Postpartum Distress Research Articles

Postpartum depression, and post-traumatic stress disorder and resultant risk factors among teenage mothers: a community-based study

The prevalence of postpartum depression in teenage mothers is higher than that in adult mothers. The present study aimed to investigate the prevalence of depression, distress, and post-traumatic stress disorders (PTSD) following childbirth and its resultant risk factors among teenage mothers. Material and Methods. This cross-sectional study was carried out on 167 teenage women aged 11–19 years, 8-week after giving birth, in Tabriz, Iran. The data were collected using by socio-demographic characteristics questionnaire, Edinburgh Postnatal Depression Scale, Posttraumatic Stress Disorder Checklist and Postpartum Distress Measure scale. Results. The study results revealed that 12.6% and 7.2% of the participants had postpartum depression and PTSD, respectively. The results showed that the variables of the number of children, dissatisfaction with marriage, and history of preconception depression were among the risk factors associated with postpartum depression. The results indicated that unwanted pregnancy, lack of spousal support, insufficient income, and infant restlessness variables were predictors of PTSD. Conclusion. Based on our findings, it is crucial to identify teenage mothers with predisposing factors for postpartum depression and PTSD. Providing family planning counseling to reduce unwanted pregnancies, training fathers to support their spouses, and ensuring timely referral of high-risk individuals are essential interventions to address the mental health challenges faced by teenage mothers.

Joint effects of traffic-related air pollution and hypertensive disorders of pregnancy on maternal postpartum depressive and anxiety symptoms.

Ambient air pollution has been linked to postpartum depression. However, few studies have investigated the effects of traffic-related NOx on postpartum depression and whether any pregnancy-related factors might increase susceptibility. To evaluate the association between traffic-related NOx and postpartum depressive and anxiety symptoms, and effect modification by pregnancy-related hypertension. This study included 453 predominantly low-income Hispanic/Latina women in the MADRES cohort. Daily traffic-related NOx concentrations by road class were estimated using the California LINE-source dispersion model (CALINE4) at participants' residential locations and averaged across pregnancy. Postpartum depressive and anxiety symptoms were evaluated by a validated questionnaire (Postpartum Distress Measure, PDM) at 1, 3, 6 and 12 months postpartum. Multivariate linear regressions were performed to estimate the associations at each timepoint. Interaction terms were added to the linear models to assess effect modification by hypertensive disorders of pregnancy (HDPs). Repeated measurement analyses were conducted by using mixed effect models. We found prenatal traffic-related NOx was associated with increased PDM scores. Specifically, mothers exposed to an IQR (0.22 ppb) increase in NOx from major roads had 3.78% (95% CI: 0.53-7.14%) and 5.27% (95% CI: 0.33-10.45%) significantly higher 3-month and 12-month PDM scores, respectively. Similarly, in repeated measurement analyses, higher NOx from major roads was associated with 3.06% (95% CI: 0.43-5.76%) significantly higher PDM scores across the first year postpartum. Effect modification by HDPs was observed: higher freeway/highway and total NOx among mothers with HDPs were associated with significantly higher PDM scores at 12 months postpartum compared to those without HDPs. This study shows that prenatal traffic-related air pollution was associated with postpartum depressive and anxiety symptoms. The study also found novel evidence of greater susceptibility among women with HDPs, which advances the understanding of the relationships between air pollution, maternal cardiometabolic health during pregnancy and postpartum mental health. Our study has potential implications for clinical intervention to mitigate the effects of traffic-related pollution on postpartum mental health disorders. The findings can also offer valuable insights into urban planning strategies concerning the implementation of emission control measures and the creation of green spaces.

A longitudinal study examining the associations between prenatal and postnatal maternal distress and toddler socioemotional developmental during the COVID-19 pandemic.

