Psychological Distress Among Pregnant Canadian Women During COVID-19 Pandemic: The Role of Social Isolation and Support

• In Event: COVID-19 Crisis and Pregnancy Experiences

Abstract

Background: Little is known about the psychological effects of pandemic countermeasures such as physical distancing and work/learn from home. Previous disaster studies have consistently observed increases in mental health problems following large-scale disasters (e.g., earthquakes; Fergusson et al 2014; the world Trade Center attacks; Adams & Boscarino 2005). The degree or severity of exposure to disaster consistently and strongly predicts greater psychological impairment (McFarlane & Williams 2012). Pregnant women may be especially vulnerable to the negative psychological effects of COVD-19 public health measures, both because they represent a demographic typically most affected by disasters and because pregnancy itself entails significant life changes that require major psychosocial and emotional adjustments (Dunkel-Schetter, 2011). Physical distancing policies implemented as a countermeasure to COVID-19 are especially concerning because social support buffers the negative effects of prenatal distress (Reid & Taylor, 2015). We hypothesize that feelings of social isolation will mediate and social support will moderate the effects of objective exposure to COVID-19 stressors on psychological distress.
Methods: 6078 pregnant Canadian individuals were recruited between April 5 and July 13 2020 via social media ads and completed self-report measures of anxiety (PROMIS Anxiety), depression (Edinburgh Postnatal Depression Scale), social support (Interpersonal Support Evaluation List and Social Support Effectiveness Questionnaire), and objective stress (which we adapted from previous disaster studies; King et al., 2015). We used established cut-off scores for anxiety (T-score ≥60) and depression symptoms (≥13).
Results: We found substantially elevated anxiety and depression symptoms compared to similar pre-pandemic pregnancy cohorts, with 34% reporting clinically relevant symptoms (above cut off) of depression and 49.4% reporting clinically relevant symptoms of anxiety. These prevalence estimates are 3-4 times higher than the 9-12% for depression (Brody et al. 2018) and 18-25% for anxiety (Dennis et al. 2017) in large-scale surveys (see Figure 1). Higher symptoms of depression and anxiety were associated with feelings of social isolation due to the COVID-19 pandemic, r = 0.54 and 0.46, p < 0.0001 respectively. Higher levels of perceived social support and support effectiveness were associated with lower psychological symptoms, r = -0.36 and -0.37, p < 0.0001 respectively. Scoring of the objective stress measure is ongoing and once completed mediator and moderator analysis will be included in the presentation.
Conclusion: This study shows concerningly elevated symptoms of anxiety and depression among pregnant individuals during the COVID-19 pandemic that may have long-term impacts on their children. Social support appears to be a protective factor for psychological distress and thus may help mitigate long-term negative outcomes.

Authors

• Gerald Giesbrecht, University of Calgary (U of C)
  Presenting Author

• Lianne M Tomfohr-Madsen, The University of Calgary
  Non-Presenting Author

• Catherine Lebel, University of Calgary, AB
  Non-Presenting Author