The COVID-19 Pandemic and Mental Well-Being of Pregnant Women in Japan: Need for Economic and Social Policy Interventions

Abstract

Objective: This study explores the mental well-being of pregnant women during the COVID-19 pandemic in Japan. Methods: We collected 1777 responses from pregnant women through an online survey. Using the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS), we calculated the percentage of pregnant women above the cut-off (≥ 13), and the factor scores of anhedonia, anxiety, and depression. Regression analyses were performed to identify factors and socio-economic characteristics correlated with depressive symptoms. Results: The point prevalence of pregnant women with an EPDS score of ≥13 was 17%. The mean scores were 0.73, 3.68, and 1.82 for anhedonia, anxiety, and depression, respectively. The probability of becoming above the cutoff score positively correlated with the cancellation of planned informal support, higher perceived risk for infection of COVID-19, difficulties in household finances, and lack of social support. Moreover, being younger, less wealthy, unemployed, and without a partner showed a significantly higher possibility of having a score above the cutoff. Conclusions: The present study found a high percentage of pregnant women with depressive symptoms. Notably, COVID-19 related variables including perceived risk for the infection, fear of decreasing economic wealth, and social support were significantly associated with depressive symptoms.

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.…”

“…The pooled prevalence rate of depression among pregnant women in the first trimester was 21% (95% CI 17-27%, I 2 = 51.2%) and that among women in the second trimester was 20% (95% CI 17-22%, I 2 = 91.0%). The data of pregnant women in the third trimester were given in 3 studies (Matsushima and Horiguchi, 2020;Patabendige et al, 2020;Wu et al, 2020b), and the pooled prevalence of depression in the third trimester was 22% (95% CI 12-33%, I 2 = 96.6%).…”