Pregnancy during the pandemic: the impact of COVID-19-related stress on risk for prenatal depression

Abstract

Background Pregnant women may be especially susceptible to negative events (i.e. adversity) related to the coronavirus disease 2019 (COVID-19) pandemic and negative affective responses to these events (i.e. stress). We examined the latent structure of stress and adversity related to the COVID-19 pandemic among pregnant women, potential antecedents of COVID-19-related stress and adversity in this population, and associations with prenatal depressive symptoms. Method We surveyed 725 pregnant women residing in the San Francisco Bay Area in March−May 2020, 343 of whom provided addresses that were geocoded and matched by census tract to measures of community-level risk. We compared their self-reported depressive symptoms to women matched on demographic factors and history of mental health difficulties who were pregnant prior to the pandemic. Results Women who were pregnant during the pandemic were nearly twice as likely to have possible depression than were matched women who were pregnant prior to the pandemic. Individual- and community-level factors tied to socioeconomic inequality were associated with latent factors of COVID-19-related stress and adversity. Beyond objective adversity, subjective stress responses were strongly associated with depressive symptoms during the pandemic. Conclusions Highlighting the role of subjective responses in vulnerability to prenatal depression and factors that influence susceptibility to COVID-19-related stress, these findings inform the allocation of resources to support recovery from this pandemic and future disease outbreaks. In addition to policies that mitigate disruptions to the environment due to the pandemic, treatments that focus on cognitions about the self and the environment may help to alleviate depressive symptoms in pregnant women.

Melatonin: From Neurobiology to Treatment

“…Given the marked antioxidant action and the consequent important neuroprotective effect exerted by melatonin, this hormone plays a crucial role in the neuronal formation, differentiation and proliferation [ 26 ]. Thus, alterations in the circadian rhythm induced by different negative conditions such as stress, psychopathology, viral infection, drugs of abuse etc., may cause maternal disorders often associated to insomnia and dramatic reduction in melatonin synthesis and secretion [ 28 , 29 , 30 ] which may result in preterm delivery and negative consequences, such as low birthweight and desynchronization of circadian rhythm for the fetus and possible altered development during early childhood [ 25 , 31 ]. Accordingly, a very important interrelationship between melatonin, autism spectrum disorder and attention-deficit-hyperactivity disorder, two severe neurodevelopmental pathologies strictly associated to altered sleep pattern and disruption of circadian rhythm, has been recently suggested [ 32 , 33 ].…”

“…On the basis of these evidences more recently the biomedical community has been alerted to the need of particular attention to the children delivered by mother exposed, during pregnancy, to the stressful conditions elicited by SARS-CoV-2 [ 30 , 34 ].…”

Loneliness and Depressive Symptoms among Pregnant Black Women during the COVID-19 Pandemic

“…In a sample of 164 pregnant women who lived in San Francisco Bay Area of which 82 women participated in an observational study in February–May 2019 (3% Black) and 82 women completed a survey in April 2020 (1% Black), pregnant women enrolled during the pandemic had higher levels of prenatal depression than pregnant women enrolled prior to the pandemic (King et al, 2021). The two cohorts were similar on maternal characteristics (e.g., maternal age, parity, gestational weeks, socioeconomic status) (King et al, 2021). However, the study did not assess prenatal depression across pregnancy (prior to the pandemic and during the pandemic) within the same sample of women.…”

Maternal Prenatal Somatization, Postnatal Depression, and Offspring Temperament During the COVID-19 Pandemic

“…We recruited women to participate in the Stanford COVID-19 Perinatal Experiences (COPE) project via online advertisements in April-May of 2020 (T1), as the COVID-19 pandemic surged in the United States (see King et al, 2021 for the full study description). Inclusion criteria into the broader study were that participants be either pregnant or less than 6 months postpartum, and at least 18 years of age.…”

“…For example, King et al, (2021) found that a sample of women who were pregnant at the beginning of the U.S. surge of the COVID-19 pandemic had higher levels of depressive symptoms than did a matched sample of women who were pregnant several years prior to the pandemic. King et al found further that symptoms of depression during the pandemic were higher in women who reported greater fear of infection, sociodemographic vulnerability (e.g., financial difficulty, being a person of color), and changes to their prenatal care.…”