Elevated psychological distress, experienced by pregnant women and parents, has been well-documented during the COVID-19 pandemic. Most research focuses on the first 6-months postpartum, with single or limited repeated measures of perinatal distress. The present longitudinal study examined how perinatal distress, experienced over nearly 2years of the COVID-19 pandemic, impacted toddler socioemotional development. A sample of 304 participants participated during pregnancy, 6-weeks, 6-months, and 15-months postpartum. Mothers reported their depressive, anxiety, and stress symptoms, at each timepoint. Mother-reported toddler socioemotional functioning (using the Brief Infant-Toddler Social and Emotional Assessment) was measured at 15-months. Results of structural equation mediation models indicated that (1) higher prenatal distress was associated with elevated postpartum distress, from 6-weeks to 15-months postpartum; (2) associations between prenatal distress and toddler socioemotional problems became nonsignificant after accounting for postpartum distress; and (3) higher prenatal distress was indirectly associated with greater socioemotional problems, and specifically elevated externalizing problems, through higher maternal distress at 6weeks and 15months postpartum. Findings suggest that the continued experience of distress during the postpartum period plays an important role in child socioemotional development during the COVID-19 pandemic.

Psychological distress in pregnancy and postpartum: a cross-sectional study of Babol pregnancy mental health registry

BackgroundPsychological distress (PD) is a significant issue during pregnancy and postpartum, adversely affecting both children and mothers. This study aims to determine PD's prevalence and risk factors in a large Iranian population sample during pregnancy and postpartum.MethodsA cross-sectional study was conducted using data from the Babol Pregnancy Mental Health Registry (located in the north of Iran) between June 2020 and March 2021. A total of 2305 women were included, with 1639 during pregnancy and 666 during postpartum. Psychological distress was assessed using the Brief Symptoms Inventory (BSI-18), and data were analyzed using independent t-tests and multiple logistic regressions.ResultsThe prevalence of psychological distress, defined by a cut-off score of BSI ≥ 13, was 19% during pregnancy and 15% during postpartum. Multivariate logistic analysis revealed that high-risk pregnancy was the leading risk factor for psychological distress during the antenatal period (β = 1.776, P < 0.001), as well as its three subscales: somatization (β = 1.355, P = 0.019), anxiety symptoms (β = 2.249, P < 0.001), and depressive symptoms (β = 1.381, P = 0.028). Additionally, women with a gestational age < 20 weeks had a higher risk of psychological distress (β = 1.344, P = 0.038) and the somatization subscale (β = 1.641, P < 0.001). During the postpartum period, women residing in urban areas were at higher risk of psychological distress (β = 1.949, P = 0.012), as well as two subscales: anxiety symptoms (β = 1.998, P = 0.012) and depressive symptoms (β = 1.949, P = 0.020).ConclusionThe high prevalence of psychological distress emphasizes detecting and treating PD during pregnancy and postpartum, particularly in women with high-risk pregnancies. This study suggests that obstetricians and midwives should implement programs to identify women experiencing psychological distress during early pregnancy through postpartum visits.

The Role of Social Support and Acculturation Factors on Postpartum Mental Health Among Latinas in the MADRES Pregnancy Cohort.

We examined the associations between social support and postpartum mental health in 137 U.S. and foreign-born Latinas in the MADRES pregnancy cohort. We also examined whether language, years in the U.S., and country of birth moderates these relationships. Participants were administered PROMIS support measures 1month postpartum; the Perceived Stress and Postpartum Distress Measure 3, 6, and 12months postpartum; and the CESD scale 12months postpartum. Perceived stress was lower at 6months postpartum for women reporting higher emotional (p = 0.01), informational (p = 0.03), and instrumental support (p < 0.001); and lower at 12months postpartum for women reporting higher emotional support (p = 0.01). Distress at 6months was lower in women reporting higher emotional support (p = 0.03). Interactions suggest that associations were stronger for mothers that speak Spanish, spent fewer years in the U.S., and were born in Central America.

A Preliminary Investigation of Prenatal Anxiety Sensitivity and Postpartum Distress.

