Risk for Depressive Symptoms among Hospitalized Women in High-Risk Pregnancy Units during the COVID-19 Pandemic

Abstract

Objective: Higher rates of mental disorders, specifically depression, were found among affected people in previous epidemiological studies taken after disasters. The aim of the current study was to assess risk for depression among pregnant women hospitalized during the “coronavirus disease 2019” (COVID-19) pandemic, as compared to women hospitalized before the COVID-19 pandemic. Study design: A cross-sectional study was performed among women hospitalized in the high-risk pregnancy units of the Soroka University Medical Center (SUMC). All participating women completed the Edinburgh Postnatal Depression Scale (EPDS), and the results were compared between women hospitalized during the COVID-19 strict isolation period (19 March 2020 and 26 May 2020) and women hospitalized before the COVID-19 pandemic. Multivariable logistic regression models were constructed to control for potential confounders. Results: Women hospitalized during the COVID-19 strict isolation period (n = 84) had a comparable risk of having a high (>10) EPDS score as compared to women hospitalized before the COVID-19 pandemic (n = 279; 25.0% vs. 29.0%, p = 0.498). These results remained similar in the multivariable logistic regression model, while controlling for maternal age, ethnicity and known mood disorder (adjusted odds ratio (OR) 1.0, 95% CI 0.52–1.93, p = 0.985). Conclusion: Women hospitalized at the high-risk pregnancy unit during the COVID-19 strict isolation period were not at increased risk for depression, as compared to women hospitalized before the COVID-19 pandemic.

Mental Health of Pregnant and Postpartum Women During the Coronavirus Disease 2019 Pandemic: A Systematic Review and Meta-Analysis

“…A total of 23 studies (Ayaz et al, 2020;Berthelot et al, 2020;Ceulemans et al, 2020;Durankuş and Aksu, 2020;Farewell et al, 2020;Gu et al, 2020;He et al, 2020;Lebel et al, 2020;Li et al, 2020;Liu et al, 2020;Mappa et al, 2020;Matsushima and Horiguchi, 2020;Oskovi-Kaplan et al, 2020;Parra-Saavedra et al, 2020;Patabendige et al, 2020;Preis et al, 2020;Saccone et al, 2020;Sade et al, 2020;Silverman et al, 2020;Wu et al, 2020b;Yue et al, 2020;Zanardo et al, 2020;Zhang and Ma, 2020) performed with 20 569 participants (16,797 pregnant women and 3,772 postpartum women) during the COVID-19 pandemic and with 3,677 pregnant women before the COVID-19 pandemic were included in this systematic review and metaanalysis. A total of 19 studies (Ceulemans et al, 2020;Durankuş and Aksu, 2020;Farewell et al, 2020;He et al, 2020;Lebel et al, 2020;Li et al, 2020;Liu et al, 2020;Mappa et al, 2020;Matsushima and Horiguchi, 2020;Oskovi-Kaplan et al, 2020;Parra-Saavedra et al, 2020;Patabendige et al, 2020;Preis et al, 2020;Saccone et al, 2020;…”

“…A total of 19 studies (Ceulemans et al, 2020;Durankuş and Aksu, 2020;Farewell et al, 2020;He et al, 2020;Lebel et al, 2020;Li et al, 2020;Liu et al, 2020;Mappa et al, 2020;Matsushima and Horiguchi, 2020;Oskovi-Kaplan et al, 2020;Parra-Saavedra et al, 2020;Patabendige et al, 2020;Preis et al, 2020;Saccone et al, 2020;Sade et al, 2020;Silverman et al, 2020;Wu et al, 2020b;Yue et al, 2020;Zhang and Ma, 2020) were cross-sectional, and 4 (Ayaz et al, 2020;Berthelot et al, 2020;Gu et al, 2020;Zanardo et al, 2020) were case-control studies. Among the 23 studies, 7 were located in China (Gu et al, 2020;He et al, 2020;Li et al, 2020;Liu et al, 2020;Wu et al, 2020b;Yue et al, 2020;Zhang and Ma, 2020), 3 were implemented in America (Farewell et al, 2020;Preis et al, 2020;Silverman et al, 2020), 3 were performed in Turkey (Ayaz et al, 2020;Durankuş and Aksu, 2020;Oskovi-Kaplan et al, 2020), 3 were undertaken in Italy (Mappa et al, 2020;Saccone et al, 2020;…”

“…The pooled prevalence of depression among pregnant women was 31% (95% CI 20-42%, I 2 = 99.4%) as shown in Figure 3. After excluding studies with a high risk of bias, 11 studies with a low risk of bias (Berthelot et al, 2020;Ceulemans et al, 2020;Durankuş and Aksu, 2020;He et al, 2020;Lebel et al, 2020;Matsushima and Horiguchi, 2020;Parra-Saavedra et al, 2020;Patabendige et al, 2020;Sade et al, 2020;Silverman et al, 2020;Wu et al, 2020b) were included. These studies showed a pooled prevalence of depression among pregnant women of 27% (95% CI 17-40%, I 2 = 99.5%).…”

“…Each of the 7 remaining studies took place in a different country. For used scales (Supplementary Figure 5), 7 studies (Durankuş and Aksu, 2020;He et al, 2020;Lebel et al, 2020;Matsushima and Horiguchi, 2020;Sade et al, 2020;Silverman et al, 2020;Wu et al, 2020b) applied the Edinburgh Postpartum Depression Scale with a pooled prevalence rate of depression among pregnant women of 31% (95% CI: 15-49%, I 2 = 99.6%). Each of the 6 remaining studies utilized a different scale.…”

“…Each of the 6 remaining studies utilized a different scale. Two studies (Sade et al, 2020;Wu et al, 2020b) reported the percentages of positive depression among pregnant women in the same location during and before the COVID-19 pandemic (Supplementary Figure 3). The pooled RR was 1.08 (95% CI: 0.80-1.46, I 2 = 56.8%).…”