Examining the impact of COVID-19 on maternal mental health in the early postpartum period

• In Event: The impact of COVID-19 on mother-infant dyads

Abstract

The coronavirus outbreak (COVID-19) has impacted almost every facet of daily life since being declared a pandemic on March 11, 2020. Research is beginning to document the detrimental impact of the pandemic across the nation, with disproportionate impacts on mothers (Weeland et al., 2021). Specifically, mothers were exhibiting more depressive and anxiety symptoms during the early stages of the pandemic (Kinser et al., 2021; Zanardo et al., 2020). The current study builds on prior work by investigating whether giving birth before or following the onset of the COVID-19 pandemic is associated with postpartum depression and anxiety. In addition, this study examines whether the associations between COVID-19 and postpartum depression and anxiety vary across race/ethnicity, income-to-needs, and social support.

Data were drawn from a prospective, longitudinal, multi-method study of infants and their mothers across the first two years of life (blinded for review). The sample includes 299 mothers and infants, and the sample is racially/ethnically and socioeconomically diverse (see Table 1). The outcomes of interest include maternal depression and anxiety symptoms at two months postpartum. Depressive symptoms were measured using the CES-D (Radloff, 1977) and state anxiety was assessed using the State-Trait Anxiety Inventory (Ware & Sherbourne, 1992). The predictor of interest was timing of COVID-19, which included a dichotomous indicator of whether mothers gave birth before the start of COVID-19 (0) or after the start of COVID-19 (1). Potential moderators included race/ethnicity, income-to-needs, and social support. Race/ethnicity included a mutually exclusive, categorical variable of White non-Hispanic, Black non-Hispanic, or another race. Income-to-needs was based on the reported income from the prior year divided by the federal poverty threshold for a given household size. Social support was measured using the Social Provisions Scale (Cutrona & Russell, 1987), with higher scores indicating more support. Covariates included child sex, child gestational age at birth, mothers’ age at birth, maternal employment, marital status, education, and number of adults and kids in the household. We also controlled for prenatal assessments of depression and anxiety.

Preliminary results demonstrated that giving birth following the start of COVID-19 was significantly related to higher state anxiety symptoms but was not significantly related to depressive symptoms compared to women who gave birth before the start of the pandemic (see Table 2). Additionally, race/ethnicity, income-to-needs, and social support did not significantly moderate the associations between the timing of COVID-19 and postpartum depression or anxiety symptoms (see Table 3). Future analyses will investigate a continuous measure of the timing of COVID-19 by assessing the number of days between giving birth and the start of the pandemic and mothers’ postpartum mental health. Based on our findings, it appears that women who gave birth during the pandemic are at higher risk for anxiety symptoms which could impact parenting and infant development. Prevention and intervention efforts could tailor programs to focus on the perinatal period and on anxiety symptoms to promote mother and infant well-being.
 

Authors

• Kierra Marie Pettit Sattler, University of North Carolina at Greensboro
  Presenting Author

• Esther M. Leerkes, UNC Greensboro

• Cheryl Buehler, University of North Carolina at Greensboro

• Laurie Wideman, UNC Greensboro

• Lenka Shriver, University of North Carolina at Greensboro