Comorbid Anxiety and Depression and Related Factors Among Pregnant and Postpartum Chinese Women During the Coronavirus Disease 2019 Pandemic

Abstract

Objective: To identify the prevalence of comorbid anxiety and depression (CAD) and analyze the relationship between CAD and sociodemographic and obstetric-related variables in pregnant and postpartum Chinese women during the COVID-19 pandemic.Methods: Participants were 2,237 pregnant and postpartum women (aged 19–47 years) who visited various medical institutions in China between February 28, 2020, and April 26, 2020. They were asked to complete an online survey assessing the anxiety and depression, obstetric characteristics, and sociodemographic variables. The women were grouped into the following categories in accordance with the Generalized Anxiety Disorder Scale-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9): (a) CAD, (b) “anxiety only,” (c) “depression only,” and (d) “no depression or anxiety.” After estimating the prevalence of CAD, “anxiety only,” and “depression only,” we carried out chi-squared tests and multiple logistic regression analysis to examine the related factors between these groups of pregnant and postpartum Chinese women.Results: Comorbid anxiety and depression, “anxiety only,” and “depression only,” occurred in 6.3, 5.8, and 3.9% of participants, respectively. The prevalence rates of CAD during the first, second, and third trimesters of pregnancy and the postpartum period were found to be 7.4, 6.5, 5.7, and 8.2%, respectively. The factors that differed among the groups were age (p < 0.05), marital status (p < 0.001), level of education (p < 0.05), family support (p < 0.001), and total live births (p < 0.001). “Poor family support” (odds ratio (OR): 1.90; 95% confidence interval (CI): 1.30–2.78; p = 0.0009) and “no birth” (OR: 1.91; 95% CI: 1.32–2.75; p = 0.0006) remained significant factors for the CAD group, while “poor family support” (OR: 2.16; 95% CI: 1.34–3.47; p = 0.0015) remained a significant factor for the “depression only” group when their results were compared to those of the “no depression or anxiety” group in the multiple logistic regression analysis.Conclusion: Pregnant and postpartum Chinese women with poor family support and primipara are at high risk for CAD during the COVID-19 pandemic. These results support the need for targeted perinatal programs to address CAD in pregnant and postpartum women during the pandemic period.

Fear and anxiety related to COVID-19 pandemic may predispose to perinatal depression in Italy

“…Moreover, our findings reported a significant positive correlation between fear of COVID-19 and COVID-19-related anxiety levels, as well as between fear of COVID-19 and perinatal depression levels, as already documented in previous studies ( 73 – 75 ). Furthermore, our findings documented a significant positive correlation between COVID-19-related anxiety and perinatal depression levels, as already demonstrated in previous studies ( 76 , 77 ). In fact, the fear of contagion and for the health of the child, the difficulty in promptly accessing to health care system due to the COVID-19 restrictive measures, as well as the poor availability in being supported by own partner and/or family members during the hospitalization for the delivery may represent all factors which may have determined increased depressive and anxious symptoms in women during the peripartum period ( 67 , 70 , 72 , 78 ).…”

Rates of depressive and anxiety symptoms in the perinatal period during the COVID-19 pandemic: Comparisons between countries and with pre-pandemic data

“…Although there are no specific data regarding postpartum anxiety in the aforementioned systematic reviews, we observed a higher prevalence of clinically significant symptoms of anxiety (26.6 %) compared to a previous multinational study conducted in several European countries and using the same instrument, with mothers up to 3 months following delivery (10 %; Ceulemans et al, 2021 ). Similarly, prevalence of co-morbid symptoms was higher in postpartum women in our sample (20.3 %) compared to the prevalence reported in earlier investigations with perinatal women during the pandemic ( Luo et al, 2021 – 6.3 %; Sun et al, 2021 – [pregnant only] 18 %). In our multinational sample, higher levels of clinically significant symptoms were observed among postpartum than pregnant women, which may reflect mounting psychological demands experienced by women dealing with changes/restrictions/limited access to their postnatal health care, transitioning to motherhood during a pandemic, worrying about the risk of infection to them and their baby, alongside constraints to daily living associated with the pandemic ( Diamond et al, 2020 ; Gildner and Thayer, 2020 ).…”

Inventory study of an early pandemic COVID-19 cohort in South-Eastern Sweden, focusing on neurological manifestations

“…Interestingly, the second most common comorbidity in the present COVID-19 patients was depression and anxiety (51%, Table 1). This is in line with several other studies highlighting the impact of pre-existing mental disorders and increased probability of developing COVID-19 [40][41][42].…”