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Effects of Pandemic Worry on Mental Health in Pregnant Women and Implications for Fetal Development

Fri, April 9, 2:45 to 4:15pm EDT (2:45 to 4:15pm EDT), Virtual

Abstract

Maternal anxiety and depression during pregnancy adversely affect infant intrauterine development (Bale et al., 2010; Van den Bergh et al., 2017), with negative consequences for child development across the lifespan. The impact of the COVID-19 pandemic is immense and will shape the mental health of parents and children over the next generations. Understanding the stress experienced by pregnant women during the pandemic can provide unique insight into the impact of prenatal stress on child outcomes. The current study focuses on the pandemic-related distress and its effects on prenatal symptoms of anxiety and depression in a large, diverse sample of pregnant women. We also explore how domains of resilience can buffer the effects that pandemic distress has on mental health, which could inform future intervention efforts. We hypothesized that both general and pregnancy-related pandemic worries would predict anxiety and depression; but that greater resilience would be protective against this risk. Given the disproportionate effects of COVID-19 on the Black community, interactions with race are explored.

During a period of high community spread of COVID-19 and a mandatory stay-at-home order in the region, pregnant women (N=913; 63% White, 24% Black, 8% Asian, mean age=32.42 years, SD=4.86; mean gestational age=24.74 weeks, SD=8.37) completed an online survey that assessed current worries about six general pandemic items and four pregnancy-related items, as well as several resilience factors (i.e., emotion regulation and self-reliance). The survey also screened for anxiety (Mossman et al., 2017; screening cutoff >10) and depression (Patient Health Questionnaire-2, Carey et al., 2016, screening cutoff >2) disorders. All analyses controlled for SES, maternal and gestational age, race, parity, and marital status.

Compared to White women, Black women reported higher levels of worry about the financial burden of the pandemic, having a good birthing experience, receiving good prenatal care, and having access to baby care items (ps<.05). Logistic regression showed that increased worry about family members getting COVID-19 (Exp(B)anxiety=1.42, p=.03, 95% CI=1.03-1.96; Exp(B)depression=1.42, p=.03, 95% CI=1.04-1.93) and worry about the financial burden caused by the pandemic (Exp(B)anxiety=1.31, p=.004, 95% CI=1.09-1.58; Exp(B)depression=1.37, p=.001, 95% CI=1.13-1.64) uniquely predicted both depression and anxiety (see Figure 1A-1B). For pregnancy specific worries, logistic regressions revealed that worry about having a good birthing experience (Exp(B)anxiety=1.56, p=.009, 95% CI=1.12-2.19; Exp(B)depression=2.12, p<.001, 95% CI=1.58-3.11) and worry about access to baby care items (Exp(B)anxiety=1.63, p<.001, 95% CI=1.29-2.07; Exp(B)depression=1.41, p=.004, 95% CI=1.12-1.80) uniquely predicted both depression and anxiety (see Figure 1C-1D). There was no interaction with race and worry predicting mental health. Resilience moderation analyses showed that emotion regulation buffered against the link between total worries and depression (Exp(B)=1.29,p=.012), but not anxiety (ps=.65); self-reliance did not moderate the link between worries and mental health (ps>,80). Interactions with race, worry, and resilience will be expanded upon in the talk. These data provide insight into the negative consequences of pandemic-related stress on pregnant women, particularly Black women, with consequences for their developing offspring. Targeting emotion regulation skills in pregnancy may decrease negative mental health effects caused by stressors, which in turn may improve fetal development.

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