Uptrend in Distress and Psychiatric Symptomatology in Pregnant Women During the Coronavirus Disease 2019 Pandemic

Abstract

Introduction: Prenatal maternal distress has a negative impact on the course of pregnancy, fetal development, offspring development and later psychopathologies. The study aimed to determine the extent to which the Coronavirus disease 2019 (COVID-19) pandemic may aggravate pregnant women prenatal distress and psychiatric symptomatology. Material and methods: Two cohorts of pregnant volunteer women were evaluated, one that was recruited before the COVID-19 pandemic (n=496) through advertisements in prenatal clinics in Quebec, Canada, from April 2018 to March 2020; the other (n=1258) was recruited online during the pandemic from April 2 to April 13 2020. Prenatal distress and psychiatric symptomatology were measured with the Kessler Distress Scale (K10), Post-traumatic Checklist for DSM-5 (PCL-5), Dissociative Experiences Scale (DES-II) and Positive and Negative Affect Schedule (PANAS).Results: The 1754 pregnant women (Mage=29.27, SD=4.23) were between 4 and 41 gestational weeks (M=24.80, SD=9.42), were generally educated (91.3% had post-high school training) and financially well-resourced (85.3% were above the low-income cutoff). A multivariate analysis of covariance controlling for age, gestational age, household income, education and lifetime psychiatric disorders showed a large effect size in the difference between the two cohorts on psychiatric symptoms (Wilks' λ=0.68, F6,1400=108.50, p < 0.001, partial η 2 = 0.32). According to post-hoc analyses of covariance, the COVID-19 women reported higher levels of depressive and anxiety symptoms (ES=0.57), dissociative symptoms (ES=0.22 and 0.25), symptoms of posttraumatic stress disorder (ES=0.19), negative affectivity (ES = 0.96) and less positive affectivity (ES=0.95) than the pre-COVID-19 cohort. Women from the COVID-19 cohort were more likely than pre-COVID-19 women to present clinically significant levels of depressive and anxiety symptoms [OR=1.94, χ2(1)=10.05, p=.002]. Multiple regression analyses indicated that COVID-19 pregnant women having a previous psychiatric diagnosis or low income would be more prone to elevated distress and psychiatric symptoms.Conclusions: Pregnant women assessed during the COVID-19 pandemic reported more distress and psychiatric symptoms than pregnant women assessed before the pandemic, 4 mainly in the form of depression and anxiety symptoms. Given the harmful consequences of prenatal distress on mothers and offspring, the presently observed upsurge of symptoms in pregnant women calls for special means of clinical surveillance.

Becoming a Mother During COVID-19 Pandemic: How to Protect Maternal Mental Health Against Stress Factors

“…A longitudinal study comparing 102 pregnant women and a control group of 102 non-pregnant women showed a significant increase in depression and anxiety in parturients, and an increase in negative affects and a decrease in positive affects greater than in the control group (25). Another study of 1,754 pregnant women in Canada found that women recruited after the onset of the pandemic were almost twice as likely to report symptoms of depression, anxiety disorder, or substance use disorder (26). Finally, a subsequent meta-analysis of 23 studies involving 20,569 participants (16,797 pregnant women and 3,772 postpartum women) during the COVID-19 pandemic shows that 70% of patients present with psychological distress, 31% with depressive symptoms, and 49% with insomnia (24).…”

“…In a longitudinal single-arm cohort study conducted in China between May 1 and July 31, 2020 seventy-two pregnant patients with COVID-19 participated in follow-up surveys until 3 months after giving birth (57 cases) or having abortion (15 cases). All cases infected in the first trimester and 1/3 of cases infected in the second trimester had an abortion to terminate the pregnancy, and 22.2% of pregnant patients were suffering from post-traumatic stress disorder or depression at 3 months after delivery or induced abortion (26).…”

Impact of the COVID-19 Pandemic on Anxiety and Depression Levels in Pregnant Women

“…A study evaluating depression and anxiety symptoms' levels in the COVID-19 pandemic using two separate groups as pre-pandemic and pandemic groups reported that pregnant women during the COVID-19 pandemic had higher levels of stress, anxiety, and depression than pre-COVID-19 pregnant women 26 . This result was similar to the results of our study.…”

Indirect impact of SARS‐CoV‐2 pandemic on pregnancy and childbirth outcomes: A nine‐month long experience from a university center in Lombardy

“…d Assessed at hospital discharge. mother and her fetus and the radical changes swiftly implemented in labor and birth care 35,[60][61][62][63][64][65][66][67][68][69][70][71] might explain this increase and its temporal trend.…”