Maternal mental health in Nepal and its prioritization during COVID-19 pandemic: Missing the obvious

Aryal, Shreyashi; Pant, Sagun Ballav

doi:10.1016/j.ajp.2020.102281

Cited by 13 publications

(12 citation statements)

References 7 publications

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“…The pandemic significantly impacted maternal mental health. Feelings of anxiety and depression were associated with maternal fear of vertical transmission of the virus to their infants, limited accessibility of antenatal care resources, and lack of social support [53,54]; these experiences also created a source of stress for pregnant and postpartum women without COVID [27,55]. Social distancing and isolation/quarantine procedures implemented during the pandemic increased risk of psychological problems among pregnant women and new mothers [53][54][55].…”

Section: Mental Healthmentioning

confidence: 99%

The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review

et al. 2021

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Introduction The Covid-19 pandemic affects maternal health both directly and indirectly, and direct and indirect effects are intertwined. To provide a comprehensive overview on this broad topic in a rapid format behooving an emergent pandemic we conducted a scoping review. Methods A scoping review was conducted to compile evidence on direct and indirect impacts of the pandemic on maternal health and provide an overview of the most significant outcomes thus far. Working papers and news articles were considered appropriate evidence along with peer-reviewed publications in order to capture rapidly evolving updates. Literature in English published from January 1st to September 11 2020 was included if it pertained to the direct or indirect effects of the COVID-19 pandemic on the physical, mental, economic, or social health and wellbeing of pregnant people. Narrative descriptions were written about subject areas for which the authors found the most evidence. Results The search yielded 396 publications, of which 95 were included. Pregnant individuals were found to be at a heightened risk of more severe symptoms than people who are not pregnant. Intrauterine, vertical, and breastmilk transmission were unlikely. Labor, delivery, and breastfeeding guidelines for COVID-19 positive patients varied. Severe increases in maternal mental health issues, such as clinically relevant anxiety and depression, were reported. Domestic violence appeared to spike. Prenatal care visits decreased, healthcare infrastructure was strained, and potentially harmful policies implemented with little evidence. Women were more likely to lose their income due to the pandemic than men, and working mothers struggled with increased childcare demands. Conclusion Pregnant women and mothers were not found to be at higher risk for COVID-19 infection than people who are not pregnant, however pregnant people with symptomatic COVID-19 may experience more adverse outcomes compared to non-pregnant people and seem to face disproportionate adverse socio-economic consequences. High income and low- and middle-income countries alike faced significant struggles. Further resources should be directed towards quality epidemiological studies. Plain English summary The Covid-19 pandemic impacts reproductive and perinatal health both directly through infection itself but also indirectly as a consequence of changes in health care, social policy, or social and economic circumstances. The direct and indirect consequences of COVID-19 on maternal health are intertwined. To provide a comprehensive overview on this broad topic we conducted a scoping review. Pregnant women who have symptomatic COVID-19 may experience more severe outcomes than people who are not pregnant. Intrauterine and breastmilk transmission, and the passage of the virus from mother to baby during delivery are unlikely. The guidelines for labor, delivery, and breastfeeding for COVID-19 positive patients vary, and this variability could create uncertainty and unnecessary harm. Prenatal care visits decreased, healthcare infrastructure was strained, and potentially harmful policies are implemented with little evidence in high and low/middle income countries. The social and economic impact of COVID-19 on maternal health is marked. A high frequency of maternal mental health problems, such as clinically relevant anxiety and depression, during the epidemic are reported in many countries. This likely reflects an increase in problems, but studies demonstrating a true change are lacking. Domestic violence appeared to spike. Women were more vulnerable to losing their income due to the pandemic than men, and working mothers struggled with increased childcare demands. We make several recommendations: more resources should be directed to epidemiological studies, health and social services for pregnant women and mothers should not be diminished, and more focus on maternal mental health during the epidemic is needed.

