Possible Stress–Neuroendocrine System–Psychological Symptoms Relationship in Pregnant Women during the COVID-19 Pandemic

Abstract

The COVID-19 pandemic induced long-term damages that weigh on the national health systems of various countries in terms of support and care. This review aimed to highlight the mental health impact of the COVID-19 pandemic in pregnant women. We first report data on the immune system physiopathology and the main viral infections in pregnancy, including COVID-19. Then, the attention is focused on the main factors that affect the mental health of pregnant women during the COVID-19 pandemic, such as (1) the fear of being infected and transmitting the infection to the fetus, (2) the cancellation of checkups and pre-child courses, and (3) confinement and the inability to have close friends or a partner at the time of delivery or in the first days after delivery, as well as family tensions. Because of all this, pregnant women find themselves in a stressful condition independent of the pregnancy, and thus experience anxiety, depression, insomnia, hostility, delirium, and an alteration of the mother–baby relationship. Several studies have shown an involvement of the hypothalamic–pituitary–adrenal axis and the hypothalamic–pituitary–thyroid axis in response to the pandemic. We propose a possible involvement of the neuroendocrine system as a mediator of the psychological symptoms of pregnant women induced by COVID-19-related stress.

Current Situation and Mental Health of Pregnant Women During the Prevention and Control of Novel Coronavirus Infection: A Cross-Sectional Study on the Investigation of Influencing Factors

“…The results of this study showed that the detection rate of anxiety, insomnia, and stress disorder in pregnant women was significantly higher than that in the general population, which was consistent with the conclusions of previous studies. 3 , 12 , 13 However, the detection rates of anxiety, insomnia, and stress disorders and the related average scores of pregnant women were lower than those in the early stage of COVID-19. 14–16 The reasons may be as follows: Since the first outbreak of COVID-19, China has gradually improved prevention and control measures, increased epidemic prevention supplies, and rationally deployed medical resources to reduce people’s exposure risks.…”

“…The results of this study showed that the detection rate of anxiety, insomnia, and stress disorder in pregnant women was significantly higher than that in the general population, which was consistent with the conclusions of previous studies. 3,12,13 However, the detection rates of anxiety, insomnia, and stress disorders and the related average scores of pregnant women were lower than those in the early stage of COVID-19. [14][15][16] The reasons may be as follows:…”

Impact of COVID-19 pandemic on the circadian rhythm of cesarean section deliveries

“…[28] They allow us to predict and respond better to conditions that arise as a result of light and dark cycles. [29] Studies have shown that normal vaginal delivery has a circadian rhythm; [10,11] however, it changes with external factors such as neuraxial labor analgesia, induction, oxytocin, and interventional birth. [30] In humans, the onset of normal vaginal delivery is mostly between 23:00 and 06:00, regardless of gestational age.…”

“…[28] They allow us to predict and respond better to conditions that arise as a result of light and dark cycles. [29] Studies have shown that normal vaginal delivery has a circadian rhythm; [10,11] however, it changes with external factors such as neuraxial labor analgesia, induction, The values are given as n (%). Statistically significant values are written in bolt (P < .05).…”

“…[9] In some cases, the circadian system is disrupted due to lockdown regulations, and physical distance restrictions lead to negative pregnancy outcomes and result in cesarean section (CS). [6] Although many studies have examined the circadian rhythm of spontaneous vaginal deliveries, [11,12] few studies have focused on the circadian rhythms of CS deliveries. This study aimed to investigate the circadian rhythm of CS delivery and determine whether it was affected by the COVID-19 pandemic.…”