Mental health status of pregnant and breastfeeding women during the COVID‐19 pandemic—A multinational cross‐sectional study

Abstract

Introduction Evidence on perinatal mental health during the coronavirus disease 2019 (COVID‐19) pandemic and its potential determinants is limited. Therefore, this multinational study aimed to assess the mental health status of pregnant and breastfeeding women during the pandemic, and to explore potential associations between depressive symptoms, anxiety, and stress and women's sociodemographic, health, and reproductive characteristics. Material and methods A cross‐sectional, web‐based study was performed in Ireland, Norway, Switzerland, the Netherlands, and the UK between 16 June and 14 July 2020. Pregnant and breastfeeding women up to 3 months postpartum who were older than 18 years of age were eligible. The online, anonymous survey was promoted through social media and hospital websites. The Edinburgh Depression Scale (EDS), the Generalized Anxiety Disorder seven‐item scale (GAD‐7), and the Perceived Stress Scale (PSS) were used to assess mental health status. Regression model analysis was used to identify factors associated with poor mental health status. Results In total, 9041 women participated (including 3907 pregnant and 5134 breastfeeding women). The prevalence of major depressive symptoms (EDS ≥ 13) was 15% in the pregnancy cohort and and 13% the breastfeeding cohort. Moderate to severe generalized anxiety symptoms (GAD ≥ 10) were found among 11% and 10% of the pregnant and breastfeeding women. The mean (±SD) PSS scores for pregnant and breastfeeding women were 14.1 ± 6.6 and 13.7 ± 6.6, respectively. Risk factors associated with poor mental health included having a chronic mental illness, a chronic somatic illness in the postpartum period, smoking, having an unplanned pregnancy, professional status, and living in the UK or Ireland. Conclusions This multinational study found high levels of depressive symptoms and generalized anxiety among pregnant and breastfeeding women during the COVID‐19 outbreak. The study findings underline the importance of monitoring perinatal mental health during pandemics and other societal crises to safeguard maternal and infant mental health.

Mental health among postpartum women during the COVID‐19 pandemic

“…Homeschooling, whose burden is mainly borne by mothers, was also reported by participants as a significant preoccupation that reduced self-care. Our interviews suggest that motherhood during the pandemic can be stressful for these reasons, which could further contribute to the findings of Ceulemans et al (2021) 1 .…”

“…Concerns about the pandemic and public health measures to curb the spread, such as quarantine and limited access to friends, family and health professionals could contribute to the worsened psychological wellbeing now reported in pregnant and postpartum mothers during this pandemic 3 . In semi-structured interviews that we conducted with postpartum women, women described their experience of being in lockdown as 'stuck in a little house with not enough space', 'less optimistic' and 'losing clarity of thought', which supports the findings of Ceulemans et al (2021) 1 .…”

“…These behavioral changes in response to the pandemic are associated with weight gain 5 , which in turn could be an additional source of distress associated with body dissatisfaction and weight stigma in women. Thus, changes in these lifestyle behaviors could contribute to poor mental health status reported in pregnant and postpartum women during the pandemic observed in Ceulemans et al (2021) 1 .…”

“…We read with great interest the article by Ceulemans et al (2021) 1 on maternal mental health issues during the COVID-19 pandemic. We would like to provide some additional insights from our recent interviews with 12 postpartum women during the pandemic to triangulate and support these quantitative findings.…”

Vaccine Willingness and Impact of the COVID-19 Pandemic on Women’s Perinatal Experiences and Practices—A Multinational, Cross-Sectional Study Covering the First Wave of the Pandemic

“…Some of the measures included the obligation to work from home, the closure of schools and the abrupt discontinuation of people's recreational and social life [11]. Although the "lockdown" had positive effects on reducing virus transmission [11,12], it may have increased mental health distress among pregnant and breastfeeding women [13][14][15][16]. In addition to the potential adverse impact on emotional wellbeing, the restrictions may also have affected women's perinatal experiences and/or breastfeeding practices or may have been disruptive to women's access to health services and the extent of support received [17,18].…”