The impact of Covid-19 restrictions on depressive symptoms in low-risk and high-risk pregnant women: a cross-sectional study before and during pandemic

The association of COVID-19 lockdowns with adverse birth and pregnancy outcomes in 28 high-income countries: a systematic review and meta-analysis

We conducted a systematic review and meta-analysis to review the association of lockdowns with adverse birth and pregnancy outcomes (ABPOs) and related inequalities, in high-income countries (HICs). Databases (EMBASE, MEDLINE/PubMed and Web of Science) were searched from 1 January 2019 to 22 June 2023 for original observational studies based in HICs that compared the rates of ABPOs, before and during lockdowns. The risk of bias was assessed using the Newcastle-Ottawa tool for cohort studies. We ran random-effects meta-analyses and subgroup analyses per region, lockdown period, ethnicity group and deprivation level and adjusted for underlying temporal trends. A total of 132 studies were meta-analysed from 28 HICs. Reduced rates of preterm birth (reported by 26 studies) were associated with the first lockdown (relative risk 0.96, 95% confidence interval 0.93-0.99), 11 studies adjusted for long-term trends and the association remained (0.97, 0.95-0.99), and subgroup analysis found that this association varied by continental region. Ten studies reported positive screening rates for possible depression antenatally, and lockdown was associated with increases in positive screening rates (1.37, 1.06-1.78). No other ABPOs were associated with lockdowns. Investigation of inequalities was limited due to data availability and heterogeneity; further research is warranted on the effect of lockdowns on health inequalities. This study was funded by the National Institute of Health Research, School of Primary Care Research and registered on PROSPERO (CRD42022327448).

[Mental Health of Women After Childbirth: Inpatient Family Rooms as a Resource? A Pilot Study]

Social support is a key factor in mental health. Obstetric wards can promote social support by providing family rooms. Family rooms are not yet universally accessible. Studies on their influence on the maternal psyche are also lacking. The present study examines the mental health of women with and without accommodation in a family room on an obstetric ward.113 patients filled in standardized scales on anxiety, depression, psychological well-being and post-traumatic stress symptoms 1-3 days postpartum. In addition, obstetric data of birth mode, pregnancy and birth complications were collected. Recruitment during strict pandemic visiting restrictions made it possible to compare women in the family room (constant presence of the partner) and women without a family room (without any visits).In the overall sample, anxiety (22.6%) and lack of psychological well-being (33.6%) were particularly evident. The two groups did not differ in terms of mental health, but women with birth complications and an unplanned birth mode in the family room had significantly lower anxiety scores than women without a family room.Women with birth complications exhibited higher post-traumatic stress symptoms overall. Additionally, women in the family room were significantly more often primipara, they more often had an unplanned birth mode and they differed in the frequency of their birth complications.This study provides first evidence for a psychoprotective influence of family rooms on anxiety in patients with previous complications and unplanned birth modes. A discussion on promoting family rooms, especially for patients with peripartal complications, appears necessary. Further studies on the effectiveness of family rooms are required.

Tracking pregnant women's mental health through social media: an analysis of reddit posts

Objectives

Present an artificial intelligence-enabled pipeline for estimating the prevalence of depression and general anxiety among pregnant women using texts from their social media posts. Use said pipeline to analyze mental health trends on subreddits frequented by pregnant women and report on interesting insights that could be helpful for policy-makers, clinicians, etc.

Materials and methods

We used pretrained transformer-based models to build a natural language processing pipeline that can automatically detect depressed pregnant women on social media and carry out topic modeling to detect their concerns.

Results

We detected depressed posts by pregnant women on Reddit and validated the performance of the depression classification model by carrying out topic modeling to reveal that depressive topics were detected. The proportion of potentially depressed surprisingly reduced during the pandemic (2020 and 2021). Queries related to antidepressants, such as Zoloft, and potential ways of managing mental health dominated discourse before the pandemic (2018 and 2019), whereas queries about pelvic pain and associated stress dominated the discourse during the pandemic.

Discussion and Conclusion

Supportive online communities could be a factor in alleviating stress related to the pandemic, hence the reduction in the proportion of depressed users during the pandemic. Stress during the pandemic has been associated with pelvic pain among pregnant women, and this trend is confirmed through topic modeling of depressive posts during the pandemic.

