Abstract
Objectives: This study examined the trajectory of perinatal depressive symptoms in Portuguese women during the COVID-19 pandemic and the role of individual, relational, and contextual risk and protective factors. Methods: This 3-wave longitudinal study followed 290 pregnant women from the third trimester of pregnancy until 6-months postpartum. Women self-reported on depressive symptoms, psychological (anxiety, perceived stress, mindfulness), relational (perceived social support, dyadic adjustment, sexual wellbeing), and contextual (lockdown status) factors. Results: Women who were under strict lockdown presented significantly higher scores of depressive symptoms at baseline (by 1.38 EPDS points) than women who were not under strict lockdown measures. Mixed Growth Models showed that trajectories of depressive symptoms were explained by differences in women’s baseline depression. Differences in women’s depressive symptoms at baseline were mainly explained by higher anxiety and lower social support (22% and 24% for women under lockdown; 39% and 6% for women not on lockdown, respectively). Conclusion: Preventative interventions targeted at pregnant women should aim to reduce anxiety and enhance women’s social support to prevent depression in pregnancy and postpartum during the COVID-19 pandemic.
Highlights
During pregnancy and postpartum, changes to women’s physiological, psychological, and relational functioning can affect mothers’ mental health [1], with direct and indirect consequences to their physical health, the couple’s relationship, and their child [2–4]
A recent review found that heightened life stress and low social support are the most common risk factors for postpartum depression and that prenatal depression is the strongest predictor of postnatal depression [5]
The transition to motherhood is typically stressful for mothers, with both external stressors and Maternal Depressive Symptoms During COVID-19 individual factors contributing to the potential development of depression [6]
Summary
Changes to women’s physiological, psychological, and relational functioning can affect mothers’ mental health [1], with direct and indirect consequences to their physical health, the couple’s relationship, and their child [2–4]. According to the vulnerability-stress-adaptation framework—a theoretical framework that aims to explain the development of psychopathology in several settings—, both distal and proximal factors contribute to the onset and maintenance of a disorder. According to this model, relatively minor stressors may lead to mental health problems in a highly vulnerable person, whereas a major stressful event might cause a similar reaction in a person with low vulnerability [6]. Relatively minor stressors may lead to mental health problems in a highly vulnerable person, whereas a major stressful event might cause a similar reaction in a person with low vulnerability [6] This model enables us to understand how stressful events may increase the risk of developing maternal psychopathology
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