COVID-19 can exacerbate mental health symptoms among pregnant and postpartum women

Although delivery is often anticipated with optimism and enthusiasm, around 10-20% of pregnant women also experience mental health problems during the weeks immediately before and after birth. Depression, anxiety, and trauma-related disorders can all be exacerbated by increased stress related to pregnancy and postpartum experiences. But it is not known how the stressors of a significant health pandemic can affect these complications.

In a new study published in Psychiatry Review, researchers at Brigham and Women’s Hospital surveyed pregnant women and those who had recently given birth, finding the rates of depression, generalized anxiety, and post-traumatic stress disorder (PTSD) symptoms, which were exacerbated by pain-related pain. COVID-19 and health concerns.

We know that the perinatal period is already a time when women are particularly vulnerable to mental health problems. We mainly wanted to see what factors related to the pandemic could be associated with mental health symptoms. “

Cindy Liu, Ph.D., Corresponding Author, Department of Pediatric Neonatal Medicine and Department of Psychiatry

Researchers launched the Perinatal Experiences and COVID-19 Effects Study (PEACE) to better understand the mental health and well-being of pregnant and postpartum people in the United States during the COVID-19 pandemic. Among 1,123 of these women surveyed between May 21 and August 17, 2020, researchers found that more than 1 in 3 (36.4%) reported clinically significant levels of depression. Before the pandemic, rates of perinatal depression (depression occurring during or after pregnancy) were generally considered to be 15-20%. Additionally, 1 in 5 (22.7%) reported clinically significant levels of generalized anxiety and 1 in 10 (10.3%) reported symptoms above the clinical threshold for PTSD.

Specifically, the researchers found that around 9 percent of the participants reported feeling a strong sense of pain, loss or disappointment due to the pandemic. This group was about five times more likely to experience clinically meaningful measures of mental health symptoms. A greater number of respondents (18%) reported being “very worried” or “extremely worried” about the health risks related to COVID-19. This group was up to four times more likely to experience clinically significant psychiatric symptoms.

Researchers recruited participants for the PEACE survey primarily through word of mouth, using posts on email lists and social media groups. They noted that as a result, the sample population was quite homogeneous: 89.9% were white, 92.1% had at least a university education, and 98% lived with their spouse or partner. Family income for 45 percent of the participants was over $ 150,000.

“People who work from home, who have maternity leave, or who just have time to take a survey like this are disproportionately white and wealthy,” Liu said. “This is a limitation to this work. Through a survey, we can get in-depth information very quickly, but we lack the perspectives of various important segments of the population.”

The researchers used standardized measures to assess health concerns and pain experiences related to COVID-19. “We were looking for associations that would inform what we can do as clinical service providers to better support families during this time,” said co-author Carmina Erdei, MD, of the Department of Pediatric Neonatal Medicine. “We wanted to know what is taken away when a new mother is unable to participate in the usual rituals around the birth and reception of a new family member. The answers to the survey offer valuable insight and help guide what we professionals do. health care we can do better. “

The researchers were able to examine how previous mental health diagnoses, as self-reported by the respondents, affected these rates. They found that those with pre-existing diagnoses were 1.6 to 3.7 times more likely to have clinically meaningful measures of the three conditions analyzed. But high psychiatric distress was observed in participants regardless of their mental health histories.

The qualitative data collected through the survey also provided the team with surprising insights into the perinatal experience, but these results have not yet been systematically analyzed. Researchers note that respondents’ mental health experiences correspond to what they observed clinically during the first months of the pandemic, when many of the usual perinatal supports, such as assistance from a partner, family member or peer group, they were limited by the surrounding fears. Risks of COVID-19 infection and disruption of support services.

“Obstetric practices were unable to screen even mental health symptoms, all while people’s mental health was under the greatest pressure,” said co-author Leena Mittal, MD, of the Department of Psychiatry. “Mental health supports have persisted and returned in new ways, and the amount of innovation surrounding the provision of group and individual care, particularly using virtual platforms, is phenomenal. From a psychiatric standpoint, we are not never been so busy, and individuals and families who feel they need mental health care should seek it out.