Distress during pregnancy and postpartum is common and contributes to poor infant and maternal outcomes, such as developmental delays and mental health disorders, respectively. Anxiety sensitivity, or fear of the symptoms of anxiety (eg, palpitations, confusion), is a risk factor known to increase distress across psychological and health-related conditions. Given the physiologic and emotional changes that occur during the perinatal period, anxiety sensitivity may be a salient risk factor for maternal distress. In this pilot study, we aimed to understand the unique role of prenatal anxiety sensitivity in postpartum psychological and parenting distress. Twenty-eight pregnant women (mean age, 30.86 years) were recruited from the community in a Southeastern metropolitan area of the United States. Participants completed self-report measures during their third trimester of pregnancy and again within 10 weeks postpartum. The Depression Anxiety and Stress Scales-21 and the Parenting Distress subscale of the Parenting Stress Index-4-Short Form were the primary postpartum outcome measures. Prenatal anxiety sensitivity was elevated in this sample relative to convenience samples. Prenatal anxiety sensitivity uniquely contributed to postpartum psychological (b, 1.01; P < .001) and parenting distress (b, 0.62; P = .008), after accounting for age, gravidity, and gestation. Albeit preliminary, results suggest prenatal anxiety sensitivity may be an important and malleable risk factor associated with several mental health concerns common in the perinatal period. Anxiety sensitivity may be targeted with brief interventions to prevent or reduce postpartum distress. Reducing prenatal anxiety sensitivity has the potential prevent the onset or worsening of psychological disorders among women and, in turn, may improve infant and child outcomes. Future studies should replicate these findings in a larger sample.

Magnitude of paternal postpartum psychological distress and associated factors in Addis Ababa, Ethiopia: a facility-based cross-sectional study

BackgroundThe psychological distress of fathers in the postpartum period can have adverse effects on the well-being of the family and the newborn’s development in particular. However, fathers’ mental health throughout the postpartum has remained understudied and clinically overlooked in many developing countries, including Ethiopia. This study aims to assess the prevalence of psychological distress among fathers in the postpartum period and to examine the associated factors in an Ethiopian population.MethodsA facility-based, cross-sectional study was conducted at Tikur Anbessa Specialized Hospital (TASH) and Gandhi Memorial Hospital (GMH) in Addis Ababa, Ethiopia. A systematic sampling method was employed to include 280 fathers whose partners gave birth 6 to 8 weeks before the interview. Psychological distress was assessed using a validated Amharic version of the Kessler Psychological Distress Scale (K10) through a telephone interview. The collected data was analyzed using SPSS version 26. Descriptive statistics were used to summarize the data. Multivariable logistic regression was run to determine the variables associated with paternal postpartum psychological distress (K10 total score ≥ 7, a validated cut-off score in an urban Ethiopian setting), and odds ratio with 95% confidence intervals were obtained. A two-tailed p-value < 0.05 was considered for statistical significance.ResultsAbout one-fifth of the fathers endorsed having distress symptoms during the postpartum period. Those with lower income (AOR = 11.31, 95% CI: 4.10, 31.15), unintended pregnancy (AOR = 3.96, 95% CI: 1.02, 15.46), poor social support (AOR =3.28 95% CI: 1.43, 7.50), poor infantile health (AOR = 8.20, 95% CI: 2.35, 28.66) and maternal postpartum distress (AOR = 12.10, 95% CI: 3.15, 46.48) had significantly higher odds of having paternal postpartum distress.ConclusionsPaternal postpartum distress was present in one-fifth of the fathers included in this study. This calls for due attention and efforts for early detection of those at risk of paternal distress and the development of interventions that consider their specific needs.

