The Impact of the COVID-19 Pandemic on Maternal and Perinatal Health: A Scoping Review

Abstract

Introduction: Maternal health is a critical public health issue, and the Coronavirus Disease 2019 (COVID-19) pandemic has had a multifaceted impact on the health and wellbeing of pregnant individuals and mothers. Methods: A scoping review was conducted to compile evidence on direct and indirect impacts of the pandemic on maternal health and provide an overview of the most significant outcomes thus far. Working papers and news articles were considered appropriate evidence along with peer-reviewed publications in order to capture rapidly evolving updates. Narrative descriptions were written about subject areas for which the authors found the most evidence.Results: While the search yielded numerous publications, most studies were methodologically weak. Pregnant individuals were not found to experience more severe symptoms than the general population, and intrauterine, vertical, and breastmilk transmission were unlikely. Labor, delivery, and breastfeeding guidelines for COVID-19 positive patients varied. Severe increases in maternal mental health issues, such as clinically relevant anxiety and depression, were reported. Domestic violence appeared to spike. Prenatal care visits decreased, healthcare infrastructure was strained, and potentially harmful policies implemented with little evidence. Women were more vulnerable to losing their income due to the pandemic than men, and working mothers struggled with increased childcare demands. Conclusion:Pregnant women and mothers were not found to be at higher risk for COVID-19 than the general population, however they seem to face disproportionate adverse socio-economic consequences. High income and low- and middle-income countries alike faced significant struggles. Further resources should be directed towards quality epidemiological studies.

Household chaos, maternal stress, and maternal health behaviors in the United States during the COVID-19 outbreak

“…Mothers are at greater risk than fathers for loss of employment and reduced work hours during the COVID-19 pandemic. 11 Despite one quarter of our sample losing their job or reducing their work hours (24.7%), this factor was not related to more household chaos. While reduced work hours allow for more time to be dedicated to caregiving, the potential adverse effects on household chaos may take longer to materialize.…”

“…Nevertheless, many women reported disruption to their daily lives from the COVID-19 pandemic, namely, in their childcare duties and employment status, which has been demonstrated in mothers in other countries. 11,12 Finally, one limitation is the current sample was recruited through listservs, social media, and other electronic means, and may be at risk for more distress from pandemic-related media exposure compared to others. 34 Considering current stress in this sample (6.9 ± 1.9, May 2020) is comparable to a Canadian sample of 253 mothers of young children during the pandemic who were recruited without social media methods (6.8 ± 1.9, April 2020), 10 it may be that mothers' stress levels are high regardless of recruitment strategy.…”

“…As shown in a recent scoping review of the COVID-19 outbreak's impact on maternal health, there are both direct and indirect effects of the pandemic on mothers' everyday lives. 11 Mothers in high-income countries have experienced disruptions in childcare and increasing domestic demands, and mothers of all countries surveyed have experienced disproportional job loss compared to fathers. 11 In a study of 2463 mothers of younger children (1-10 years), 12 differing factors were related to poor maternal mental health within each country, including maternal unemployment and high maternal education (the Netherlands) and poor physical health (Italy and China), whereas having grandparents help serve as caregivers was protective for lowering the risk for poor mental health (China).…”

“…11 Mothers in high-income countries have experienced disruptions in childcare and increasing domestic demands, and mothers of all countries surveyed have experienced disproportional job loss compared to fathers. 11 In a study of 2463 mothers of younger children (1-10 years), 12 differing factors were related to poor maternal mental health within each country, including maternal unemployment and high maternal education (the Netherlands) and poor physical health (Italy and China), whereas having grandparents help serve as caregivers was protective for lowering the risk for poor mental health (China). 12 Across all three countries, family conflict and maternal stress were related to worse maternal mental health whereas resilience was related to better mental health.…”

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

“…While half of the pregnant women indicated that the pandemic affected their ongoing pregnancy experience, only a minority of breastfeeding women felt that COVID-19 had an impact on how they personally dealt with breastfeeding. As reflected by the quotations and described elsewhere [ 42 , 43 ], pregnant women attributed their negative experience to the reduced medical follow-up, the absence of the partner during antenatal care visits and increased anxiety or stress due to the current situation. Overall, breastfeeding women generally denied that the pandemic influenced their breastfeeding practices.…”