Adverse Perinatal Outcomes Predicted by Prenatal Maternal Stress Among U.S. Women at the COVID-19 Pandemic Onset

Preis, Heidi; Mahaffey, Brittain; Pati, Susmita; Heiselman, Cassandra; Lobel, Marci

doi:10.1093/abm/kaab005

Cited by 63 publications

(68 citation statements)

References 69 publications

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“…In addition, we found that greater mental health and distress symptoms were experienced by those who identified as non-White and who reported lower education and less income. This is in line with research indicating that ethnic-minority status and financial stress predict elevated mental health problems in pregnant women during COVID-19 (Deng et al 2020 ; Preis et al 2021 ; Thayer and Gildner 2020 ). Ethnic minorities and low-income individuals might experience greater stress as a result of COVID-19 (e.g., greater financial concerns) and have less access to particular coping strategies (e.g., internet access to have face-to-face virtual interactions).…”

Section: Discussionsupporting

confidence: 87%

Coping strategies mediate the associations between COVID-19 experiences and mental health outcomes in pregnancy

Khoury

Atkinson

Bennett

et al. 2021

Arch Womens Ment Health

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The COVID-19 pandemic has resulted in elevated mental health problems for pregnant women. Effective coping strategies likely reduce the impact of COVID-19 on mental health. This study aimed to (1) understand how COVID-19 stressors are related to different coping strategies and (2) identify whether coping strategies act as mechanisms accounting for the associations between COVID-19 stressful experiences and mental health problems in pregnancy. Participants were 304 pregnant women from Ontario, Canada. Depression, anxiety, insomnia, and perceived stress were assessed using validated measures. COVID-related stressors (i.e., financial difficulties, social isolation), subjective negative impact of COVID-19, and coping strategies used in response to COVID-19 were assessed by questionnaires. Results indicated that the subjective negative impact of COVID-19 was associated with more dysfunctional coping and less emotion-focused coping, whereas specific COVID-19 stressors, namely financial difficulties and social isolation, were associated with more dysfunctional coping and problem-focused coping. Dysfunctional coping was linked to elevated mental health problems and emotion-focused coping was linked to less mental health problems. Dysfunctional coping and emotion-focused coping partially mediated the effects of specific COVID-19 stressors on mental health outcomes. Findings indicate that coping is one pathway through which the COVID-19 pandemic impacts mental health in pregnancy. Supports and interventions for pregnant women during the pandemic should focus on bolstering coping skills, in order to minimize the mental health consequences of COVID-19.

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Section: Discussionsupporting

confidence: 87%

Coping strategies mediate the associations between COVID-19 experiences and mental health outcomes in pregnancy

Khoury

Atkinson

Bennett

et al. 2021

Arch Womens Ment Health

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“…Because PREPS-Preparedness, Place and Mode of Birth, Birth Preference Incongruence, and Birth Satisfaction were all associated, and since previous work indicates that PREPS-Preparedness is associated with higher risk of unplanned operative births [ 29 ] (which are by definition incongruent with preferred birth), a path model was explored. As can be seen in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…At the pandemic onset, expectations regarding birth swiftly changed and uncertainty is likely to have caused great distress since women were concerned about birthing without their loved ones, wearing a mask, or having an obstetric team clad in a hazmat suit [ [25] , [26] , [27] ]. Women expressed worries regarding being unprepared for birth due to pandemic-related restrictions which increased the risk of clinically significant anxiety symptoms [ 28 ] and unplanned operative deliveries [ 29 ]. Pandemic-related restrictions along with concerns regarding perinatal infection led to a possible shift in women’s preferences regarding out-of-hospital births [ 30 , 31 ].…”

Section: The Covid-19 Pandemic and Its Impact On Pregnant Womenmentioning

confidence: 99%

“…We aimed to identify the degree to which prenatal pandemic-related perceptions and pandemic-related antenatal and intrapartum practices would contribute to birth satisfaction. Finally, because evidence suggests that pandemic-related unpreparedness stress is associated with higher rates of unplanned operative births [ 29 ], we explored mediating processes related to the association between unpreparedness stress and birth satisfaction.…”

