A Mixed-Methods Pilot Study of Perinatal Risk and Resilience During COVID-19

Abstract

Introduction/Objectives: National guidelines underscore the need for improvement in the detection and treatment of mood disorders in the perinatal period. Exposure to disasters can amplify perinatal mood disorders and even have intergenerational impacts. The primary aim of this pilot study was to use mixed-methods to better understand the mental health and well-being effects of the coronavirus disease 2019 (COVID-19) pandemic, as well as sources of resilience, among women during the perinatal period. Methods: The study team used a simultaneous exploratory mixed-methods design to investigate the primary objective. Thirty-one pregnant and postpartum women participated in phone interviews and were invited to complete an online survey which included validated mental health and well-being measures. Results: Approximately 12% of the sample reported high depressive symptomatology and 60% reported moderate or severe anxiety. Forty percent of the sample reported being lonely. The primary themes related to stress were uncertainty surrounding perinatal care, exposure risk for both mother and baby, inconsistent messaging from information sources and lack of support networks. Participants identified various sources of resilience, including the use of virtual communication platforms, engaging in self-care behaviors (eg, adequate sleep, physical activity, and healthy eating), partner emotional support, being outdoors, gratitude, and adhering to structures and routines. Conclusions: Since the onset of COVID-19, many pregnant and postpartum women report struggling with stress, depression, and anxiety symptomatology. Findings from this pilot study begin to inform future intervention work to best support this highly vulnerable population.

Physical exercise and economic burden associated with anxiety symptoms in pregnant women during the COVID-19 pandemic

“…These factors mentioned above may contribute to the development and persistence of anxiety symptoms among pregnant women (30,32). During the COVID-19 pandemic, the results of previous studies showed that pregnant women had higher prevalence of anxiety symptoms compared to the general population or the pregnant women before the COVID-19 outbreak, which is in line with the present study (4,(33)(34)(35). For example, a large cross-sectional survey showed that the prevalence of anxiety symptoms in workers during the epidemic period of the COVID-19 in China was 3.4% (36).…”

Mental Health of Pregnant and Postpartum Women During the Coronavirus Disease 2019 Pandemic: A Systematic Review and Meta-Analysis

“…Some included studies also reported a high prevalence of fear (67.46%) (Gu et al, 2020), loneliness (60%) (Farewell et al, 2020), and PTSD (15.04%) (He et al, 2020) among pregnant women and a high RR of thoughts of self-harm among pregnant women in the same locations (during the COVID-19 pandemic vs. before the COVID-19 pandemic), (RR = 2.85; 95% CI: 1.70-8.85) (Wu et al, 2020b), although these data were not used in the final meta-analysis.…”

“…A total of 23 studies (Ayaz et al, 2020;Berthelot et al, 2020;Ceulemans et al, 2020;Durankuş and Aksu, 2020;Farewell et al, 2020;Gu et al, 2020;He et al, 2020;Lebel et al, 2020;Li et al, 2020;Liu et al, 2020;Mappa et al, 2020;Matsushima and Horiguchi, 2020;Oskovi-Kaplan et al, 2020;Parra-Saavedra et al, 2020;Patabendige et al, 2020;Preis et al, 2020;Saccone et al, 2020;Sade et al, 2020;Silverman et al, 2020;Wu et al, 2020b;Yue et al, 2020;Zanardo et al, 2020;Zhang and Ma, 2020) performed with 20 569 participants (16,797 pregnant women and 3,772 postpartum women) during the COVID-19 pandemic and with 3,677 pregnant women before the COVID-19 pandemic were included in this systematic review and metaanalysis. A total of 19 studies (Ceulemans et al, 2020;Durankuş and Aksu, 2020;Farewell et al, 2020;He et al, 2020;Lebel et al, 2020;Li et al, 2020;Liu et al, 2020;Mappa et al, 2020;Matsushima and Horiguchi, 2020;Oskovi-Kaplan et al, 2020;Parra-Saavedra et al, 2020;Patabendige et al, 2020;Preis et al, 2020;Saccone et al, 2020;…”

“…A total of 19 studies (Ceulemans et al, 2020;Durankuş and Aksu, 2020;Farewell et al, 2020;He et al, 2020;Lebel et al, 2020;Li et al, 2020;Liu et al, 2020;Mappa et al, 2020;Matsushima and Horiguchi, 2020;Oskovi-Kaplan et al, 2020;Parra-Saavedra et al, 2020;Patabendige et al, 2020;Preis et al, 2020;Saccone et al, 2020;Sade et al, 2020;Silverman et al, 2020;Wu et al, 2020b;Yue et al, 2020;Zhang and Ma, 2020) were cross-sectional, and 4 (Ayaz et al, 2020;Berthelot et al, 2020;Gu et al, 2020;Zanardo et al, 2020) were case-control studies. Among the 23 studies, 7 were located in China (Gu et al, 2020;He et al, 2020;Li et al, 2020;Liu et al, 2020;Wu et al, 2020b;Yue et al, 2020;Zhang and Ma, 2020), 3 were implemented in America (Farewell et al, 2020;Preis et al, 2020;Silverman et al, 2020), 3 were performed in Turkey (Ayaz et al, 2020;Durankuş and Aksu, 2020;Oskovi-Kaplan et al, 2020), 3 were undertaken in Italy (Mappa et al, 2020;Saccone et al, 2020;…”

Effects of COVID-19 pandemic lockdown on gestational diabetes mellitus: A retrospective study

“…Moreover, approximately 12% of pregnant women reported high depressive symptomatology and 60% reported moderate or severe anxiety during this period. On the other hand, they also showed a range of resilience factors, including engaging in self-care, such as maintaining physical activity and eating healthily [4] . Nevertheless, the greater difficulties in following this frontline treatment for GDM during lockdown may explain why more patients had poor diabetes control and required insulin therapy during this period compared with 2019.…”