Pregnancy-related psychopathology: A comparison between pre-COVID-19 and COVID-19–related social restriction periods

Abstract

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic impacted in a still undefined way pregnant women’s mental health. There are reports of mood and affect changes in the general population and the suggestion that similar changes occur also in the pregnant population. The greater vulnerability of women during the COVID-19 restriction period may translate into a greater risk for mental disorders in the gestational period. We hypothesised that pregnant women in the pre-pandemic period would have less psychopathology and more psychological support than pregnant women during the pandemic restriction period. AIM To compare pregnant women for anxiety, prenatal depression, psychopathology, and social support before and after the awareness of the pandemic. METHODS We administered to women willing to participate in their 2 nd -3 rd trimesters of pregnancy the Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory Form Y (STAI-Y), and the Symptom CheckList-90-Revised (SCL-90R); we further collected sociodemographic variables and explored women’s social support. The comparison was cross-sectional. The first sample was termed nonCOVID-19 because data were gathered before the COVID-19 outbreak (January 2020-February 2020) was declared, and the second sample termed COVID-19 because participants were already subjected to the COVID-19–related restrictive measures (January 2021-February 2021). Since normal distribution was not met (Shapiro-Wilk test applied), we applied nonparametric Mann-Whitney’s U -test to compare psychometric tests. Ethical standards were met. RESULTS The nonCOVID-19 group reported higher support from partners only, while the COVID-19 group reported multiple support ( χ 2 = 9.7181; P = 0.021); the nonCOVID-19 group scored higher than the COVID-19 group only on state anxiety among psychometric scales [STAI-Y1, nonCOVID-19 median = 39 (95%CI: 39.19-51.10) vs COVID-19 median= 32 (95%CI: 30.83-38.90); Mann-Whitney’s U =117.5, P = 0.00596]. Other measures did not differ meaningfully between the two groups. Scores on the EPDS, the state and trait subscales of the STAI-Y, and most SCL-90R subscales inter-correlated with one another. The anxiety component of the EPDS, EPDS-3A, correlated poorly with other measures, while it was the Global Symptom Index of the SCL-90-R that correlated most strongly with most measures. Our results are at odds with most literature and do not confirm increased depression and anxiety rates in pregnant women during the pandemic. CONCLUSION The ability of pregnant women to deal with novel generalised threats involves mobilization of inner resources. Increasing sources of social support may have produced...

Depressive Symptoms during Pregnancy: Prevalence and Correlates with Affective Temperaments and Psychosocial Factors

“…Another explanation could be the resilience provided by expecting a child, which correlates with perceived stress and anxiety [ 23 , 24 ]. In fact, higher perceived stress and anxiety have been observed in prepandemic samples, compared to samples after the breakthrough of the pandemic [ 25 , 26 , 27 ], which we attributed to the increased ability of pregnant women to cope with novel generalised threats and mobilise inner resources, such as those related to resilience [ 26 ], probably based on increased brain plasticity, which is induced by pregnancy [ 27 ].…”

Is peripartum anhedonia a missing target?

“…Results may reflect COVID-19-related health concerns and a lack of social support caused by the COVID-19 pandemic, but it could be also interesting to consider that precisely due to the isolation, many pregnant women were able to enjoy the closeness of their partners and families during the lockdown and this could have constituted a protective factor with respect to the risk of mood deflection or anhedonia. 4 Since a lack of appropriate maternal-fetal care can increase the risk of negative mental health outcomes in both mother and infant, perinatal medicine is an important component of women's health. Mental health care for perinatal women should not only foresee effective screening strategies and deliver targeted therapies to women, taking into account ethnicity, socioeconomic status, and history of stressful life events (such as abuse or trauma), but also different clinical phenotypes and severity of perinatal depression.…”

COVID‐19 pandemic effects: Examining prenatal internalizing symptoms and infant temperament

“…However, very few studies have utilized a pre-pandemic comparison group to determine whether symptoms during this period occur above and beyond typical prenatal levels. Italian researchers have demonstrated mixed findings (Chieffo et al, 2022;Scandurra et al, 2023), warranting additional research with women living in the United States given COVID-19 related policies and the severity of outbreaks differed across countries. Moreover, no known studies have compared pregnancy-specific anxiety prior to and during later waves of the pandemic, which may be an especially salient form of anxiety during this period due to uncertainty regarding how perinatal infection may affect the developing fetus.…”