Abstract
Introduction: We aimed to measure the impact of the COVID-19 pandemic on maternal mental health, stratifying on pregnancy status, trimester of gestation, and pandemic period/wave. Methods: Pregnant persons and persons who delivered in Canada during the pandemic, >18 years, were recruited, and data were collected using a web-based strategy. The current analysis includes data on persons enrolled between 06/2020–08/2021. Maternal sociodemographic indicators, mental health measures (Edinburgh Perinatal Depression Scale (EPDS), Generalized Anxiety Disorders (GAD-7), stress) were self-reported. Maternal mental health in pregnant women (stratified by trimester, and pandemic period/wave at recruitment) was compared with the mental health of women who had delivered; determinants of severe depression were identified with multivariate logistic regression models. Results: 2574 persons were pregnant and 626 had already delivered at recruitment. Participants who had delivered had significantly higher mean depressive symptom scores compared to those pregnant at recruitment (9.1 (SD, 5.7) vs. 8.4 (SD, 5.3), p = 0.009). Maternal anxiety (aOR 1.51; 95%CI 1.44–1.59) and stress (aOR 1.35; 95%CI 1.24–1.48) were the most significant predictors of severe maternal depression (EDPS ˃ 13) in pregnancy. Conclusion: The COVID-19 pandemic had a significant impact on maternal depression during pregnancy and in the post-partum period. Given that gestational depression/anxiety/stress has been associated with preterm birth and childhood cognitive problems, it is essential to continue following women/children, and develop strategies to reduce COVID-19′s longer-term impact.
Highlights
We aimed to measure the impact of the COVID-19 pandemic on maternal mental health, stratifying on pregnancy status, trimester of gestation, and pandemic period/wave
Trimester of pregnancy and pandemic period/wave had a different impact on maternal depression, with those in their third trimester and those recruited during the 2nd wave having higher depressive symptoms than the other pregnant participants; suggesting that the closer one came to their planned delivery time, especially during the 2nd wave when closures were reinstated and while the vaccines were not yet available, the higher the level of depression
Far, during this pandemic, maternal anxiety, and stress as well as living in rural areas were all significant predictors of severe maternal depression during pregnancy
Summary
We aimed to measure the impact of the COVID-19 pandemic on maternal mental health, stratifying on pregnancy status, trimester of gestation, and pandemic period/wave. Maternal mental health in pregnant women (stratified by trimester, and pandemic period/wave at recruitment) was compared with the mental health of women who had delivered; determinants of severe depression were identified with multivariate logistic regression models. Conclusion: The COVID-19 pandemic had a significant impact on maternal depression during pregnancy and in the post-partum period. COVID-19-related public health measures and pandemic-related stressors have contributed to emotional distress, depression and anxiety [1,2]. Interventions such as indefinite confinement and conflicting public health messaging intensified distress, especially among vulnerable populations including pregnant persons [3]. No large-scale Canadian study has evaluated the impact of the pandemic on mental health during and after pregnancy, across the first three waves of the COVID-19 pandemic
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