Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China

Abstract

BACKGROUND: On January 20, 2020, a new coronavirus epidemic with human-to-human transmission was officially declared by the Chinese government, which caused significant public panic in China. In light of the coronavirus disease 2019 outbreak, pregnant women may be particularly vulnerable and in special need for preventive mental health strategies. Thus far, no reports exist to investigate the mental health response of pregnant women to the coronavirus disease 2019 outbreak. OBJECTIVE: This study aimed to examine the impact of coronavirus disease 2019 outbreak on the prevalence of depressive and anxiety symptoms and the corresponding risk factors among pregnant women across China. STUDY DESIGN: A multicenter, cross-sectional study was initiated in early December 2019 to identify mental health concerns in pregnancy using the Edinburgh Postnatal Depression Scale. This study provided a unique opportunity to compare the mental status of pregnant women before and after the declaration of the coronavirus disease 2019 epidemic. A total of 4124 pregnant women during their third trimester from 25 hospitals in 10 provinces across China were examined in this crosssectional study from January 1, 2020, to February 9, 2020. Of these women, 1285 were assessed after January 20, 2020, when the coronavirus epidemic was publicly declared and 2839 were assessed before this pivotal time point. The internationally recommended Edinburgh Postnatal Depression Scale was used to assess maternal depression and anxiety symptoms. Prevalence rates and risk factors were compared between the pre-and poststudy groups. RESULTS: Pregnant women assessed after the declaration of coronavirus disease 2019 epidemic had significantly higher rates of depressive symptoms (26.0% vs 29.6%, P¼.02) than women assessed before the epidemic declaration. These women were also more likely to have thoughts of self-harm (P¼.005). The depressive rates were positively associated with the number of newly confirmed cases of coronavirus disease 2019 (P¼.003), suspected infections (P¼.004), and deaths per day (P¼.001). Pregnant women who were underweight before pregnancy, primiparous, younger than 35 years, employed full time, in middle income category, and had appropriate living space were at increased risk for developing depressive and anxiety symptoms during the outbreak. CONCLUSION: Major life-threatening public health events such as the coronavirus disease 2019 outbreak may increase the risk for mental illness among pregnant women, including thoughts of self-harm. Strategies targeting maternal stress and isolation such as effective risk communication and the provision of psychological first aid may be particularly useful to prevent negative outcomes for women and their fetuses.

Psychosocial factors associated with postpartum psychological distress during the Covid-19 pandemic: a cross-sectional study.

“…The present study ndings show that the prevalence of postpartum depressive and post-traumatic stress symptoms among the women experiencing childbirth during the Covid-19 pandemic was higher than that reported in previous studies before the pandemic. Literature data report that approximately 10-16% of women met major depression's criteria at 3 months postpartum [24,[33][34][35][36]. The ndings for our cohort (30.7%) are shared by a recent study that reported that 30% of the mothers who delivered during the Covid-19 pandemic had a global EPDS score > 12 compared with 11.9% in an antecedent matched group of postpartum women [36].…”

“…Recent literature regarding the Covid-19 outbreak has largely focused on mental health and psychological needs during pregnancy. Following o cial statements on human-to-human transmission of SARS-CoV-2, there was a clinically signi cant rise in the prevalence of depressive and anxiety symptoms among pregnant women in their third trimester [22][23][24].…”

The Need for Additional Mental Health Support for Women in the Postpartum Period in the Times of Epidemic Crisis

“…In the time of epidemic crisis, women after childbirth are exposed to several of the above-mentioned consequences (social isolation, higher life stress), which may worsen their mental health, and the existing psychosocial resources may not be su cient to cope with the process of transition to motherhood, which can result in the development / intensi cation of depressive symptoms. Previous studies [9,10] described the effects of the covid-19 epidemic on the depression and anxiety levels of pregnant women. Recent assessment of depression symptoms with the Edinburgh Postnatal Depression Scale revealed signi cantly higher rates of depressive symptoms among pregnant women assessed after the declaration of covid-19 epidemic in comparison to women assessed in pre-epidemic period [10].…”

“…Previous studies [9,10] described the effects of the covid-19 epidemic on the depression and anxiety levels of pregnant women. Recent assessment of depression symptoms with the Edinburgh Postnatal Depression Scale revealed signi cantly higher rates of depressive symptoms among pregnant women assessed after the declaration of covid-19 epidemic in comparison to women assessed in pre-epidemic period [10]. However, there are no reports on the occurrence of severe depressive symptoms among women in the postpartum period during epidemic crisis.…”

Awareness of Coronavirus Disease From Conception to Delivery: Antenatal Mental Journey Breaking Anxiety During Outbreak

“…In the present study, 47% of participants thought that social media was not being used e ciently for informing the society. Wu Y et al reported apart from the bene ts of social media, it causes extreme fear, isolation, fear of death, and proneness to depression among the society, especially during the time of lockdown [14].…”