COVID-19 may deepen mental health symptoms among pregnant and postpartum women

Dec. 8, 2020

In a new study, researchers from Brigham and Women’s Hospital surveyed pregnant women and those who had recently given birth, finding concerning rates of depression, generalized anxiety and post-traumatic stress disorder (PTSD) symptoms, which were found to be exacerbated by COVID-19-related grief and health worries, according to a press release from the hospital.

The research was published in Psychiatry Research.

Approximately 10 to 20 percent of pregnant women experience mental health challenges during the weeks immediately before and after birth. Depression, anxiety and trauma-related disorders can all be exacerbated by increased stress related to pregnancy and postpartum experiences.

“We know the perinatal period is already a time in which women are particularly vulnerable to mental health concerns,” said corresponding author Cindy Liu, PhD, of the Department of Pediatric Newborn Medicine and the Department of Psychiatry. “We primarily wanted to see what factors related to the pandemic might be associated with mental health symptoms.”

The researchers launched the Perinatal Experiences and COVID-19 Effects Study (PEACE) to better understand the mental health and well-being of pregnant and postpartum women within the United States during the COVID-19 pandemic. Among 1,123 of these women surveyed between May 21 and August 17, 2020, the researchers found that more than 1-in-3 (36.4 percent) reported clinically significant levels of depression. Before the pandemic, rates of perinatal depression (depression occurring during or after pregnancy) were generally considered to be 15-20 percent. Furthermore, 1-in-5 (22.7 percent) reported clinically significant levels of generalized anxiety, and 1-in-10 (10.3 percent) reported symptoms above the clinical threshold for PTSD.

In particular, the researchers found that approximately 9 percent of participants reported feeling a strong sense of grief, loss, or disappointment as a result of the pandemic. This group was roughly five times more likely to experience clinically significant measures of mental health symptoms. More respondents (18 percent) reported being “very worried” or “extremely worried” about COVID-19-related health risks. This group was up to over four times more likely to experience clinically significant psychiatric symptoms.

The researchers recruited participants for the PEACE survey primarily via word-of-mouth, using posts on email lists and in social media groups. They noted that as a result, the sample population was fairly homogenous: 89.9 percent were white, 92.1 percent were at least college educated, and 98 percent were living with their spouse or partner. The household income for 45 percent of the participants was over $150,000.

The researchers were able to examine how previous mental health diagnoses, as self-reported by the respondents, impacted these rates. They found that those with pre-existing diagnoses were 1.6-to-3.7 times more likely to have clinically significant measures of the three conditions analyzed. But elevated psychiatric distress was observed in participants regardless of their mental health histories.

“Obstetric practices weren’t able to screen for mental health symptoms as well, all while people’s mental health was under the most pressure,” said co-author Leena Mittal, MD, of the Department of Psychiatry. “Mental health supports have persisted and come back in new ways, and the amount of innovation surrounding delivering group and individual care, especially using virtual platforms, is phenomenal. On the psychiatry side of things, we have never been busier, and individuals and families who feel they need mental health care should seek it.” 

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