: Penn State Worry Questionnaire-Abbreviated, Kessler Psychological Distress Scale, Pregnancy-Related Anxiety Scale, focus booklet, and focus group discussion. RESULTS Participants reported experiencing moderate levels of worry and distress and low levels of pregnancy-related anxiety prior to the start of the Birthing Beautiful Babies Sisters Offering Support intervention. Eighty women participated in Birthing Beautiful Babies Sisters Offering Support. Eleven focus groups were conducted to assess their experience. Participants reported a perceived increase in their knowledge about panic attacks and stress and ability to manage stressors effectively. They found that all completed activities contributed to their development and application of skills. They reported they enjoyed Birthing Beautiful Babies Sisters Offering Support because of the supportive environment, openness, and emphasis on sisterhood. Participants provided helpful feedback about the structure and flow of the intervention. CONCLUSION Limitations of the present study and future directions are discussed.
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Affiliation(s)
| | | | | | - Debra Bell
- Birthing Beautiful Communities, Cleveland, OH, USA
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20
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Does the COVID-19 Pandemic Affect Labor-Related Anxiety and Prevalence of Depressive Symptoms in Pregnant Women? J Clin Med 2022; 11:jcm11216522. [DOI: 10.3390/jcm11216522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 10/23/2022] [Accepted: 11/02/2022] [Indexed: 11/06/2022] Open
Abstract
The COVID-19 pandemic undoubtedly had significant effects on women’s health and the course of pregnancy. The aim of this single-center study was to explore the impact of the COVID-19 pandemic on adult pregnant and postpartum women’s mental health, as well as to identify factors associated with depressive symptoms, anxiety and fear of delivery. The 465 women included in this questionnaire-based cohort study were divided into two groups: one (controls) of women who gave birth before (n = 190), and the second who were pregnant and delivered during the pandemic (n = 275). The COVID-19 pandemic affected the severity of self-reported anxiety regarding childbirth (mean scores 2.7 vs. 2.36, p = 0.01). The depression (19.84 ± 13.23) and anxiety (16.71 ± 12.53) scores were higher in pregnant women during the COVID 19 pandemic, compared to women who gave birth before the pandemic (8.21 ± 7.38 and 11.67 ± 9.23, respectively). These findings demonstrate the magnitude of the pandemic’s impact on women’s mental health, and actions to improve the mental health of pregnant women in Poland may be crucial for maternal and fetal well-being.
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21
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Depression in pregnant and postpartum women during COVID-19 pandemic: systematic review and meta-analysis. Obstet Gynecol Sci 2022; 65:287-302. [PMID: 35754363 PMCID: PMC9304439 DOI: 10.5468/ogs.21265] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 05/19/2022] [Indexed: 11/08/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) emerged as a global pandemic in March 2020 and caused a big crisis, especially the health crisis. Pregnant and postpartum women experienced significant physical, social, and mental changes that put them at higher risk for several conditions during the pandemic. This study aimed to report the prevalence of depression in pregnant and postpartum women during the COVID-19 pandemic. Eligible studies were identified using several databases. Prevalence analysis was conducted using MedCalc ver. 19.5.1. This systematic review and meta-analysis was registered in PROSPERO on July 12, 2021 with registration number CRD42021266976. We included 54 studies with 95.326 participants. The overall prevalence of depression was 32.60% among pregnant and postpartum women during the COVID-19 pandemic. The rate was higher among pregnant women (31.49%) compared to postpartum women (27.64%). The prevalence of depression among pregnant and postpartum women increased during the COVID-19 pandemic.
