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Maternal prenatal and postnatal distress during the COVID-19 pandemic and infants’ early socioemotional development

Wed, April 7, 10:00 to 11:30am EDT (10:00 to 11:30am EDT), Virtual

Abstract

Background: The COVID-19 pandemic is associated with a significant increase in psychological distress among pregnant women (Berthelot et al., 2020). Since prenatal distress would be associated with poor outcomes in newborns and mothers such as early gestational age, lower birth weight and developmental delays (Meaney, 2018; Graignic-Philippe et al., 2014) it is suggested that the effect of the COVID-19 pandemic on pregnant women and their newborn should be closely monitored (Buekens et al., 2020). To our knowledge, no study has yet documented the impact of prenatal and postnatal maternal distress on infant development during the current pandemic. The present study aims to evaluate whether symptoms of anxiety and depression in pregnant women during the COVID-19 pandemic predicts symptoms at two-months postpartum and whether postnatal symptoms mediates the association between prenatal distress and early infant socioemotional development.
Methods: 225 mothers (Mage = 30.10 years, SD = 3.99) and infants (Mage = 9.65 weeks, SD = 2.73) were recruited online during the COVID-19 mandatory confinement from April 2nd to April 13th 2020 and were followed-up at 2 months postpartum. Anxiety and depressive symptoms were assessed at both time points using the Kessler Psychological Distress Scale (K10, ⍺ = .88) and the Edinburgh Postnatal Depression Scale (EPDS, ⍺ = .84). Infant socioemotional development was assessed using the Ages and Stages Questionnaire: Social-Emotional, Second Edition (ASQ:SE-2, ⍺ = .64). Structural equation modeling analyses were performed using maximum likelihood parameter estimates (see Figure 1). The indirect pathway from prenatal distress to infant development through postnatal distress was assessed using Bootstrapping with 10 000 bootstrap samples and was considered significant when the 95% confidence interval did not include 0.
Results: Indices revealed an excellent fit for the model: χ2(4, N = 225) = 7.402, p = .116, CFI = .993, NFI = .984, RMSEA = .062 with 90% CI [.000, .130]. The indirect effect of prenatal distress on infant socioemotional development via postnatal distress was significant (β = .187, p < .001, 95% CI: 0.120 to 0.259) and maternal prenatal distress had no direct effect on infant socioemotional development. Only offspring of mothers who reported clinically significant symptoms at both time points were at higher risk of reaching the monitoring/clinical cut-off at the ASQ:SE-2 (Relative Risk = 1.86), compared to mothers without clinically significant symptoms. Prenatal distress, in the absence of postnatal distress, was not associated with significant developmental delays in infants (Relative Risk = 0.94).
Clinical and scientific implications: The results suggest that (1) the surge of prenatal maternal distress observed during the COVID-19 is associated with an increased risk of presenting high levels of anxiety and depressive symptoms during the first two months after delivery, and that (2) these symptoms are associated with poor socioemotional development in the child. Our findings call for special means of clinical surveillance in mothers during the COVID-19 pandemic and for innovative (online) interventions aiming to support maternal mental health not only during pregnancy, but also after delivery.

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