Association of Antenatal COVID-19–Related Stress With Postpartum Maternal Mental Health and Negative Affectivity in Infants

Antenatal stress is a significant risk factor for poor postpartum mental health. The association of pandemic-related stress with postpartum outcomes among mothers and infants is, however, less well understood. To examine the association of antenatal COVID-19-related stress with postpartum maternal mental health and infant outcomes. This cohort study was conducted among 318 participants in the COVID-19 Risks Across the Lifespan study, which took place in Australia, the UK, and the US. Eligible participants reported being pregnant at the first assessment wave between May 5 and September 30, 2020, and completed a follow-up assessment between October 28, 2021, and April 24, 2022. COVID-19-related stress was assessed with the Pandemic Anxiety Scale (score range, 0-4, with higher scores indicating greater COVID-19-related stress). The 8-item Patient Health Questionnaire (score range, 0-3, with higher scores indicating more frequent symptoms of depression) was used to measure maternal depression at each time point, and the 7-item General Anxiety Disorder scale (score range, 0-3, with higher scores indicating more frequent symptoms of anxiety) was used to measure generalized anxiety at each time point. At follow-up, postpartum distress was assessed with the 10-item Postpartum Distress Measure (score range, 0-3, with higher scores indicating greater postpartum distress), and infant outcomes (negative and positive affectivity and orienting behavior) were captured with the Infant Behavior Questionnaire (score range, 1-7, with higher scores indicating that the infant exhibited that affect/behavior more frequently). The study included 318 women (mean [SD] age, 32.0 [4.6] years) from Australia (88 [28%]), the US (94 [30%]), and the UK (136 [43%]). Antenatal COVID-19-related stress was significantly associated with maternal postpartum distress (β = 0.40 [95% CI, 0.28-0.53]), depression (β = 0.32 [95% CI, 0.23-0.41]), and generalized anxiety (β = 0.35 [95% CI, 0.26-0.44]), as well as infant negative affectivity (β = 0.45 [95% CI, 0.14-0.76]). The findings remained consistent across a range of sensitivity analyses. The findings of this cohort study suggest that targeting pandemic-related stressors in the antenatal period may improve maternal and infant outcomes. Pregnant individuals should be classified as a vulnerable group during pandemics and should be considered a public health priority, not only in terms of physical health but also mental health.

Understanding the Dynamics of Online Social Support Among Postpartum Mothers in Online Communities.

Despite previous attempts to identify types of social support among postpartum mothers, researchers have overlooked how and why postpartum mothers seek and offer social support as well as the dynamics of participation in online communities. The objective of the current study was to explore possible answers through grounded theory approach of interviews with 24 mothers who have experienced postpartum depression and psychological distress. The primary motivation to join the community was a desire for connectedness and reassurance. Initially engaged to seek information, users began to share not only informational and tangible support, but also emotional and esteem support as they gained comfort with their membership in these groups. Findings suggest that affirming normalcy while coping with postpartum distress is an integral part of the social support shared among postpartum mothers. Moreover, the findings indicated that to maximize the sustainability as well as the effectiveness of online communities for postpartum mothers, motivating silent users to participate and reciprocate is crucial.

The effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy during COVID-19 pandemic: a ramdomized controlled trial

