Behavioral coping phenotypes and associated psychosocial outcomes of pregnant and postpartum women during the COVID-19 pandemic

Abstract

The impact of COVID-19-related stress on perinatal women is of heightened public health concern given the established intergenerational impact of maternal stress-exposure on infants and fetuses. There is urgent need to characterize the coping styles associated with adverse psychosocial outcomes in perinatal women during the COVID-19 pandemic to help mitigate the potential for lasting sequelae on both mothers and infants. This study uses a data-driven approach to identify the patterns of behavioral coping strategies that associate with maternal psychosocial distress during the COVID-19 pandemic in a large multicenter sample of pregnant women (N = 2876) and postpartum women (N = 1536). Data was collected from 9 states across the United States from March to October 2020. Women reported behaviors they were engaging in to manage pandemic-related stress, symptoms of depression, anxiety and global psychological distress, as well as changes in energy levels, sleep quality and stress levels. Using latent profile analysis, we identified four behavioral phenotypes of coping strategies. Critically, phenotypes with high levels of passive coping strategies (increased screen time, social media, and intake of comfort foods) were associated with elevated symptoms of depression, anxiety, and global psychological distress, as well as worsening stress and energy levels, relative to other coping phenotypes. In contrast, phenotypes with high levels of active coping strategies (social support, and self-care) were associated with greater resiliency relative to other phenotypes. The identification of these widespread coping phenotypes reveals novel behavioral patterns associated with risk and resiliency to pandemic-related stress in perinatal women. These findings may contribute to early identification of women at risk for poor long-term outcomes and indicate malleable targets for interventions aimed at mitigating lasting sequelae on women and children during the COVID-19 pandemic.

The Prevalence of Fear of Childbirth and Its Association With Intolerance of Uncertainty and Coping Styles Among Pregnant Chinese Women During the COVID-19 Pandemic

“…A similar result was obtained in a cross-sectional survey during the pandemic ( 16 ). In addition, it is confirmed that passive coping strategies of pregnant women are correlated with depression, anxiety, and psychological distress ( 63 ). Daglar et al also suggested that optimistic coping styles with stress were correlated with pregnant women's self-confidence ( 64 ).…”

Perinatal depression screening and prevention: Descriptive findings from a multicentric program in the South of Italy

“…Also, women with depressive symptoms show more avoidant behaviors than those with no levels of depression (68). A change of the coping strategies through psychoeducational programs is one of the aims of the therapeutic approaches for reducing vulnerability to stress in patients at risk of depression after childbirth (69). In fact, psychological interventions based on cognitive behavioral techniques are encouraged for improving dysfunctional coping strategies (69,70).…”

“It's always hard being a mom, but the pandemic has made everything harder”: A qualitative exploration of the experiences of perinatal women during the COVID-19 pandemic

“…Unfortunately, increased social media exposure during the COVID pandemic is associated with higher rates of depression and anxiety, perhaps due to the ease of access to distressing information. ( Werchan et al, 2022 , Gao et al, 2020 , Geirdal et al, 2021 ) Thus, women in this study found themselves in a bind between their desire to connect and the negative mental health effects of social media use. It is important to continue to further understand how to utilize the beneficial aspects of social media while minimizing the psychological harm.…”

“…( Morganstein and Ursano, 2020 ) Likewise, during this COVID-19 pandemic, women during the perinatal period reported high levels of stress, anxiety, and depression ( Basu et al, 2021 , Farewell et al, 2020 , Tomfohr-Madsen et al, 2021 ); those who engaged in passive coping (e.g., higher use of screen time, intake of comfort foods) experienced higher levels of psychological distress. ( Werchan et al, 2022 )…”

“…Previous research shows that engagement in health behaviors and proximity to outdoor space is associated with less stress in those pregnant during the COVID-19 pandemic. ( Werchan et al, 2022 ) Participants in this study actively sought outdoor spaces and engaged in self-care activities to deal with stress. Furthermore, the participants used healthy cognitive strategies, in particular, participants exhibited considerable gratitude for their personal situations and for the unexpected benefits of the pandemic (e.g.…”