Abstract
BackgroundPregnancy has been shown to be times in a woman’s life particularly prone to mental health issues, however a substantial percentage of mothers report subclinical perinatal mental health symptoms that go undetected. Experiences of prenatal trauma, such as the COVID-19 pandemic, may exacerbate vulnerability to negative health outcomes for pregnant women and their infants. We aimed to examine the role of: 1) anxiety, depression, and stress related to COVID-19 in predicting the quality of antenatal attachment; 2) perceived social support and COVID-19 appraisal in predicting maternal anxiety and depression.MethodsA sample of 150 UK expectant women were surveyed during the COVID-19 pandemic. Questions included demographics, pregnancy details, and COVID-19 appraisal. Validated measures were used to collect self-reported maternal antenatal attachment (MAAS), symptoms of anxiety (STAI), depression (BDI-II), and stress related to the psychological impact of COVID-19 (IES-r).ResultsWe found that the pandemic has affected UK expectant mothers’ mental health by increasing prevalence of depression (47%), anxiety (60%) and stress related to the psychological impact of COVID-19 (40%). Women for whom COVID-19 had a higher psychological impact were more likely to suffer from depressive (95% HDPI = [0.04, 0.39]) and anxiety symptoms (95% HPDI = [0.40, 0.69]). High depressive symptoms were associated with reduced attachment to the unborn baby (95% HPDI [-0.46, -0.1]). Whilst women who appraised the impact of COVID-19 to be more negative showed higher levels of anxiety (HPDI = [0.15, 0.46]), higher social support acted as a protective factor and was associated with lower anxiety (95% HPDI = [-0.52, -0.21]).ConclusionsThe current findings demonstrate that direct experience of prenatal trauma, such as the one experienced during the COVID-19 pandemic, significantly amplifies mothers’ vulnerability to mental health symptoms and impairs the formation of a positive relationship with their unborn baby. Health services should prioritise interventions strategies aimed at fostering support for pregnant women.
Highlights
Pregnancy has been shown to be times in a woman’s life prone to mental health issues, a substantial percentage of mothers report subclinical perinatal mental health symptoms that go undetected
Bayesian modelling To investigate our first hypothesis, we examined whether symptoms of anxiety (STAI)-State and BDI-II scores were predictive of the quality of maternal antenatal attachment
The lack of association between stress related to the psychological impact of COVID-19 and antenatal attachment is similar to the findings reported by [39] that war trauma is not directly associated to maternal-fetal attachment in women living in war conditions
Summary
Pregnancy has been shown to be times in a woman’s life prone to mental health issues, a substantial percentage of mothers report subclinical perinatal mental health symptoms that go undetected. Research shows that in times of natural disasters, e.g. pandemics, there is an increased risk in mental health issues such as Post-Traumatic Stress Disorder (PTSD), depression, and anxiety [1]. Pregnancy has been extensively shown to be times in a woman’s life especially prone to mental health issues [2,3,4]. A substantial percentage of mothers report subclinical perinatal depressive symptoms that go undetected. It has been documented that up to 40% of women experiences sub-clinical perinatal depressive symptoms that are likely to remain undetected by practitioners, yet have similar adverse long-term impacts as the more severe symptoms associated with clinical maternal depression [7, 9]
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