Prevalence of Depressive Symptoms Among Pregnant and Postpartum Women in China During the COVID-19 Pandemic

Abstract

Objective: According to recent studies, the COVID-19 pandemic has been associated with an increased risk of mental health problems across many subpopulations including pregnant and postnatal women. This study examined the prevalence and correlates of depressive symptoms (depression hereafter) in Chinese pregnant and postpartum women during the COVID-19 pandemic. Methods: This was a multicenter, cross-sectional study comprising 1309 pregnant and postpartum women across 12 provinces in China during the COVID-19 pandemic. Depression was assessed using the nine-item Patient Health Questionnaire. Univariate analyses and multivariate logistic regression analyses were conducted. Results: The prevalence of depression in pregnant and postpartum women was 27.43% (95% confidence interval [CI] = 25.01%-29.85%). Women who were worried about themselves or their babies being infected with COVID-19 (odds ratio [OR] = 2.562, 95% CI = 1.670-3.929), and those who had delayed regular medical checkups (OR = 2.434, 95% CI = 1.580-3.750) were at higher risk of depression. Compared with those living in central and western parts of China, women living in northern (OR = 0.513, 95% CI = 0.326-0.807) and southeastern parts of China (OR = 0.626, 95% CI = 0.463-0.846) were less likely to have depression. Conclusions: The COVID-19 pandemic was associated with an increased likelihood of mental health problems among pregnant and postnatal women. Over a quarter of the pregnant and postpartum women in China had depression during the COVID-19 pandemic. Considering the negative health impact of depression, preventive measures, regular mental health screening, and medical checkups are needed with the goal to reduce the risk of depression in this vulnerable population during a pandemic.

Comorbid Anxiety and Depression and Related Factors Among Pregnant and Postpartum Chinese Women During the Coronavirus Disease 2019 Pandemic

“…One reason for this difference may be the time difference in data collection. Two previous studies (Bo et al, 2021;Jiang et al, 2021) Meanwhile, the present study found that the prevalence of CAD remained unchanged during the perinatal period. The prevalence of "anxiety only" in the first trimester of pregnancy was lower, and that in the third trimester, it was higher.…”

“…Jiang et al (2021) found that between February 5, 2020, and February 28, 2020, 18.1% of pregnant women in China suffered from anxiety and 45.9% suffered from depression (Jiang et al, 2021). Likewise, Bo et al (2021) found that 27.43% of pregnant and postpartum women in China experienced depression between February 22, 2020, andMarch 10, 2020. In the United States, 43.3% of the pregnant women reported moderate to severe anxiety symptoms at the end of April 2020 (Preis et al, 2020), while in Italy, 44.2% of postpartum women experienced depression between March 8, 2020, and June 15, 2020 (Ostacoli et al, 2020). A meta-analysis of 23 studies conducted with 20,569 pregnant and postpartum women during the COVID-19 pandemic found that the prevalence rates of anxiety and depression among the pregnant women were 37% (95% CI: 25-49%) and 31% (95% CI: 20-42%), respectively and the prevalence rate of depression among the postpartum women was 22% (95% CI: 15-29%) (Yan et al, 2020).…”

One Year Into the Pandemic: A Systematic Review of Perinatal Mental Health Outcomes During COVID-19

“…In addition, general conflict, poor family functioning and martial distress emerged as significant risk factors for perinatal anxiety during the pandemic ( 56 , 72 , 74 , 81 , 89 , 98 , 116 , 117 , 128 ). Pregnant women's own health anxiety ( 81 , 98 , 103 , 117 , 118 , 129 ) and partner's perceived fear of COVID-19 ( 116 ) were understood to be contributing to pregnant women's increased anxiety and preventative behavior such as increased hygiene practices and social distancing ( 62 , 71 , 116 , 134 ). Women strictly adhering to the rules and safety recommendations reported greater symptoms ( 98 ).…”

“…Women who did not have information about the effect of COVID-19 on pregancy were at higher risk of anxiety ( 110 ). Delay in or cancellation of planned informal support and reduced prenatal care were associated with an increase in depressive and anxiety symptoms ( 57 , 81 , 96 , 98 , 103 , 129 ). Women who accessed prenatal care information ( 121 ) and perceived strong support from healthcare staff ( 67 ) were at significantly lower risk of psychological distress.…”

Maternal mental health and well-being during the COVID-19 pandemic in Beijing, China

“…In Beijing, routine post-natal home visits were replaced by telephone consultations. This effectively protected pregnant and postpartum women from infection, but the effects of these policies on their psychological status and wellbeing are unknown [ 11 ]. Since stress and anxiety in the postpartum period can negatively impact both mother and infant [ 12 ], it is important to understand the psychological repercussions of this pandemic and lockdown on maternal health.…”