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Section: Mental Healthmentioning

confidence: 99%

The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review

et al. 2021

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“…Antenatal COVID-19 anxiety, COVID risk perception and perceived social support significantly determined the rates of generalized anxiety. Our study results imply that along with the fundamental need to integrate screening for anxiety in existing antenatal programs, provision of psychological assistance to pregnant women in dealing with secondary mental health challenges related with COVID-19 and prioritization of maternal mental health, especially in Asian nations, is mandated ( Ali and Shahil Feroz, 2020 , Aryal and Pant, 2020 ).…”

Section: Discussionmentioning

confidence: 85%

Anxiety among pregnant women during the COVID-19 pandemic in India − A multicentric study

Tikka

Parial²,

Pattojoshi

et al. 2021

Asian Journal of Psychiatry

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While higher anxiety during antenatal period cause several maternal and foetal health related complications, lower anxiety levels are found to be associated with lesser “precautionary behaviours” and consequently greater risk of infection, during the COVID-19 pandemic. In this study, we aimed to assess rates and determinants of generalized anxiety at the time of the pandemic as well as anxiety that was specific to the context of being pregnant during the COVID-19 pandemic. (COVID-19-antenatal anxiety) in Indian women. This hospital-based, cross-sectional study using face-to-face interviews was conducted at antenatal clinics of five medical college hospitals in India. The Generalized Anxiety Disorder-7 scale (GAD −7) and a customized scale to assess antenatal COVID-19 anxiety along with other tools that assessed social support and COVID-19-risk perception were administered to 620 pregnant women. We found that the percentage of women with moderate or severe anxiety based on GAD −7 was 11.1%. Multivariate analysis showed that higher COVID-19-risk perception, greater antenatal COVID-19 anxiety and lower perceived support significantly predicted moderate and severe generalized anxiety. Greater number of weeks of gestation, lower education, semiurban habitat and lower perceived social support were significant predictors of antenatal COVID-19 anxiety. We conclude that the rates of anxiety in pregnant women though not very high, still warrant attention and specific interventions.

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“…Pregnant women with COVID-19 reportedly had a disproportionately poor socioeconomic status, regardless of the economic status of the country (26) . These reports were also a source of stress for pregnant and postpartum women without COVID-19 (27) , (28) . Pregnant women and new mothers were more likely to experience mental illness than non-pregnant women (29) .…”

Section: Impact Of Disasters On Pregnant Womenmentioning

confidence: 99%

“…Pregnant women and new mothers were more likely to experience mental illness than non-pregnant women (29) . Social distancing, isolation, and quarantine procedures implemented during the pandemic increased the risk of psychological problems in pregnant women and new mothers (22) , (23) , (28) . A longitudinal study of emergency department visits in the United States reported increases in mental health conditions, suspected child abuse and neglect, drug overdose, and suicide attempts, but not intimate partner violence (30) .…”

Section: Impact Of Disasters On Pregnant Womenmentioning

confidence: 99%

The Significance of Observing the Risk of Non-communicable Diseases after Large-scale Disasters and Communicable Disease Epidemics

Metoki

2021

JMA J

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Non-communicable diseases (NCDs) are a global challenge, accounting for 71% of all deaths worldwide. The spread of coronavirus disease 2019 (COVID-19) and past huge disasters have affected the prevention and treatment of NCDs and require urgent action. In this narrative review, I will discuss several reports on the risk of NCDs during past disasters and propose possible future directions. Hypertension, the most common NCD, carries a high risk of death due to cerebrovascular, renal, and other complications. Effective use of information and communication technology-based telemedicine is necessary to manage the risk of cardiovascular diseases during disasters and pandemics. We observed the cumulative incidence of metabolic syndrome in subjects from tsunami-affected areas. We found that moving into prefabricated temporary housing was a risk factor for a higher incidence of metabolic syndrome in elderly females. Our follow-up of 1,009 subjects showed a slight, but significant, increase in HbA1c values after a state of emergency was introduced, even though the lockdown was not as stringent as in other countries. In a study elucidating the prevalence of wheezing and eczema symptoms and the associated factors after the Great East Japan Earthquake, psychological effects, such as depression and self-reported posttraumatic stress disorder, were observed, particularly in people with allergic diseases. In recent years, new birth cohort studies have been initiated to complement the studies designed to collect information across multiple generations, such as the Lifelines study in the Netherlands and the Avon Longitudinal Study of Parents and Children (ALSPAC) study in the UK. It is desirable to assess the effects of COVID-19 to complement the existing cohort studies in Japan as well.

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Maternal mental health in Nepal and its prioritization during COVID-19 pandemic: Missing the obvious

Cited by 13 publications

References 7 publications

The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review

The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review

Anxiety among pregnant women during the COVID-19 pandemic in India − A multicentric study

The Significance of Observing the Risk of Non-communicable Diseases after Large-scale Disasters and Communicable Disease Epidemics

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