BackgroundSuccessful breastfeeding is related to the psychosocial conditions of the mother. Covid19 pandemic resulted in psychological consequences in women during postpartum period. Maternal anxiety and distress reduce the chances of exclusive breastfeeding. The present study aimed to investigate the effect of counseling with stress management approach on postpartum anxiety and distress and breastfeeding self-efficacy (BSE) during COVID-19 pandemic.MethodThis randomized controlled clinical trial was conducted on 64 breastfeeding mothers referred to health care centers in Tabriz, Iran in 2021. Participants were assigned into the intervention and control groups in a ratio of 1: 1 using block randomization in a block size of 4 and 6. The intervention group participated in six individual 60–90 min sessions. Spielberger State-Trait Anxiety Inventory (STAI), postpartum distress (PMD), and BSE questionnaires were completed before and 4-week after the intervention by the control and intervention groups. Independent t-test and ANCOVA were used to compare the outcomes between two groups.ResultsAccording to the ANCOVA results by controlling the baseline values and after the intervention, the mean score of anxiety in the intervention group was lower than that in the control group [Adjusted Mean Difference (AMD): -13.82, 95%, confidence interval (CI): -12.35 to -15.29, (p < 0.001)]. Further, the mean score of postpartum distress after intervention was lower in the intervention group compared with that in the control group [AMD:5.31 95% CI: -3.00 to -7.37 (p < 0.001)]. After the intervention, the mean score of BSE in the intervention group was significantly higher than that in the control group [AMD: 25.57, 95% CI: 22.85 to 28.29 (p < 0.001)].ConclusionStress management counseling can improve postpartum anxiety and distress and BSE and increase breastfeeding. However, more studies are needed for a definitive conclusion.Trial registrationIranian Registry of Clinical Trials (IRCT): IRCT20171007036615N6. Date of registration: 15/09/2021.

FAMILY CONFLICT AS PREDICTOR OF POSTPARTUM DISTRESS

The study investigated family conflict as a predictor of postpartum distress. Two hundred and seven (207) women in their postpartum period participated in the study and were purposefully drawn from two government-owned tertiary healthcare providers in Lokoja. One hypothesis was tested: Family conflict will be significantly related to postpartum distress. The symptoms distress checklist (SCL90) and Family Environment Scale were used for data collection. Linear regression analysis was used to analyze the data. The results showed a significant relationship between family conflict and psychosomatization (β= .20, t= 2.98, P &lt; .005). The result also shows a significant relationship between family conflict and obsessive compulsion (β = .20, t= 2.90, P &lt;.005). Family conflict and hostility are also related (β= .24, t= 3.68, P &lt; .005). There was a significant relationship between family conflict and phobic anxiety (β = .33, t=5.04, P &lt;.001). The implication and limitations were discussed, and suggestions were made for further study.

Maternal psychological distress in the early postpartum period during COVID-19 pandemic: a pilot study

BackgroundThe coronavirus disease 2019 infection (COVID-19) pandemic is a new global outbreak disease. According to the Taiwan Centers for Diseases Control statement, hospitals had to change their corresponding measures to prevent the spread of COVID-19. The frequency of parental visits to the special care nursery was reduced from three times to once daily. Visiting was not permitted from April 4 to May 10, 2020, and rooming-in with healthy neonates was discontinued, which could increase maternal postpartum distress. Therefore, this study was conducted to determine whether COVID-19 prevention increased maternal psychological distress.MethodsThis prospective study used convenience sampling to enroll healthy mothers who had just delivered via normal spontaneous delivery. Based on the neonates’ status and visiting times, mothers were grouped into no-rooming-in, rooming-in, no-visiting, and one-visit/day groups. Mothers’ baseline characteristics were compared using the Chi-square or Fisher's exact test and t-test. Salivary cortisol levels and scores of Chinese versions of the Perceived Stress Scale (PSS) and State-Trait Anxiety Inventory were evaluated on postpartum days 1 and 3 and analyzed by one-way analysis of variance and a paired t-test.ResultsThere were 16, 58, 28, and 47 women categorized as no-rooming-in, rooming-in, no-visit, and one-visit/day groups, respectively. No significant differences were found between groups in mothers’ baseline characteristics and postpartum salivary cortisol levels. The PSS on day 3 was significantly higher than on day 1 in every group (p < 0.001). The PSS increasing trend in the no-rooming-in group was significantly greater than that in the no-visit group (p = 0.02) and significantly greater in the rooming-in group than that in the one-visit/day group (p = 0.001).ConclusionPostpartum stress increased for all mothers and was an even more significant response to the COVID-19 pandemic than the stress associated with neonates’ hospitalization.

Seeing Red: A Grounded Theory Study of Women's Anger after Childbirth.

