Mental Health of Pregnant and Postpartum Women Before and During Covid-19: A Longitudinal Study

• In Event: Early Life Impacts of COVID-19: Prenatal and Early Childhood

Abstract

The novel coronavirus 2019 (Covid-19) pandemic has been uniquely challenging for pregnant and postpartum women (Berthelot et al., 2020; Thapa et al., 2020). Uncontrollable stress such as experiencing a pandemic amplifies risk for maternal depression and anxiety, and poor maternal mental health is linked to adverse mother and child outcomes (Buss et al., 2011; Davis & Sandman, 2012; Khatri et al., 2019; Lancaster et al., 2010). This study examined change in symptoms of depression and anxiety in response to the Covid-19 pandemic among women who were pregnant or postpartum, and investigated whether change was moderated by sociodemographic factors and Covid-specific adversity. Method: 135 women enrolled in an existing longitudinal study completed self-report questionnaires including the EPDS and STAI-short form at three timepoints: early pregnancy, a follow-up prior to the start of the Covid-19 pandemic, and during the Covid-19 pandemic. Results: Symptoms of depression and anxiety changed from early pregnancy to Covid-19. Depressive symptoms were higher during the pandemic as compared to pre-Covid (F(1, 134)=44.68, p<.001, partial η2=.25) and just as high as they were during early pregnancy (F(1, 134)=0.04, p=.84, partial η2=.00). Symptoms of anxiety were higher during the pandemic as compared to both pre-Covid (F(1, 134)=52.50, p<.001, partial η2=.28) and early pregnancy (F(1, 134)=6.67, p=.011, partial η2=.05). Women living at or below 200% of the poverty line reported greater symptoms of depression and anxiety during early pregnancy (p’s<.05), but there were no sociodemographic differences in depressive or anxious symptoms during the Covid-19 pandemic (p’s>.05; Figure 1). Women who experienced higher levels of Covid-specific adversity (e.g., exposure to the virus, unemployment or economic insecurity, changes in relationships) showed a greater increase in symptoms of depression and anxiety during Covid (p’s<.05; Figure 2). Conclusion: The Covid-19 pandemic has been accompanied by significant increases in mental health symptoms for pregnant and postpartum women that are equally or even more potent than increases seen in early pregnancy. Though the pandemic’s effects appear to extend beyond socioeconomic bounds, Covid-specific adversity is a risk factor for greater mental health difficulties. It is critical to implement screening for adversity specific to the pandemic in addition to broad mental health symptoms at prenatal and postpartum visits during this extraordinary time. Identifying mothers at-risk for mental health difficulties may increase mental health care utilization, mitigate fetal and infant exposure to maternal depression and anxiety, and ultimately could help prevent future adverse child outcomes.

Authors

• Sarah E. D. Perzow, University of Denver
  Presenting Author

• Ella-Marie P. Hennessey, University of Denver
  Non-Presenting Author

• Camille Hoffman, University of Colorado Anschutz Medical Campus
  Non-Presenting Author

• Nancy Grote, University Of Washington
  Non-Presenting Author

• Benjamin Hankin, University of Illinois at Urbana-Champaign
  Non-Presenting Author

• Elysia Davis, University of Denver
  Non-Presenting Author