Abstract
The COVID-19 pandemic affects the mental health status of perinatal women, which makes it important to gain insight into and to effectively measure specific stressors of the COVID-19 pandemic. Therefore, we aimed to develop a COVID-19 Perinatal Perception Questionnaire (COVID19-PPQ). In-depth interviews were conducted during the first national lockdown period with pregnant women, new mothers and perinatal healthcare professionals, resulting in (a) a 27-item pregnancy and (b) a 21-item postpartum scale. Explorative factor analyses (EFA) in sample Ia (N = 154) and Ib (N = 90), and confirmatory factor analyses (CFA) in sample IIa (N = 113) and IIb (N = 81) were conducted to test the psychometric properties of both scales. For the pregnancy scale, EFA suggested a three-factor solution (risk of infection, contact, future), which was confirmed by CFA and resulted in a final nine-item scale. For the postpartum scale, a three-factor solution (first postpartum week, COVID-19 measures, fear for infection) was suggested by EFA and confirmed by CFA, resulting in a final ten-item scale. Symptoms of depression and pregnancy-specific distress were significantly correlated with the pregnancy (sub)scale(s), while symptoms of postpartum depression and anxiety showed significant correlations with the COVID-19 measures and fear for infection subscale. The COVID19-PPQ seems to be a valid instrument for assessment of perinatal COVID-19-related stress perception, showing adequate psychometric properties for both the pregnancy and postpartum scale. Future research should examine the use of this instrument in clinical practice during new episodes of the COVID-19 pandemic.
Highlights
The COVID-19 pandemic and lockdown have a major impact on the psychological and social wellbeing of individuals (Rajkumar, 2020)
A three-factor solution was suggested in the scree plot, with a ‘risk of infection’ factor, ‘contact’ factor and ‘future’ factor, explaining 38.6% of the variance (Table 2)
When we performed a confirmatory factor analyses (CFA) on the pregnancy scale in the second pregnancy sample (IIa) with the items and dimensions of the Explorative factor analyses (EFA) of the first sample (Ia), we found a poor model fit (CFI = .75, normed fit index (NFI) = .68, Tucker-Lewis Index (TLI) = .69, root mean square error of approximation (RMSEA) = .13, lower bound = .11)
Summary
The COVID-19 pandemic and lockdown have a major impact on the psychological and social wellbeing of individuals (Rajkumar, 2020). Women in the perinatal period may have been affected, since these women are more vulnerable for environmental stressors It seems likely that the lockdown restrictions regarding pregnancy care, work and social activities have affected women in the perinatal period in various other ways as well. It is important to gain insight into the specific aspects of stressors of the COVID-19 pandemic affecting the mental health status in the perinatal period, and to measure these stressors effectively. The aim of the current study was to develop a COVID-19 Perinatal Perception Questionnaire (COVID19-PPQ), using input by in-depth interviews of pregnant women, women who gave birth recently and perinatal healthcare professionals
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