Persistent intense anger is indicative of postpartum distress, yet maternal anger has been little explored after childbirth. Using grounded theory, we explained how and why mothers develop intense anger after childbirth and the actions they take to manage their anger. Twenty mothers of healthy singleton infants described their experiences of anger during the first two postpartum years. Mothers indicated they became angry when they had violated expectations, compromised needs, and felt on edge (e.g., exhausted, stressed, and resentful), particularly around infants’ sleep. Mothers described suppressing and/or expressing anger with outcomes such as conflict and recruiting support. Receiving support from partners, family, and others helped mothers manage their anger, with more positive outcomes. Women should be screened for intense anger, maternal-infant sleep problems, and adequacy of social supports after childbirth. Maternal anger can be reduced by changing expectations and helping mothers meet their needs through social and structural supports.

Associations between New Mothers’ Partner-Oriented Sexual Values and Sexual Distress in the Transition to Parenthood

ABSTRACT Women commonly experience heightened sexual distress in pregnancy and postpartum, and there is limited knowledge of protective factors. Women report declines in the importance of sexuality during this time, suggesting that valuing sexuality could be a relevant individual difference factor. It may be particularly protective for women to feel successful in living in line with their sexual values. In a longitudinal study, we examined associations between the extent to which women valued their role as a sexual partner, and their success living in line with this partner-oriented sexual value, with their sexual distress. Women (N = 367) reported the importance of their role as a sexual partner, success living according to this value, and sexual distress during pregnancy (18–20 weeks) and at 3, 6, 12 and 24-months postpartum. More strongly valuing one’s role as a sexual partner was associated with more sexual distress, both between-person (i.e., across women) and within-person (i.e., variation within women over time). Above and beyond these effects, greater success at living in line with one’s partner-oriented sexual value was associated with less sexual distress. Finding ways to live in line with one’s sexual values may protect against sexual distress for new mothers in the transition to parenthood.

Perceived vulnerability to immigration policies among postpartum Hispanic/Latina women in the MADRES pregnancy cohort before and during the COVID-19 pandemic.

Introduction and Objectives:Research suggests that perceived immigration policy vulnerability has important health implications. Coupled with the mental and physical stressors accompanying the postpartum period and a growing awareness of the discrimination and structural racism experienced by marginalized communities globally, the coronavirus disease 2019 period may have exacerbated stress among vulnerable populations, specifically postpartum Hispanic/Latina women. This study evaluated perceived immigration policy vulnerability (i.e. discrimination, social isolation, and family threats) in early postpartum Hispanic/Latina women in Los Angeles before and during the coronavirus disease 2019 pandemic.Methods:The Perceived Immigration Policy Effects Scale (PIPES) was administered cross-sectionally at 1 month postpartum to 187 Hispanic/Latina women in the MADRES cohort. Respondents between September 2018 and March 2020 were classified as “pre-pandemic” (N = 128), between March 2020 and July 2020 as “early pandemic” (N = 38), and between August 2020 and November 2021 as “later pandemic” (N = 21). Average PIPES subscale scores were dichotomized into “higher” and “lower” groups (⩽median, >median) and logistic regression models were performed.Results:Approximately half of participants had incomes of <$50,000 (50.3%) and were Latin American born (54.6%). After adjusting for age, nativity, education, income, postpartum distress, and employment status, early pandemic respondents had 5.05 times the odds of a higher score on the perceived discrimination subscale (95% CI: 1.81, 14.11), 6.47 times the odds of a higher score on the social isolation subscale (95% CI: 2.23, 18.74), 2.66 times the odds of a higher score on the family threats subscale (95% CI: 0.97, 7.32), and 3.36 times the odds of a higher total score (95% CI: 1.19, 9.51) when compared to pre-pandemic respondents. There were no significant subscale score differences between later pandemic and pre-pandemic periods.Conclusion:Higher perceived immigration policy vulnerability was reported among postpartum women during the early coronavirus disease 2019 pandemic versus pre-pandemic periods. This suggests greater social inequities during the early pandemic period.

