Maternal-fetal bonding during the COVID-19 pandemic

Amanda Koire,Cindy H Liu,Leena Mittal,Carmina Erdei

doi:10.1186/s12884-021-04272-9

Amanda Koire, Cindy H Liu + Show 2 more

Open Access

https://doi.org/10.1186/s12884-021-04272-9

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Abstract

BackgroundThe pregnant population experienced unique COVID-19 physical and psychosocial stressors such as direct health concerns related to the virus and loss of access to resources since the COVID-19 emerged as a global pandemic in early 2020. Despite these COVID-19-related stress and concerns, the maternal experience of bonding with their unborn children has not been well studied. This work aimed to study the association between mental health history, current mental health symptoms, psychological factors, COVID-19-related worries, and self-reported maternal-fetal bonding of pregnant women.MethodsThis online, survey-based cross-sectional study focused on women pregnant during the pandemic and assessed 686 women using data collected from May 19, 2020 to October 3, 2020. Enrolled respondents completed assessments in which they self-reported maternal-fetal bonding, mental health symptomatology, psychological factors, and COVID-19-related worries regarding health, pregnancy, and resources.ResultsDepressive symptoms in pregnant women were associated with lower quality maternal-fetal bonding, while a higher level of anxiety was positively associated with bonding; however, past history of depression or generalized anxiety diagnosis did not appear to be as relevant as active symptomatology. Maternal resilience, but not distress tolerance, appeared to be a protective factor resulting in improved bonding. Higher levels of worry regarding impact of COVID-19 on health were significantly associated with improved bonding, while worries regarding the impact of COVID-19 on the pregnancy or resources were not significantly associated with bonding. The study also found associations between different sociodemographic variables and bonding, including a strong positive association between first time motherhood and bonding and a negative association between higher education and income and bonding.ConclusionsThis study was the first to report potential protective and risk factors to the maternal-fetal bonding process in women pregnant during the COVID-19 pandemic. Unique COVID-19 concerns exist; however, anxiety and COVID-19 concerns do not appear to undermine maternal-fetal bonding while active depressive symptomatology may negatively influence bonding; interventions increasing maternal resilience may be particularly valuable.

Highlights

The pregnant population experienced unique COVID-19 physical and psychosocial stressors such as direct health concerns related to the virus and loss of access to resources since the COVID-19 emerged as a global pandemic in early 2020
This study aimed to examine the associations between mental health history, current mental health symptoms, maternal psychological factors, worries related to the COVID-19 pandemic, and self-reported maternal-fetal bonding in pregnant women
17.8% of patients had a prior diagnosis of Depression while 27.0% had a prior diagnosis of Generalized Anxiety Disorder

Summary

Introduction

The pregnant population experienced unique COVID-19 physical and psychosocial stressors such as direct health concerns related to the virus and loss of access to resources since the COVID-19 emerged as a global pandemic in early 2020. Under non-pandemic conditions, a first pregnancy [30], later gestational age [24], ultrasound visualization of the fetus [31], and better partner support [32] appear to promote maternal-fetal bonding, while higher maternal education levels [32], depressive symptoms [32, 33], and substance abuse history [30] are potential risks to successful bonding; the influence of anxiety on maternalfetal bonding has received mixed reports [19, 22, 34] Individual characteristics such as psychological resilience or distress tolerance are thought to have a role on one’s well-being during the COVID-19 pandemic [35,36,37] but have not been well-studied even under non-pandemic conditions [38]. Poor maternal mental health can lead to difficulties in this bonding process and existing evidence suggests that the rates of anxiety and depression among pregnant women have increased during the pandemic beyond an already high general prevalence [39]

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