Psychological impact of COVID‐19 quarantine measures in northeastern Italy on mothers in the immediate postpartum period

Abstract

Objective To explore whether quarantine measures and hospital containment policies among women giving birth in a COVID‐19 “hotspot” area in northeastern Italy enhanced psycho‐emotional distress in the immediate postpartum period. Methods We designed a non‐concurrent case–control study of mothers who gave birth during a COVID‐19 quarantine period between March 8 and May 3, 2020 (COVID‐19 study group), with an antecedent group of matched postpartum women (control group) who delivered in the same period in 2019. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) on the second day postpartum. Results The COVID‐19 study group (n=91) had significantly higher mean EPDS scores compared with the control group (n=101) (8.5 ± 4.6 vs 6.34 ± 4.1; P<0.001). Furthermore, 28.6% of women in the COVID‐19 group had a global EPDS score above 12. Analysis of three EPDS subscales revealed significantly higher scores among the COVID‐19 group compared with the control group for anhedonia (0.60 ± 0.61 vs 0.19 ± 0.36; P<0.001) and depression (0.58 ± 0.54 vs 0.35 ± 0.45; P=0.001). Conclusions Concerns about risk of exposure to COVID‐19, combined with quarantine measures adopted during the COVID‐19 pandemic, adversely affected the thoughts and emotions of new mothers, worsening depressive symptoms.

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].…”

“…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]. An EPDS score > 13 was self-identi ed by another online survey in 15% of women before and in 40.7% during the outbreak for the same cohort of women who were pregnant or within the rst year after delivery [35].…”

Mental health status of pregnant and breastfeeding women during the COVID‐19 pandemic: A call for action

“…In conclusion, our results point towards an increased likelihood of depressive symptoms and anxiety among pregnant women and women in the early postpartum period during the COVID‐19 lockdown, thereby corroborating previous findings 4 . Obstetricians and policymakers should be aware that COVID‐19, along with its isolation measures, may put a high(er) burden on the emotional wellbeing of pregnant women and women in the early postpartum period.…”

Postpartum mood among universally screened high and low socioeconomic status patients during COVID-19 social restrictions in New York City.

“…Importantly, the distinction between our method of universally screening all postpartum patients and previous studies exploring maternal mood during the COVID-19 pandemic (25-28) likely explains, at least in part, the differences in our ndings compared to theirs. That is, they not only did not differentiate between SES, but in addition likely suffered from well understood methodological limitations associated with sampling bias in choosing only to study individuals who independently responded to social media announcements (25,26), anonymously e-mailed online survey requests (27) or other voluntary participation requests (28). Second, we were unable to analyze the data for demographic differences beyond SES.…”

“…Reduced pollution levels, a decline in the rates of automobile accidents, and a lower incidence of non-COVID infectious disease (24) all appear secondary to imposed social, educational and employment restrictions. Unsurprisingly, early explorations into the impact of the COVID-19 pandemic on maternal populations have reported increases in anxiety and depression (25)(26)(27)(28). While these ndings represent valuable contributions to the literature, the majority of these studies have suffered from important methodological limitations, including relying solely on self-selection recruitment methods, such as social media advertisements (25,26) and e-mailed online surveys (27) that are prone to biased sampling, may directly in uence outcome measures, and are well understood threats to the generalizability of the ndings.…”