Effect of the Covid 19 pandemic on depression and mother-infant bonding in uninfected postpartum women in a rural region

Comparison of the prevalence of probably postpartum depression before and during the covid-19 pandemic in Turkey: a systematic review and meta-analysis

PURPOSE

To determine the prevalence of probably postpartum depression and the effect of COVID-19 pandemic on the prevalence of probably postpartum depression based on the results of the studies in Turkey.

METHODS

Systematic review and meta-analysis of cross-sectional studies. The key words postpartum depression or postnatal depression and Turkey were searched in the electronic databases of PubMed, EbscoHost, OVID Journals, Science Direct, Web of Science, ULAKBIM Databases, DergiPARK, TR Dizin, YÖK-Natural Thesis Centre. The systematic review was performed by following PRISMA and COSMOS-E. Data were collected by using a data extraction tool developed by the researchers. The quality of the studies was evaluated by utilizing The Joanna Briggs Institute's Critical Appraisal Checklist for Analytical Cross Sectional Studies. Obtained data were synthesized with meta-analysis, narrative synthesis, subgroup analysis and meta-regression.

RESULTS

The total sample size of 34 studies included in this meta-analysis was 10 236. The cut-off score for the EPDS was considered as ≥ 13 in 30 studies and ≥ 12 in four studies. The pooled probably postpartum depression prevalence was 17.8% (95% CI: 0.153-0.206; 95% Prediction Interval: 0.070-0.383). It was found to be 16.3% before the pandemic (95% CI: 0.065-0.358; 95% Prediction Interval: 0.065-0.358) and increased to 20.2% during the pandemic (95% CI: 0.068-0.468; 95% Prediction Interval: 0.068-0.468), though the difference was not significant (Q = 1.77; df: 1; p = 0.184). The meta-regression analysis showed that the prevalence of probably postpartum depression did not change depending on the geographical region where the studies were performed, the time of data collection and the cut-off point of the EPDS. However, the studies reported many factors related to women, their infants and families that affected the prevalence of probably postpartum depression.

OUTCOMES

This meta-analysis revealed that the prevalence of probably postpartum depression was very high, increased during the pandemic and was affected by many risk factors. It may be recommended that healthcare professionals take protective and improving measures for the mental health of women at high risk during the perinatal period and provide early diagnosis, treatment, monitoring and care services.

The effect of COVID-19 during pregnancy on postpartum depression and mother-infant attachment

BACKGROUND

The psychiatric impacts of the COVID-19 pandemic are well-documented; however, its effects during the postnatal period have been less explored.

AIMS

We aimed to investigate the effect of COVID-19 on mother-infant attachment and postnatal depression in pregnant women during the pandemic.

METHODS

The study group consisted of women with the diagnosis of 'pregnancy and COVID-19' after the 20th gestational week (n = 55). The control group included women who did not have a history of COVID-19 in their pregnancy or until the study date (n = 52). Edinburgh Postpartum Depression Scale (EPDS) and Postpartum Attachment Scale (PPAS) were administered to the participants. COVID-19 patients were grouped according to the WHO classification.

RESULTS

The mean EPDS score was higher in the study group than in the control group (9.55 (7.17) vs. 6.65 (6.72) (P = 0.006)). There was no difference between the groups in the number of individuals with depression (EPDS score > 13) and PPAS factors. The mean EPDS score was found to be higher in the hospitalized group (P = 0.025). The mean EPDS score in the group with moderate or severe disease was higher than mild disease group (16 (8.49) vs. 8.67 (6.57) (P = 0.039)), there was no difference in terms of PPAS.

CONCLUSION

While the presence of COVID-19 during pregnancy has been associated with elevated postpartum depression scores in pandemic pregnant women, hospitalization of women who had COVID-19 during pregnancy and had at least one family member with moderate or more severe illness resulted in higher depression scores. The presence of COVID-19 during pregnancy does not affect mother-infant attachment. It is recommended that women with a history of COVID-19 during pregnancy be evaluated more carefully for postpartum depression.

Depression in the time of COVID-19: Examination of prenatal and postpartum depression, rurality, and the impact of COVID-19

BACKGROUND

To determine the impact of the COVID-19 pandemic on prenatal and postpartum depressive symptoms in rural versus urban populations.

METHODS

A retrospective cohort study was conducted among 24,227 cisgender women who gave birth from 2010 to 2021 at an academic medical center located in a rural midwestern state. Exclusion criteria were <18 years old, incarcerated, or without a documented zip code. The Patient Health Questionnaire-9 (PHQ-9) was administered during pregnancy and the Edinburgh Postnatal Depression Scale (EPDS) during postpartum. A sub-cohort also completed a COVID-related questionnaire. Rurality was defined as living in a county with <50,000 people. The COVID-19 era was defined as 1/1/2020 to 9/25/2021. Chi-square and Fisher exact tests were used as appropriate. Significance was set at α < 0.05.

RESULTS

Rural participants were more likely (p ≤ 0.001) to exhibit clinical depression symptoms before the pandemic in both the prenatal (8.63 % of rural participants vs. 6.49 % of urban participants) and postpartum periods (11.19 % rural vs. 9.28 % urban). During the pandemic, urban participants had increased postpartum depression. Rural participants endorsed more financial and labor concerns, whereas urban participants expressed support system concerns.

LIMITATIONS

Study data were gathered from participants who gave birth at a single, midwestern hospital. Results may not be widely generalizable given the homogeneity of participants.

CONCLUSIONS

Rural women experienced higher rates of prenatal and postpartum depressive symptoms compared to their urban counterparts. The COVID-19 pandemic was a significant stressor, revealing specific mental health vulnerabilities among birthing people.