Section: Hypothesis and Guiding Questionsmentioning

confidence: 99%

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The impacts of the COVID-19 pandemic on birth satisfaction in a prospective cohort of 2,341 U.S. women

et al. 2022

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Problem Birth satisfaction is an important health outcome that is related to postpartum mood, infant caretaking, and future pregnancy intention. Background The COVID-19 pandemic profoundly affected antenatal care and intrapartum practices that may reduce birth satisfaction. Aim To investigate the extent to which pandemic-related factors predicted lower birth satisfaction. Methods 2,341 women who were recruited prenatally in April-May 2020 and reported a live birth between April-October 2020 were included in the current analysis. Hierarchical linear regression to predict birth satisfaction from well-established predictors of birth satisfaction (step 1) and from pandemic-related factors (step 2) was conducted. Additionally, the indirect associations of pandemic-related stress with birth satisfaction were investigated. Findings The first step of the regression explained 35% of variance in birth satisfaction. In the second step, pandemic-related factors explained an additional 3% of variance in birth satisfaction. Maternal stress about feeling unprepared for birth due to the pandemic and restrictions on companions during birth independently predicted lower birth satisfaction beyond the non-pandemic variables. Pandemic-related unpreparedness stress was associated with more medicalized birth and greater incongruence with birth preference, thus also indirectly influencing birth satisfaction through a mediation process. Discussion Well-established contributors to birth satisfaction remained potent during the pandemic. In addition, maternal stress and restriction on accompaniment to birth were associated with a small but significant reduction in birth satisfaction. Conclusion Study findings suggest that helping women set flexible and reasonable expectations for birth and allowing at least one intrapartum support person can improve birth satisfaction.

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“…The present study is part of an ongoing international collaboration aiming to investigate the psychological implications of the COVID-19 pandemic among pregnant women [4,34,41]. The results from the United States (US) sample revealed that pregnant women experienced substantial anxiety during the COVID-19 pandemic [4,34].…”

Section: Introductionmentioning

confidence: 93%

Women’s Depressive Symptoms during the COVID-19 Pandemic: The Role of Pregnancy

Yirmiya

Yakirevich-Amir

Preis

et al. 2021

IJERPH

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The Coronavirus Disease 2019 (COVID-19) pandemic has multiple ramifications for pregnant women. Untreated depression during pregnancy may have long-term effects on the mother and offspring. Therefore, delineating the effects of pregnancy on the mental health of reproductive-age women is crucial. This study aims to determine the risk for depressive symptoms in pregnant and non-pregnant women during COVID-19, and to identify its bio-psycho-social contributors. A total of 1114 pregnant and 256 non-pregnant women were recruited via social media in May 2020 to complete an online survey that included depression and anxiety questionnaires, as well as demographic, obstetric and COVID-19-related questionnaires. Pregnant women also completed the Pandemic-Related Pregnancy Stress Scale (PREPS). Pregnant women reported fewer depressive symptoms and were less concerned that they had COVID-19 than non-pregnant women. Among pregnant women, risk factors for depression included lower income, fewer children, unemployment, thinking that one has COVID-19, high-risk pregnancy, earlier gestational age, and increased pregnancy-related stress. Protective factors included increased partner support, healthy behaviors, and positive appraisal of the pregnancy. Thus, being pregnant is associated with reduced risk for depressive symptoms during the pandemic. Increased social support, engaging in health behaviors and positive appraisal may enhance resilience. Future studies of pregnant versus non-pregnant women could clarify the role of pregnancy during stressful events, and clarify aspects of susceptibility and resilience during pregnancy.

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Adverse Perinatal Outcomes Predicted by Prenatal Maternal Stress Among U.S. Women at the COVID-19 Pandemic Onset

Cited by 63 publications

References 69 publications

Coping strategies mediate the associations between COVID-19 experiences and mental health outcomes in pregnancy

Coping strategies mediate the associations between COVID-19 experiences and mental health outcomes in pregnancy

The impacts of the COVID-19 pandemic on birth satisfaction in a prospective cohort of 2,341 U.S. women

Women’s Depressive Symptoms during the COVID-19 Pandemic: The Role of Pregnancy

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