The Association between Delivery during the COVID-19 Pandemic and Immediate Postpartum Maternal Cognitive Function

Abstract

Survivors of the 2003 SARS epidemic were found to have higher rates of adverse mental conditions. This study aimed to assess cognitive function in women delivering during the COVID-19 pandemic, as compared to women who delivered before the COVID-19 pandemic. A cohort study was performed during the immediate postpartum period of women delivering singletons at term. Cognitive function was assessed using an objective neurocognitive test (Symbol Digit Modalities Test SDMT90, SDMT4) and a subjective self-estimation questionnaire (Attention Function Index AFI). The exposed group was recruited during the COVID-19 outbreak in Israel (May 2020), whereas the comparison group consisted of women delivering at the same medical center before the COVID-19 pandemic (2016–2017). Multivariable regression models were constructed to control potential confounders. There were 79 parturients recruited during the COVID-19 pandemic and compared with 123 women who delivered before the COVID-19 pandemic. Women delivering during the COVID-19 pandemic scored lower in the subjective AFI test compared to the unexposed group (70.0 ± 15.4 vs. 75.1 ± 14.7, p = 0.018). However, no significant difference was found in the objective SDMT tests scores. These results remained similar in the multivariable regression models when controlling for maternal age, ethnicity and time from admission to assessment, for AFI, SDMT90 and SDMT4 scores (p = 0.014; p = 0.734; p = 0.786; respectively). While no significant difference was found in objective tests, our findings propose that the exposure to the COVID-19 pandemic is independently associated with a significant decrease in subjective maternal cognitive function during the immediate postpartum period.

Prevalence of postpartum depression in women amid the COVID‐19 pandemic: A systematic review and meta‐analysis

“…Postpartum depression disorder is the most common postpartum illness among women 9 . According to the DSM‐5 definition, PPD occurs 4 weeks after delivery while others define it as commencing at any time in the first year after delivery 10 . Postpartum depression threatens not only the health of mothers but also the health of infants, and infants of depressed mothers may have developmental disorders, reduced cognitive function, as well as problems pertaining to social communication with their parents and peers 11 …”

“…9 According to the DSM-5 definition, PPD occurs 4 weeks after delivery while others define it as commencing at any time in the first year after delivery. 10 Postpartum depression threatens not only the health of mothers but also the health of infants, and infants of depressed mothers may have developmental disorders, reduced cognitive function, as well as problems pertaining to social communication with their parents and peers. 11 Approximately 10%-16% of women in the postpartum period experience a period of major depression and many of them also suffer from anxiety disorders.…”

Psychological health status in postpartum women during COVID-19 pandemic: A systematic review and meta-analysis

“…This left 45 papers for full-text screening, of which 16 were excluded: data for postpartum women were not reported separately in nine studies ( Li et al, 2021 ; Masters et al, 2021 ; Perzow et al, 2021 ; Wang et al, 2021 ; Liu et al, 2021 ; Stepowicz et al, 2020 ; Xue et al, 2021 ; Chaves et al, 2022 ; Farewell et al, 2020 ); psychological health symptoms were not screened by validated scales in three studies ( Dib et al, 2020 ; Ollivier et al, 2021 ; Jafree et al, 2021 ), and four studies reported the mean score for psychological health symptoms instead of prevalence ( Mayopoulos et al, 2021 ; McFarland et al, 2021 ; Shayganfard et al, 2020 ; Fernandes et al, 2021 ). Finally, 29 articles were included in the meta-analysis ( Loret de Mola et al, 2021 ; Pariente et al, 2020 ; Racine et al, 2021 ; Silverman et al, 2020 ; An et al, 2021 ; Basu et al, 2021 ; Bo et al, 2020 ; Boekhorst et al, 2021 ; Ceulemans et al, 2021 ; Ceulemans et al, 2020 ; Chrzan-Dętkoś et al, 2021 ; Fallon et al, 2021 ; Guvenc et al, 2021 ; Hamami et al, 2020 ; Hiiragi et al, 2021 ; Hui et al, 2021 ; Liang et al, 2020 ; Lorentz et al, 2020 ; Mariño-Narvaez et al, 2021 ; Molgora and Accordini, 2020 ; Oskovi-Kaplan et al, 2021 ; Ostacoli et al, 2020 ; Spinola et al, 2020 ; Stojanov et al, 2021 ; Suárez-Rico et al, 2021 ; Sun et al, 2020b ; Suzuki, 2022 ; Zanardo et al, 2020 ; Zeng et al, 2020 ).

