863 COVID-19-related perinatal stress associated with increased depression risk

Abstract

OBJECTIVE: Elective induction of labor aids in managing timing of delivery and reducing risks associated with late-term pregnancy. Results of a recent randomized controlled trial showed that rates of cesarean section and hypertensive disorders were lower with elective induction compared to expectant management. The primary objective of this study was to determine the safety of elective induction at or beyond 39 weeks gestation by comparing incidence of maternal and neonatal outcomes among women who did and did not opt for elective induction. STUDY DESIGN: This was a prospective cohort study of low-risk pregnant women delivering at a regional tertiary obstetric care center. The study group was composed of low-risk pregnant women who opted for elective induction at or beyond 39 weeks gestation between May 1, 2019 and November 30, 2019 and between February 15, 2020 and August 15 2020. The comparison group included low-risk pregnant women who opted for expectant management and delivered during the same timeframes. Outcomes were compared between groups. For categorical variables, relative risks with confidence intervals were determined. For continuous variables, differences between means were determined. Significance levels of 0.05 (two-sided) were used. RESULTS: There were 228 participants with 112 (49.1%) in the elective induction group and 116 (50.9%) in the comparison group. Patient characteristics are described in Table 1. There was no significant difference in maternal and neonatal outcomes (Table 2). The use of ripening agents was significantly greater in the elective induction group (p < 0.0001). Length of stay on antepartum and labor and delivery units were significantly greater among the elective induction group (p < 0.0001 and p ¼ 0.0015, respectively). Length of stay on postpartum was significantly greater in the comparison group (p ¼ 0.0368). CONCLUSION: Elective induction does not have increased maternal or neonatal risks compared to expectant management. It can be offered to patients, although they should be counseled on the increased time and amount of cervical ripening needed for elective induction.

Empfehlungen zu SARS-CoV-2/COVID-19 in Schwangerschaft, Geburt und Wochenbett – Update November 2021 (Langfassung)

“…Zunehmende psychosoziale Belastungen von Schwangeren während der SARS-CoV-2-Pandemie mit teils höheren Raten der psychologischen Folgen im Vergleich der Zahl klinisch vom Virus be-troffenen Patientinnen sind vielfältig berichtet worden [235][236][237][238], u. a.: ▪ Depressionen [239][240][241][242] ▪ Angst [239,240,[243][244][245][246] ▪ Einsamkeit [239] ▪ Stress [240,245,247] ▪ Häusliche Gewalt [248][249] ▪ Essstörungen [250] ▪ Schwangerschaftsbezogene Ängste [250] Die Prävalenz von Angstzuständen und Depressionen bei schwangeren Frauen hat während der COVID-19-Epidemie deutlich zugenommen. In einer Metaanalyse betrug die Gesamtprävalenz von Angstzuständen bei Schwangeren während der COVID-19-Pandemie 42 % (95 % KI 26-57 %) und von Depressionen bei 25 % (95 % KI 20-31 %).…”