Maternal mental health during COVID-19 pandemic outbreak: A cross-sectional comparative study

Abstract

BackgroundAs COVID-19 spread in several countries, social distancing measures was implemented around the world, affecting the quality of lives for millions of people. The impact was more pronounced on vulnerable populations such as pregnant women, who are at even more risk due to their suppressed immune system. Moreover, mental health disorders are more common among pregnant women compared to non-pregnant. This study aims to assess the influence of social isolation measures due to the COVID-19 pandemic on the mental health of women in their third trimester and postpartum.Material and methodsThis is a cross-sectional survey-based study conducted in Khalid University Hospital, Riyadh, Saudi Arabia, between the months of April to May 2021, to explore depression and anxiety levels in females who gave birth during the COVID-19 pandemic. In addition to background demographic data, the survey included Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder Scale-7 (GAD-7) were utilized to detect symptoms of depression and anxiety, respectively.ResultsA total of 283 women were included in this study, almost half of them were ante-natal (n-141) and the rest were post-natal (n = 124). 62.3% were in the age groups of 25–35 years. Based on the PHQ-9 scoring, 65% of the study sample had depression (ranging from mild to severe). Moreover, based on GAD-7 scoring, 49.1% had anxiety (ranging from mild to severe). No association was found between PHQ-9 and GAD-7 scores and different sociodemographic and obstetric factors. Additionally, the mean scores of women infected with COVID-19 vs. women who has never been diagnosed with COVID-19 were closely comparable.ConclusionsWe reported a high prevalence of depression and anxiety among pregnant women during COVID-19 pandemic. Policymakers and health care providers are advised to implement targeted preventive measures for pregnant women to improve mental health in times of epidemics.

Risk of Postpartum Depression: The Considerable Role of Maternal Health Status and Lifestyle

“…We found significant associations between the risks of PPD and age, level of education, employment, level of income, and area of residence. This is similar to the findings of previous studies and could be related to social and family dynamics, or the pressures of studying or working while pregnant or mothering [12,13,19,20], as well as the increase in these pressures during the pandemic [15]. This also echoes the findings of other international studies on the effects of the pandemic on maternal mental health [7,9,33].…”

“…Our findings echo other Saudi studies, as 74% of our study sample scored over 14 on the EPDS [13,17]. This could be due to the circumstances of the COVID-19 pandemic, as our survey was conducted between April and November 2021 (during the height of the pandemic) and reflects the critical findings of Papworth et al (2021) who found that 90% of mothers who had recently given birth felt isolated due to the COVID-19 restrictions, as well as several other international studies that showed that women during COVID-19 were more likely to present clinically significant levels of depressive and anxiety symptoms [7,9,15,33,34].…”

“…Our findings for 45% of the study sample who reported difficulties with their last birth are concerning and could be attributed to the COVID-19 restrictions in place at the time, as well as systematic and cultural issues in maternity and obstetrics care [7,9,11,12,14,15,33]. We calculated that the odds of developing PPD after a difficult birth were 11 times higher, which was significant, with a probability of around 91.7%.…”

“…Much remains undiscovered about the health and lifestyle-related factors that may contribute to the risk of PPD among mothers living in Saudi Arabia, especially during emergency events, such as the COVID-19 pandemic. Previous studies from Saudi Arabia have reported increasing prevalence rates of PPD [13,15,17,19,20]. Most recently, a prevalence rate of 75.5% was found, associated with the number of weeks since birth, lack of family support, and unplanned pregnancy [13].…”

“…There are several well-documented risk factors that may exacerbate the potential development of PPD, including a prior history of depression and anxiety (either in pregnancy or previously) [6,8,11,12], a family history of mental illness, low levels of spousal support or family support [7,[11][12][13][14], isolation [7,15,16], infant health issues (including infants with special needs) or breastfeeding and maternal health challenges (including mode of birth or delivery, such as caesarean section or birth trauma) [12], unplanned pregnancy [12][13][14], difficulties with breastfeeding [12], chronic health issues, fatigue and poor sleep quality [3,14,17,18], significant life events (e.g., the death of a loved one, moving houses or job changes), and financial troubles [11,12,19,20].…”