The Emotional Landscape of Pregnancy and Postpartum during the COVID-19 Pandemic in Italy: A Mixed-Method Analysis Using Artificial Intelligence

The COVID-19 pandemic affected the perinatal emotional landscape in Italy, a country that had high mortality and implemented a strict lockdown during the pandemic. This study explores the emotions and challenges of pregnant and postpartum women during the pandemic, using AI-based mixed methods. The study analyzed 1774 women from the national survey COVID-ASSESS: 1136 pregnant and 638 postpartum women. The survey had qualitative questions on emotions and feelings related to birth, communication with healthcare professionals, media, and peers and family. We used natural language processing and machine learning to classify emotions, identify themes, and extract citations from the data. Fear and anxiety replaced joy as dominant emotions during the pandemic: trust and joy decreased by 49.3% and 36.4%, respectively, while sadness and fear increased by 52.3% and 49.3%, respectively. The pandemic also induced loneliness, isolation, frustration, and anger. Women faced challenges related to birth, communication with HCPs, media, and peers and family. They also used coping strategies such as self-care, news limitation, and trying to cultivate gratitude and hope. This study provides a comprehensive exploration of the perinatal emotional landscape of Italian women during the pandemic. The findings underscore the significant psychological impact of the pandemic and also highlight women's resilience and coping strategies.

Contextualizing the experiences of Black pregnant women during the COVID-19 pandemic: 'It's been a lonely ride'

The emergence of the COVID-19 pandemic significantly changed the prenatal care experience, specifically regarding medical appointments and social opportunities. It is critical to capture this change through the narratives of pregnant people, particularly those of marginalized populations, whose voices may often be underrepresented in the literature. This mixed-methods paper summarizes the experiences of 40 pregnant Black/African American (AA) women during the COVID-19 pandemic. A cross-sectional, online survey was administered between 2020 and 2021 to assess prenatal health and the impacts of the COVID-19 pandemic on patients' pregnancy experience. Coping behaviors during the pandemic were self-reported using the COPE-IS. Univariate analyses were conducted. An additional analysis of participants (n = 4) was explored through a week-long qualitative exercise using a photo documentation procedure. Photo-Elicitation Interviews (PEI) were conducted to capture and center their pandemic pregnancy experiences. Sources of stress during the pandemic varied, with the most common being financial concerns (n = 19, 47.5%). Over half of the sample (n = 18, 54.5%) self-reported increases in their positive coping behaviors during the pandemic, such as communicating with friends and family, talking to healthcare providers, listening to music, and engaging in spiritual practices-such as prayer. The four PEI study participants reflected on the impacts of social distancing on their prenatal experience and mentioned hospital and provider-related weariness due to their race. The findings of this study suggest that during the COVID-19 pandemic, Black/AA pregnant women in Charlotte, NC used social support, mindfulness practices, self-advocacy, and health literacy to navigate challenges present during their prenatal health experience. This paper highlights the personal, social, and structural experiences of pregnant women during a public health crisis so that responsive and effective programs or policies can be planned in the future.

Do prenatal depressive symptoms developed by hospitalized women with high-risk pregnancy persist to post-partum?

This study aims to explore the level of depressive symptoms during pregnancy and after childbirth comparing women hospitalized due to high-risk pregnancy (clinical group) and women with low-risk pregnancy (control group). Seventy pregnant women (26 clinical group and 44 control group) filled in the Edinburgh Postnatal Depression Scale both during pregnancy and three months after childbirth. Results showed that the clinical group reported significant higher levels of prenatal depression than the control group, while no differences were found on postnatal depression. Data highlighted that hospitalization could represents a significant stressor that can exacerbate depression in women with high-risk pregnancy.

Prenatal Mental Representations in Italian First-Time Mothers Before and During the COVID-19 Pandemic: A Study with Interviews on Maternal Representations During Pregnancy

INTRODUCTION

Psychosocial risks increase the levels of not-integrated/ambivalent and restricted/disengaged representations during pregnancy, but no study has specifically analysed the impact of the COVID-19 pandemic on maternal representation styles.

OBJECTIVES

(1) to compare maternal representation styles in primiparous women who became pregnant before and during the COVID-19 pandemic and (2) to analyse the content of representation styles during the COVID-19 pandemic.

METHODS

A total of 37 Italian pregnant women were recruited from 2019 to 2021. The sample was divided into two groups: the pre-COVID-19 group (22 women, mean age = 33.14 years; SD = 3.78) and the COVID-19 group (15 women, mean age = 35.9 years; SD = 4.6). Interviews on maternal representations during pregnancy were administered and analysed for style and content.

RESULTS

Women during the COVID-19 pandemic reported more restricted/disengaged and less integrated/balanced representation styles than women pre-COVID-19. Content analysis showed that the COVID-19 pandemic led women to focus more on concrete aspects of pregnancy in lieu of emotional aspects, thus leading them to develop more restricted/disengaged representation styles.

CONCLUSIONS FOR PRACTICE

In future pandemics pregnant women should be supported in focusing their attention to emotions, sensations and fantasies about themselves as mothers and their children.