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22
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Clifton VL, Kumar S, Borg D, Rae KM, Boyd RN, Whittingham K, Moritz KM, Carter HE, McPhail SM, Gannon B, Ware R, Dixson BJW, Bora S, Hurst C. Associations between COVID-19 lockdown and post-lockdown on the mental health of pregnant women, postpartum women and their partners from the Queensland family cohort prospective study. BMC Pregnancy Childbirth 2022; 22:468. [PMID: 35659202 PMCID: PMC9166205 DOI: 10.1186/s12884-022-04795-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 05/27/2022] [Indexed: 12/12/2022] Open
Abstract
Background There are very few developed countries where physical isolation and low community transmission has been reported for COVID-19 but this has been the experience of Australia. The impact of physical isolation combined with low disease transmission on the mental health of pregnant women is currently unknown and there have been no studies examining the psychological experience for partners of pregnant women during lockdown. The aim of the current study was to examine the impact of the first COVID-19 lockdown in March 2020 and post lockdown from August 2020 on the mental health of pregnant women or postpartum women and their partners. Methods Pregnant women and their partners were prospectively recruited to the study before 24 weeks gestation and completed various questionnaires related to mental health and general wellbeing at 24 weeks gestation and then again at 6 weeks postpartum. The Depression, Anxiety and Stress Scale (DASS-21) and the Edinburgh Postnatal Depression Scale (EPDS) were used as outcome measures for the assessment of mental health in women and DASS-21 was administered to their partners. This analysis encompasses 3 time points where families were recruited; before the pandemic (Aug 2018-Feb 2020), during lockdown (Mar-Aug 2020) and after the first lockdown was over (Sept-Dec 2020). Results There was no significant effect of COVID-19 lockdown and post lockdown on depression or postnatal depression in women when compared to a pre-COVID-19 subgroup. The odds of pregnant women or postpartum women experiencing severe anxiety was more than halved in women during lockdown relative to women in the pre-COVID-19 period (OR = 0.47; 95%CI: 0.27–0.81; P = 0.006). Following lockdown severe anxiety was comparable to the pre-COVID-19 women. Lockdown did not have any substantial effects on stress scores for pregnant and postpartum women. However, a substantial decrease of over 70% in the odds of severe stress was observed post-lockdown relative to pre-COVID-19 levels. Partner’s depression, anxiety and stress did not change significantly with lockdown or post lockdown. Conclusion A reproductive age population appear to be able to manage the impact of lockdown and the pandemic with some benefits related to reduced anxiety. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-022-04795-9.
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Affiliation(s)
- Vicki L Clifton
- Mater Research Institute, The University of Queensland, Raymond Terrace, Level 3, Aubigny Place, South Brisbane, QLD, 4101, Australia.
| | - Sailesh Kumar
- Mater Research Institute, The University of Queensland, Raymond Terrace, Level 3, Aubigny Place, South Brisbane, QLD, 4101, Australia
| | - Danielle Borg
- Mater Research Institute, The University of Queensland, Raymond Terrace, Level 3, Aubigny Place, South Brisbane, QLD, 4101, Australia
| | - Kym M Rae
- Mater Research Institute, The University of Queensland, Raymond Terrace, Level 3, Aubigny Place, South Brisbane, QLD, 4101, Australia.,Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - Roslyn N Boyd
- Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Koa Whittingham
- Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Research Centre, Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Karen M Moritz
- School of Biomedical Sciences, the Child Health Research Centre, The University of Queensland, Brisbane, Australia
| | - Hannah E Carter
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.,Clinical Informatics Directorate, Metro South Health, Brisbane, Australia
| | - Steven M McPhail
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia.,Clinical Informatics Directorate, Metro South Health, Brisbane, Australia
| | - Brenda Gannon
- Centre for the Business and Economics of Health and School of Economics, The University of Queensland, Brisbane, Australia
| | - Robert Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Barnaby J W Dixson
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Queensland, Australia.,School of Psychology, The University of Queensland, Queensland, Australia
| | - Samudragupta Bora
- Mater Research Institute, The University of Queensland, Raymond Terrace, Level 3, Aubigny Place, South Brisbane, QLD, 4101, Australia
| | - Cameron Hurst
- Molly Wardaguga Research Centre, Charles Darwin University, Queensland, Australia
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23
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Perinatal Depression in Australian Women during the COVID-19 Pandemic: The Birth in the Time of COVID-19 (BITTOC) Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095062. [PMID: 35564456 PMCID: PMC9103175 DOI: 10.3390/ijerph19095062] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/08/2022] [Accepted: 04/09/2022] [Indexed: 02/01/2023]
Abstract
The COVID-19 pandemic has impacted perinatal mental health globally. We determined the maternal factors and pandemic-related experiences associated with clinically significant perinatal (pregnant and post-partum) depressive symptoms in Australian women. Participants (n = 2638; pregnant n = 1219, postnatal n = 1419) completed an online survey (August 2020 through February 2021) and self-reported on depression, social support, and COVID-19 related experiences. We found elevated depressive symptoms amongst 26.5% (pregnant) and 19% (postnatal) women. Multiple logistic regression analyses showed higher likelihood of elevated depression associated with residence in Victoria, lower education, past/current mental health problems, greater non-pandemic prenatal stress, age ≥ 35 years (pregnant women) and existing physical health issues or disability in self or others (postnatal women). Greater family stress/discord and lower social support (friends) was associated with higher odds of elevated perinatal depression, while lower social support (family) was significantly associated with elevated depressive symptoms in pregnant women. Greater depression was associated with social distancing, pandemic-related news exposure and changes to prenatal care (pregnant women). Single postnatal women showed lower odds of elevated depression than partnered women. Our findings underscore the importance of universal screening for depression and targeted support during a pandemic for perinatal women displaying vulnerability factors.