Perinatal depression and its associated risk factors during the COVID-19 pandemic in low- and middle-income countries: a systematic review and meta-analysis

PURPOSE

Perinatal depression significantly impacts maternal and child health, with further complexities arising during the COVID-19 pandemic. This review is the first to comprehensively synthesize evidence on the prevalence of perinatal depression and its associated risk factors in Low- and Middle-Income Countries (LMICs) during the pandemic period.

METHODS

The study protocol was registered in PROSPERO (CRD42022326991). This review followed the Joanna Briggs Institute (JBI) guideline for prevalence studies. A comprehensive literature search was conducted in six databases: PubMed, Scopus, Web of Science, PsycInfo, CINAHL, and ProQuest. Pooled prevalence estimates were computed for both prenatal and postnatal depression. Identified risk factors were summarized narratively.

RESULTS

A total of 5169 studies were screened, out of which 58 were included in the narrative review and 48 [prenatal (n = 36) and postnatal (n = 17)] were included in the meta-analysis. The pooled depression prevalence for prenatal women was 23% (95% CI: 19-27%), and for the postnatal women was 23% (95% CI: 18-30%). Maternal age, education, perceived fear of COVID-19 infection, week of pregnancy, pregnancy complications, and social and family support were identified as associated risk factors for depression.

CONCLUSIONS

Our review demonstrates an increased prevalence of perinatal depression during the COVID-19 pandemic in LMICs. It sheds light on the significant burden faced by pregnant and postnatal women and emphasizes the necessity for targeted interventions during the ongoing and potential future crisis.

First-Time Parents' Bonding with Their Baby: A Longitudinal Study on Finnish Parents during the First Eight Months of Parenthood

Early positive bonding between parents and babies promotes the development of parenting skills and parents' sensitivity to their infant's needs. Positive bonding has been suggested to decrease the risk of maltreatment. There is less research into the differences between primiparae's and their spouses' bonding with their baby and changes in the parent-to-infant bonding during the first year of the baby's life. The aim of this study was to describe bonding with one's baby and related differences and changes within first-time parents. The data were collected from nine maternal health clinics in 2019-2021 in one city in Finland. The Mother-to-Infant Bonding Scale (MIBS) and the Edinburgh Postnatal Depression Scale (EPDS) were used. The data were collected during pregnancy (T1) and when the baby was aged 1-2 months (T2) and 6-8 months (T3). The questionnaire was completed separately by the primiparae (n = 81 at T1) and their spouses (n = 79 at T1). The findings demonstrated that both parents had positive feelings for their baby. The primiparae's and their spouses' MIBS scores were relatively low at T2 and T3. The change between time points or the difference in the parents' bonding was not statistically significant when examining MIBS total scores. The present study identified a positive weak-to-moderate correlation between the MIBS and EPDS. This association was highlighted in the group of primiparae. The results of this study can be used to develop maternity and child health clinic services, and to promote parents' equal growth in parenthood.

Parental Postnatal Depression in the Time of the COVID-19 Pandemic: A Systematic Review of Its Effects on the Parent-Child Relationship and the Child's Developmental Outcomes

The international literature has shown that maternal and paternal postnatal depression (PND) is one of the most common mental illnesses in the perinatal period, with significant consequences for parent-infant relationships and infant development. The COVID-19 pandemic has increased the rates of prevalence of PND, exacerbating the mental health risk for new families. This systematic review aims to examine the effect of maternal and paternal PND on parent-infant relationships and children's development in the first 36 months after childbirth during the COVID-19 outbreak. Eligible studies were identified using the following databases: Medline, CINAHL, SCOPUS, PsycINFO, PsycARTICLES, ScienceDirect, and Web of Science. Of the 1252 studies considered, 10 studies met the inclusion criteria. Results showed that maternal PND significantly affected the quality of the early mother-infant relationship and the infant's motor, self-regulation, and socio-emotional development. In addition, the detrimental impact of maternal PND on the quality of early mother-infant relationships seems to become stronger as COVID-19 concerns increase. No studies included fathers. These findings strengthened the importance of planning targeted prevention and treatment strategies to prevent PND and its short- and long-term consequences, especially in the case of stressful and traumatic events. They also suggested the urgent need for further exploration of fathers.

Comparison of pre- and intra-COVID-19 postpartum depression among reproductive aged women: A comparative cross-sectional study in Ahvaz, Iran

BACKGROUND

The association between PPD and COVID-19 pandemic has been studied in some countries. This study aimed to compare postpartum depression before and during the COVID-19 pandemic among reproductive-aged women in Ahvaz, Iran.

METHODS

This comparative cross-sectional study involved 600 women of reproductive age in Ahvaz, Iran during the COVID-19 pandemic who were compared with 504 of their counterparts before the pandemic. Literate women who had given birth 1-6 months prior to the study, were aged 18-35, and were willing to participate in this study were recruited. A demographic questionnaire and Edinburgh Postnatal Depression Scale were used to collect the data. Independent t-test, Chi-square, and Logistic regression were used to analyze the data.

RESULTS

Before the pandemic, only 123 (24.9%) of the women had PPD, while during the pandemic, this number rose to 409 (68.2%). During the COVID-19 pandemic, the women were 8.727 times more likely to have PPD (95% CI: 5.919-12.868). During the pandemic, women with high school education and those having a high school diploma were 2.454 and 2.054 times more likely to have PPD compared to women with a university degree (95% CI: 1.508-3.996 and 1.302-3.241, respectively).

CONCLUSION

The prevalence of PPD among Iranian reproductive-aged women increased during the COVID-19 pandemic. Policymakers should seek some strategies to support women during pregnancy and postpartum in times of crises such as the COVID-19 pandemic.