COVID-19 and Perinatal Experiences (COPE)

• In Event: COVID-19 Crisis and Pregnancy Experiences

Abstract

Background: The COVID-19 pandemic has dramatically altered the social context and medical treatment of pregnant and postpartum mothers. As a result, there is both opportunity and need. There is opportunity to build foundational knowledge about biological and behavioral consequences of prenatal social isolation and prolonged insecurity/uncertainty. There is also need to provide immediate information to parents, policymakers, and care providers, about how to best support families during times of isolation and uncertainty. The central goals of this project are to (i) define primary features of pandemic stress, (ii) examine associations between perceived stress factors and subsequent ratings of maternal mental health, and (iii) evaluate factors likely to underlie individual variation in observed effects, especially pre-existing mental health diagnoses, racial/ethnic differences, SES disparities, and COVID illness.
Methods: We developed the COVID-19 and Perinatal Experiences (COPE) surveys, with input from more than 30 clinicians and researchers around the world. The COPE surveys have been translated into 7 languages and registered with the NIH Repository of COVID-19 research tools (https://dr2.nlm.nih.gov/). Protocols and translations are openly available via an Open Science Framework repository (https://osf.io/uqhcv/). We have also established a larger infrastructure to link COPE cohorts around the globe, the COVID Generation (COVGEN) Research Alliance (https://www.covgen.org/). For the present analysis we analyzed COPE-IS (https://dr2.nlm.nih.gov/search/?q=21878 ) data collected from 679 pregnant and new mothers. We first evaluated frequency of reported impacts and associated distress. We then employed exploratory factor analysis (EFA) to examine potential latent constructs underlying 14 measures extracted from COPE baseline survey data and used linear regression to test whether factor scores related to psychological distress based on Brief Symptom Inventory (BSI) total score. Data analyses are ongoing; in a future step, we will add additional data from other US COPE cohorts and will test how demographic differences and/or health risk impact effect estimates in observed significant associations.
Results: 75% of pregnant women reported changes to prenatal care due to COVID-19. 62% of mothers who delivered between March 15 and July 1, 2020 reported changes to their birth plan, 38% of which were not permitted to have their support partner present at their delivery. 69% of new and expectant mothers reported that the activity they miss the most is in-person social contact. 57.4% of women reported worsening of daily energy levels, 40.9% reported increase in sleep problems, and 78.0% reported increase in stress levels or mental health concerns. EFA established that COPE measures loaded best onto 4 factors (RMSEA = .065), all of which were significantly associated with BSI. The most robust effect was observed for the factor representing social concerns, “social distress”, far right, Figure 1 (β=0.15, p=<0.0001). This study demonstrates that uncertainty about the future, employment distress, concern about COVID-19 illness and social distress are particularly salient pandemic-related stressors with relevance to mental health. These data highlight areas where immediate intervention may serve to promote more optimal health outcomes.

Authors

• Moriah E. Thomason, New York University School of Medicine
  Non-Presenting Author

• Natalie Hiromi Brito, New York University
  Non-Presenting Author

• Michelle VanTieghem, New York University Medical Center
  Non-Presenting Author

• Carly Lenniger, New York University Medical Center
  Non-Presenting Author

• Claudia Espinoza-Heredia, New York University Medical Center
  Non-Presenting Author

• Tessa Vatalaro, New York University Medical Center
  Non-Presenting Author

• Autumn Austin, New York University Medical Center
  Non-Presenting Author

• Maya Metser, New York University
  Non-Presenting Author

• Joy Shen, New York University
  Non-Presenting Author

• Sarwat Siddiqui, New York University Medical Center
  Non-Presenting Author

• Ericka Barroso, New York University Medical Center
  Non-Presenting Author

• Mahima Golani, New York University Medical Center
  Non-Presenting Author

• Denise Werchan, Brown University
  Presenting Author