Fig.

…”

“…There were two multinational studies that recruited participants from five and 64 countries, respectively ( Basu et al, 2021 ; Ceulemans et al, 2021 ). The remaining 27 studies were conducted in 16 different countries over four continents ( Loret de Mola et al, 2021 ; Pariente et al, 2020 ; Racine et al, 2021 ; Silverman et al, 2020 ; An et al, 2021 ; Bo et al, 2020 ; Boekhorst et al, 2021 ; Ceulemans et al, 2020 ; Chrzan-Dętkoś et al, 2021 ; Fallon et al, 2021 ; Guvenc et al, 2021 ; Hamami et al, 2020 ; Hiiragi et al, 2021 ; Hui et al, 2021 ; Liang et al, 2020 ; Lorentz et al, 2020 ; Mariño-Narvaez et al, 2021 ; Molgora and Accordini, 2020 ; Oskovi-Kaplan et al, 2021 ; Ostacoli et al, 2020 ; Spinola et al, 2020 ; Stojanov et al, 2021 ; Suárez-Rico et al, 2021 ; Sun et al, 2020b ; Suzuki, 2022 ; Zanardo et al, 2020 ; Zeng et al, 2020 ). There were 16 cross-sectional studies that reported prevalence rates of psychological health symptoms during the COVID-19 pandemic ( An et al, 2021 ; Basu et al, 2021 ; Bo et al, 2020 ; Ceulemans et al, 2021 ; Ceulemans et al, 2020 ; Fallon et al, 2021 ; Guvenc et al, 2021 ; Liang et al, 2020 ; Molgora and Accordini, 2020 ; Oskovi-Kaplan et al, 2021 ; Ostacoli et al, 2020 ; Spinola et al, 2020 ; Stojanov et al, 2021 ; Suárez-Rico et al, 2021 ; Sun et al, 2020b ; Zeng et al, 2020 ).…”

“…There were 16 cross-sectional studies that reported prevalence rates of psychological health symptoms during the COVID-19 pandemic ( An et al, 2021 ; Basu et al, 2021 ; Bo et al, 2020 ; Ceulemans et al, 2021 ; Ceulemans et al, 2020 ; Fallon et al, 2021 ; Guvenc et al, 2021 ; Liang et al, 2020 ; Molgora and Accordini, 2020 ; Oskovi-Kaplan et al, 2021 ; Ostacoli et al, 2020 ; Spinola et al, 2020 ; Stojanov et al, 2021 ; Suárez-Rico et al, 2021 ; Sun et al, 2020b ; Zeng et al, 2020 ). The remaining 10 case-control studies ( Pariente et al, 2020 ; Silverman et al, 2020 ; Boekhorst et al, 2021 ; Chrzan-Dętkoś et al, 2021 ; Hamami et al, 2020 ; Hiiragi et al, 2021 ; Hui et al, 2021 ; Mariño-Narvaez et al, 2021 ; Suzuki, 2022 ; Zanardo et al, 2020 ) and three panel studies ( Loret de Mola et al, 2021 ; Racine et al, 2021 ; Lorentz et al, 2020 ) compared the differences in the risk for psychological health symptoms before and during the COVID-19 pandemic. The total sample size ranged from 50 to 5134 postpartum women from 0 days to >9 years after delivery.…”