Parent ADHD Is Associated With Greater Parenting Distress in the First Year Postpartum

Objective: Little is known about the experience of parenting infants when a mother or father has ADHD. This study examined cross-sectional predictors of parenting distress experienced by parents with and without ADHD who also have infants. Methods: Participants were 73 mother-father pairs (N = 146) of infants 6 to 10 months old. Half of the families included a parent with ADHD. Psychosocial predictors were tested using multilevel modeling. Results: Parent or partner ADHD, lower parent sleep quality, fewer social supports, and less infant surgency and effortful control were associated with greater parental distress. Infant negative affect and sleep were not associated. Conclusions: Parents with ADHD and their partners experience greater parenting distress in the first year of their child’s life than parents without ADHD. Addressing parent ADHD symptoms and co-occurring difficulties, including sleep disturbances, are potential targets for early interventions to maximize both parent and infant mental health outcomes.

Knowledge and Awareness about Postpartum Distress among the Students of Saveetha Dental College

Introduction: Postpartum depression (PPD) is the most common psychiatric condition after childbirth.&#x0D; PD has adverse long-term consequences for the mother, the infant’s development and the family environment symptoms-the core symptom of sadness or low mood, as well as fatigue/sleep disturbance and irritability. The aim of the study is to determine the Knowledge and awareness about postpartum distress among the students of saveetha dental college.&#x0D; Materials &amp; Methods: A cross-sectional survey was conducted among the study population with a sample size of 100. A self administered structured questionnaire was prepared and consisted of 15 questions. It was circulated to participants through an online platform (google form). The statistics were done using SPSS software, chi-square test was used to check the association and P value of 0.05 was said to be statistically significant.The pros of the survey is that the students of different lifestyles and cultures were surveyed . Children and adults were excluded from the survey. Simple random sampling method was the sampling method used to minimise the sampling bias.&#x0D; Results: Women during postpartum go through a lot of hormonal changes which lead to mood swings etc.They become very self conscious about their body .Mothers can also be depressed due to financial trouble, lactation etc. Chi square test: p-value=2.98&gt; 0.05 hence significant.&#x0D; Conclusion: In summary, this study demonstrated an honest level of data and positive attitudes towards women with postpartum depression. However, negative beliefs, stigma, and misconceptions still prevailed among the relations.

Perceived Discrimination and Social Isolation Among Postpartum Hispanic Women in the MADRES Pregnancy Cohort Before and After the COVID-19 Pandemic

BACKGROUND AND AIM: Previous research has shown that perceived discrimination and social isolation due to immigration policies have important health implications among US Hispanic populations. Moreover, the early postpartum period is characterized by periods of social isolation which may be exacerbated by the COVID-19 pandemic. The pandemic also coincided with a growing awareness of discrimination and structural racism experienced by marginalized communities. We evaluated differences in perceived discrimination and social isolation between early postpartum Hispanic women in Los Angeles before and during the COVID-19 pandemic. METHODS: Questionnaires were administered at one month postpartum to 176 Hispanic women in the MADRES pregnancy cohort. Perceived discrimination and social isolation are two subscales on the Perceived Immigration Policy Effects (PIPES) questionnaire. Respondents between 9/1/2018–3/1/2020 were classified as “pre-pandemic” (N=129) and between 3/1/2020–9/14/2020 as “during the pandemic” (N=47). Average social isolation and discrimination subscale scores were rounded to the nearest integer. Proportional odds models were used to evaluate COVID-19 pandemic impacts on perceived discrimination and social isolation among postpartum mothers. RESULTS:Participants were on average 28.9 (SD=5.9) years old and approximately half were born in Latin America (51.7%). Average pre-pandemic scores were 1.2 (SD=0.5) for both discrimination and social isolation and 1.4 (SD=0.6) for discrimination and 1.5 (SD=0.7) for social isolation during the pandemic. After adjusting for age, education, nativity, and postpartum distress, participants at one month postpartum during the pandemic had 3.98 times the odds of a higher score on the perceived discrimination scale (p=0.0017) and 5.29 times the odds of a higher score on the social isolation scale (p0.0001) than those responding to the questionnaire at one month postpartum before the pandemic. CONCLUSIONS:Higher perceived discrimination and social isolation at one month postpartum during the COVID-19 pandemic vs. pre-pandemic periods suggest increased social inequities during the pandemic among US Hispanic women. KEYWORDS: COVID-19, Mental health outcomes, Non-chemical stressors

