Triggering of postpartum depression and insomnia with cognitive impairment in Argentinian women during the pandemic COVID-19 social isolation in relation to reproductive and health factors

Abstract

Objective The 2019 coronavirus disease pandemic (COVID-19) required strict confinement measures that differentially impacted the individual's daily life. Thus, this work aimed to study postpartum women's mental health in Argentina during mandatory social isolation. Design A cross-sectional survey was conducted from May to July 2020, which included five validated questionnaires to assess postpartum depression (Postpartum Depression Screening Scale‐Short Form), insomnia (Insomnia Severity Index), memory complaints (Memory Complaint Scale), metacognition (Brief Metamemory and Metaconcentration Scale), and breastfeeding self-efficacy (Breastfeeding Self-Efficacy Scale-Short Form). Sociodemographic variables, social isolation characteristics, and breastfeeding practices were also collected. This study was conducted in accordance with the Declaration of Helsinki. Statistical analysis included zero-order correlations, multiple logistic regressions, and a set of structural equation models (SEM) to test direct and indirect effects. Goodness-of-fit indices were calculated for SEM. Setting Postpartum women were recruited from public hospitals, private health clinics, and online community recruitment in the Cordoba province (Argentina). Participants 305 postpartum women from Argentina. Measurements and findings 37% of women reported postpartum depression, 46% insomnia, 42% memory impairment, 60% low metaconcentration, 50% low metamemory, and 23% low breastfeeding efficacy. Also, significant associations were found demonstrating that social isolation promoted postpartum depression and insomnia were reciprocally related, which compromised female cognition and efficacy. This situation was aggravated in women during late postpartum, with previous children, and by low social support (e.g., family, health professionals), with non-exclusive breastfeeding being increased. Key conclusions This is the first study addressing postpartum women's mental status during social isolation in Argentina, which was a promoting factor for postpartum depression and insomnia that were reciprocally related. This situation was also aggravated by reproductive factors, such as late postpartum, multiparity, breastfeeding frequency, and non-exclusive breastfeeding. Additionally, breastfeeding self-efficacy depended on mental health status, and euthymia therefore favoured the practice of exclusive breastfeeding.

Prevalence of postpartum depression in women amid the COVID‐19 pandemic: A systematic review and meta‐analysis

“…The COVID‐19 pandemic is also a trigger for various types of mental health problems such as depression, anxiety and panic disorder 2 . Measures such as social distancing, reduction of religious activities, tourism, and schooling during COVID‐19 have changed people’s lifestyles and mental health outcomes, disproportionately affecting high‐risk populations 3,4 …”

“… 2 Measures such as social distancing, reduction of religious activities, tourism, and schooling during COVID‐19 have changed people’s lifestyles and mental health outcomes, disproportionately affecting high‐risk populations. 3 , 4 …”

“…mental health outcomes, disproportionately affecting high-risk populations. 3,4 Pregnancy and postpartum are challenging and are associated with disorders such as insomnia, relationship tension, and feelings of isolation, which have caused mood disorders in many women. On the other hand, environmental stressors such as natural disasters can exacerbate mood disorders during pregnancy.…”

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“…This becomes more relevant for mentally vulnerable populations, such as pregnant and postpartum women ( Perzow et al, 2021 ). These women have an increased risk for postpartum depression, which can be associated with the confinement duration, insomnia, and cognitive problems ( Miranda et al, 2021 ; Perzow et al, 2021 ; Oskovi-Kaplan et al, 2021 ).…”

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