COVID-19, lifestyle behaviors and mental health: A mixed methods study of women 6 months following a hypertensive pregnancy

Abstract

IntroductionThe COVID-19 pandemic introduced unprecedented challenges to both the physical and psychological health of postpartum women. The aim of this study was to determine how the COVID-19 pandemic affected the diet, physical activity and mental health of women 6 months following a hypertensive disorder of pregnancy.MethodsMixed methods sub-study of the Blood Pressure Postpartum trial, which recruited women following a hypertensive disorder of pregnancy from six Sydney metropolitan hospitals. Cross sectional analysis of baseline quantitative data, collected at 6-months postpartum from March 2019-February 2022, and qualitative data analysis from semi-structured telephone interviews, was performed. Dates of COVID-19 lockdowns for Sydney, Australia were collected from government websites. Diet (vegetable, fruit, alcohol, take away intake) and physical activity (walking, vigorous activity, strength training frequency and duration) were assessed using the self-report NSW Population Health Survey. Depression and anxiety were assessed using the Edinburgh Depression Scale and GAD-7 scale, respectively. Outcome data were compared between women who completed surveys “In Lockdown” vs. “Not in Lockdown” as well as “Prior to any Lockdown” vs. “During or Following any Lockdown”.ResultsOf 506 participants, 84 women completed the study surveys “In Lockdown,” and 149 completed the surveys “Prior to any Lockdown.” Thirty-four participants were interviewed. There were no statistically significant differences in diet, physical activity, depression and anxiety among women who completed the survey “In Lockdown” vs. “Not in Lockdown.” “Prior to any Lockdown,” participants were more likely to do any walking (95% vs. 89%, p = 0.017), any vigorous activity (43% vs. 30%, p = 0.006) or any strength training (44% vs. 33%, p = 0.024), spent more time doing vigorous activity (p = 0.003) and strength training (p = 0.047) and were more likely to drink alcohol at least monthly (54% vs. 38%, p < 0.001) compared with “During or Following any Lockdown.”ConclusionsOur findings suggest that the confinements of lockdown did not markedly influence the mental health, diet and physical activity behaviors of women 6 months following hypertensive pregnancy. However, physical activity levels were reduced following the emergence of COVID-19, suggesting targeted efforts may be necessary to re-engage postpartum women with exercise.Trial registrationhttps://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=376286&isReview=true, identifier: ACTRN12618002004246.

The Association between Nutrition, Physical Activity, and Cardiometabolic Health at 6 Months following a Hypertensive Pregnancy: A BP2 Sub-Study

“…This study did not include a normotensive control group, which could be incorporated into future studies of its kind to further enhance the validity of these findings for women specifically following HDP. Lifestyle behaviours may have been impacted by this study's COVID-19 context which has been associated with reduced physical activity levels [59]; thus, future studies confirming the reliability of these findings are necessary. Furthermore, due to evolving hospital restrictions and contextual apprehension to present to study sites/general practitioners during the COVID-19 pandemic, cardiometabolic outcome data were self-reported or missing for a small number of women.…”

Coffee and caffeine intake and depression in postpartum women: A cross-sectional study from the National Health and Nutrition Examination Survey 2007–2018

“…This dismal trend prompts more focus on the prevention and treatment of PPD. In addition to genetic and social variables, lifestyle factors, such as diverse diets that may contain moderate psychoactive substances, may have an impact on PPD (Gow et al, 2022). The discovery of these associations and the recommendation of a specific diet for postpartum populations will contribute to the reduction of PPD risk.…”

Obstetric and Gynecological Admissions and Hospitalizations in an Italian Tertiary-Care Hospital during COVID-19 Pandemic: A Retrospective Analysis According to Restrictive Measures

“…With this finding, in accordance with Carbone et al [21] and La Verde et al [12], it was reasonable to suppose that the lifestyle restrictions of the lockdown would have raised the likelihood of the emergence of such issues. Indeed, a decrease in physical activity, an increase in house rest, an associated rise in maternal weight, as well as stress and worry, might all be potential contributors to the rise in blood pressure [29][30][31][32].…”