Prenatal Depression During the Pandemic: Comparing a COVID-19 Cohort to a Matched Pre-Pandemic Sample

• In Event: Poster Session 04
  In Poster Session: PS 04 Topic - Solicited Content: COVID-19 Related

Abstract

Background: Prenatal depression in women has been associated with poorer outcomes for their children, from birth through adolescence in multiple domains of functioning (Rogers et al., 2020). During the COVID-19 pandemic, pregnant women have been exposed to additional stressors that may be depressogenic. Women who experience greater distress due to the impacts of the pandemic on their employment and finances (hereafter, “financial distress”) may be especially vulnerable to depression during this period. The current study tested the hypothesis that pregnant women in the midst of the pandemic have higher levels of prenatal depressive symptoms compared to a matched sample of pregnant women from a pre-pandemic cohort, and explored the association of financial distress due to COVID-19 with women’s depressive symptoms.

Method: Between 2017-2019, a “pre-pandemic” cohort of 89 pregnant women (mean[SD] age=32.45[5.11] years; mean[SD] gestational age[SD]=24.38[5.47] weeks) completed the Edinburgh Postnatal Depression Scale (EPDS; Cox et al., 1987) to measure prenatal depressive symptoms. In April 2020, an independent “COVID-19” cohort of 696 pregnant women (mean[SD] age=33.73[4.35] years; mean[SD] gestational age=26.79[8.80] weeks) completed the EPDS and responded to the question, “In general, what is the level of distress you have experienced relating to employment and financial impacts due to the COVID-19 outbreak?,” on a scale of 1(mild distress) to 7(high distress). We matched 364 women from the COVID-19 cohort to the pre-pandemic participants with respect to age, gestational age, annual income prior to pandemic, education, number of children, and number of pregnancies.

Results: A Welch’s t-test comparing levels of prenatal depression in the pre-pandemic cohort to the matched COVID-19 cohort indicated that women who are pregnant during the pandemic have significantly higher levels of prenatal depression than do “pre-pandemic” women (t(141.2)=4.06, p<.001, Cohen’s d[95% CI]=.51[-0.75,-0.27]; Figure 1). Fifty-percent of women in the COVID-19 cohort had EPDS scores above 10, indicating concerns of a depressive disorder, compared to 34% of women in the pre-pandemic cohort (2(1)=5.68, p=.017). A multiple linear regression model indicated that women reporting greater financial distress due to COVID-19 have higher levels of prenatal depression than do women reporting less financial distress due to COVID-19 (std. beta[95% CI]=0.26[0.18,0.33], p<.001; R2=.07; Figure 2), when controlling for annual income in the year prior to the pandemic.

Conclusion: We found that, on average, pregnant women concentrated in the San Francisco Bay Area during the COVID-19 pandemic have higher levels of prenatal depression compared to a matched sample of women who were pregnant prior to the pandemic. Among women pregnant during the pandemic, financial distress due to COVID-19 is positively associated with levels of prenatal depression. The pandemic is an ongoing stressor; our findings suggest that supporting women’s prenatal mental wellbeing is a critical component of current public health interventions that might reduce adverse intergenerational consequences of poorer prenatal mental health due to COVID-19. Establishing a financial safety net may help to alleviate women’s prenatal depression during the pandemic by reducing distress due to the impacts of COVID-19 on finances and employment.

Authors

• Daisy Elise Feddoes, Stanford University
  Presenting Author

• Lucy Sobey King, Stanford University
  Non-Presenting Author

• Ian Gotlib, Stanford University
  Non-Presenting Author

• Kathryn Humphreys, Vanderbilt University
  Non-Presenting Author