The Association between Delivery during the COVID-19 Pandemic and Immediate Postpartum Maternal Cognitive Function.

Hagai Hamami,Talya Lanxner Battat,Elad Mazor,Gali Pariente,Tamar Wainstock,Eyal Sheiner,Tamar Kosef,Asnat Walfisch

doi:10.3390/jcm9113727

Hagai Hamami, Talya Lanxner Battat + Show 6 more

Open Access

https://doi.org/10.3390/jcm9113727

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Abstract

Survivors of the 2003 SARS epidemic were found to have higher rates of adverse mental conditions. This study aimed to assess cognitive function in women delivering during the COVID-19 pandemic, as compared to women who delivered before the COVID-19 pandemic. A cohort study was performed during the immediate postpartum period of women delivering singletons at term. Cognitive function was assessed using an objective neurocognitive test (Symbol Digit Modalities Test SDMT90, SDMT4) and a subjective self-estimation questionnaire (Attention Function Index AFI). The exposed group was recruited during the COVID-19 outbreak in Israel (May 2020), whereas the comparison group consisted of women delivering at the same medical center before the COVID-19 pandemic (2016–2017). Multivariable regression models were constructed to control potential confounders. There were 79 parturients recruited during the COVID-19 pandemic and compared with 123 women who delivered before the COVID-19 pandemic. Women delivering during the COVID-19 pandemic scored lower in the subjective AFI test compared to the unexposed group (70.0 ± 15.4 vs. 75.1 ± 14.7, p = 0.018). However, no significant difference was found in the objective SDMT tests scores. These results remained similar in the multivariable regression models when controlling for maternal age, ethnicity and time from admission to assessment, for AFI, SDMT90 and SDMT4 scores (p = 0.014; p = 0.734; p = 0.786; respectively). While no significant difference was found in objective tests, our findings propose that the exposure to the COVID-19 pandemic is independently associated with a significant decrease in subjective maternal cognitive function during the immediate postpartum period.

Highlights

Coronavirus disease 2019 (COVID-19), was first identified in December 2019 in China’s Hubei province, and has since become a global concern, resulting in the ongoing coronavirus pandemic [1]
A total of 79 women who delivered during the COVID-19 pandemic and the COVID-19 outbreak in Israel, and 123 women who delivered before the COVID-19 pandemic, were included in the final analysis
Our study found that delivering during the COVID-19 pandemic is independently associated with a significant decrease in maternal subjective cognitive function during the immediate postpartum period

Summary

Introduction

Coronavirus disease 2019 (COVID-19), was first identified in December 2019 in China’s Hubei province, and has since become a global concern, resulting in the ongoing coronavirus pandemic [1]. A recent study assessed the mental health status of Chinese people from Hubei province during the COVID-19 pandemic and demonstrated higher rates of anxiety, depression, and alcohol consumption [4]. One particular group that might be negatively affected by the pandemic is pregnant women and women during the postpartum period, since stress is thought to have a significant effect on pregnancy outcomes [5]. Another cohort study that assessed risk for depression among pregnant women hospitalized in a high-risk pregnancy ward during the COVID-19 pandemic demonstrated comparable risk for depression compared to pregnant women hospitalized before the pandemic [6]

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