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24
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Ghassabian A, Jacobson MH, Kahn LG, Brubaker SG, Mehta-Lee SS, Trasande L. Maternal Perceived Stress During the COVID-19 Pandemic: Pre-Existing Risk Factors and Concurrent Correlates in New York City Women. Int J Public Health 2022; 67:1604497. [PMID: 35479764 PMCID: PMC9035490 DOI: 10.3389/ijph.2022.1604497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
Objective: We examined whether pre-pandemic mental health and sociodemographic characteristics increased the susceptibility of pregnant women and mothers of young children to stress in the early months of the COVID-19 pandemic. Methods: Between April and August 2020, we surveyed 1560 women participating in a sociodemographically diverse birth cohort in New York City. Women reported their perceived stress, resiliency, and financial, familial/societal, and health-related concerns. We extracted pre-pandemic information from questionnaires and electronic health records. Results: Pre-pandemic history of depression, current financial difficulties, and COVID-19 infection were the main risk factors associated with high perceived stress. Being Hispanic and having higher resiliency scores and preexisting social support were protective against high perceived stress. Major contributors to current perceived stress were financial and familial/societal factors related to the COVID-19 pandemic. Among pregnant women, changes to prenatal care were common, as were changes to experiences following birth among postpartum women and difficulties in arranging childcare among mothers of young children. Conclusion: Our findings suggest that major risk factors of higher stress during the pandemic were similar to those of other major traumatic events.
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Affiliation(s)
- Akhgar Ghassabian
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, United States
- *Correspondence: Akhgar Ghassabian,
| | - Melanie H. Jacobson
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States
| | - Linda G. Kahn
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Sara G. Brubaker
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, United States
| | - Shilpi S. Mehta-Lee
- Department of Obstetrics and Gynecology, New York University Grossman School of Medicine, New York, NY, United States
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, United States
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
- Department of Environmental Medicine, New York University Grossman School of Medicine, New York, NY, United States
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25
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Melatonin: From Neurobiology to Treatment. Brain Sci 2021; 11:brainsci11091121. [PMID: 34573143 PMCID: PMC8468230 DOI: 10.3390/brainsci11091121] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 08/12/2021] [Accepted: 08/23/2021] [Indexed: 01/12/2023] Open
Abstract
Melatonin, the major regulator of the sleep/wake cycle, also plays important physiological and pharmacological roles in the control of neuronal plasticity and neuroprotection. Accordingly, the secretion of this hormone reaches the maximal extent during brain development (childhood-adolescence) while it is greatly reduced during aging, a condition associated to altered sleep pattern and reduced neuronal plasticity. Altogether, these properties of melatonin have allowed us to demonstrate in both experimental models and clinical studies the great chronobiotic efficacy and sleep promoting effects of exogenous melatonin. Thus, the prolonged release formulation of melatonin, present as a drug in the pharmaceutical market, has been recently recommended for the treatment of insomnia in over 55 years old subjects.
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