Universal prevention of distress aimed at pregnant women: a systematic review and meta-analysis of psychological interventions

BackgroundThere is sufficient meta-analytic evidence that antenatal interventions for women at risk (selective prevention) or for women with severe psychological symptoms (indicated prevention) are effective in reducing postpartum distress. However, women without risk or severe psychological symptoms might also experience distress. This meta-analysis focused on the effectiveness of preventive psychological interventions offered to universal populations of pregnant women on symptoms of depression, anxiety, and general stress. Paternal and infant outcomes were also included.MethodWe included 12 universal prevention studies in the meta-analysis, incorporating a total of 2559 pregnant women.ResultsOverall, ten studies included depression as an outcome measure, five studies included stress, and four studies anxiety. There was a moderate effect of preventive interventions implemented during pregnancy on the combined measure of maternal distress (d = .52), on depressive symptoms (d = .50), and on stress (d = .52). The effect on anxiety (d = .30) was smaller. The effects were not associated with intervention timing, intervention type, intervention delivery mode, timing of post-test, and methodological quality. The number of studies including partner and/or infant outcomes was too low to assess their effectiveness.ConclusionsThis meta-analysis suggests that universal prevention during pregnancy is effective on decreasing symptoms of maternal distress compared to routine care, at least with regard to depression. While promising, the results with regard to anxiety and stress are based on a considerably lower number of studies, and should thus be interpreted with caution. More research is needed on preventing other types of maternal distress beyond depression. Furthermore, there is a lack of research with regard to paternal distress. Also, given the large variety in interventions, more research is needed on which elements of universal prevention work. Finally, as maternal distress symptoms can affect infant development, it is important to investigate whether the positive effects of the preventive interventions extend from mother to infant.Systematic review registration numberInternational prospective register of systematic reviews (PROSPERO) registration number: CRD42018098861.

Psychological impact of COVID-19 quarantine measures in northeastern Italy on mothers in the immediate postpartum period.

ObjectiveTo explore whether quarantine measures and hospital containment policies among women giving birth in a COVID‐19 “hotspot” area in northeastern Italy enhanced psycho‐emotional distress in the immediate postpartum period.MethodsWe designed a non‐concurrent case–control study of mothers who gave birth during a COVID‐19 quarantine period between March 8 and May 3, 2020 (COVID‐19 study group), with an antecedent group of matched postpartum women (control group) who delivered in the same period in 2019. Participants completed the Edinburgh Postnatal Depression Scale (EPDS) on the second day postpartum.ResultsThe COVID‐19 study group (n=91) had significantly higher mean EPDS scores compared with the control group (n=101) (8.5 ± 4.6 vs 6.34 ± 4.1; P<0.001). Furthermore, 28.6% of women in the COVID‐19 group had a global EPDS score above 12. Analysis of three EPDS subscales revealed significantly higher scores among the COVID‐19 group compared with the control group for anhedonia (0.60 ± 0.61 vs 0.19 ± 0.36; P<0.001) and depression (0.58 ± 0.54 vs 0.35 ± 0.45; P=0.001).ConclusionsConcerns about risk of exposure to COVID‐19, combined with quarantine measures adopted during the COVID‐19 pandemic, adversely affected the thoughts and emotions of new mothers, worsening depressive symptoms.