Pregnancy mental health declines throughout the COVID-19 lockdown
A recent preprint study
that was published on the medRxiv* server looked at how pregnant women's mental
health changed during the first COVID-19-related lockdown in France and how anxiety
symptoms persisted for two months after the lockdown ended. This may aid in
defining more suitable interventions that will be needed during upcoming
pandemics.
Prior significant
respiratory disease outbreaks caused by pathogenic coronaviruses, known as SARS
and Middle East respiratory syndrome, occurred in 2002 and 2013, respectively
(MERS). These were shown to be more severe than usual in pregnant women, who
were more likely to experience acute respiratory distress syndrome.
Due to these experiences,
it was decided early on that pregnant women should be at a higher risk of
developing a more severe virus-related illness during the ongoing COVID-19
pandemic. As a result, they were urged to isolate or avoid interactions with
people outside of their homes for longer periods than the general population.
But numerous studies have
since shown that lockdowns during prior infectious disease outbreaks have been
linked to increases in anxiety, sadness, mental discomfort, and sleep
difficulties, some of which persist after the lockdown is lifted.
The elimination of social
and emotional support networks, which is already known to increase the risk of
mental illness during pregnancy and the postpartum period, is the second source
of distress.
Thirdly, because of the recognized
increased risk for this group of women, they were more likely to experience
worry about their health and the wellbeing of the unborn child. Lockdowns'
imposed isolation would only make this situation worse.
And ultimately, this
might affect their general health and the health of their kids, as well as the
typical mother-infant attachment.
Several recent
publications have discussed the pandemic's unfavorable effects, including the
increased levels of anxiety, sadness, and anger among pregnant women. Based on
the information acquired during the Covimater investigation, the current
preprint was created.
The objectives were to
comprehend how women saw their mental states before and during the first
lockdown in France, which occurred from March to May 2020, as well as how
frequently anxiety occurred and the reasons associated with its symptoms two
months after the lockdown.
To learn how the woman
thought her mental health had altered, the researchers asked her questions like
"Just before the lockdown, on a psychological level, how did you
feel?" and "During the lockdown, how did you feel?"
They also inquired as to
whether certain feelings, such as relief, serenity, frustration, anxiety, and
despair, were felt more or less intensely than usual during the lockdown.
Finally, using the Hospital Anxiety and Depression Scale, patients were
evaluated for anxiety symptoms at the second time point.
Demographic tabular data,
such as self-employed or managerial level women, blue-collar or regular
employees, students, or unemployed women; age; educational attainment; and
financial status were used in the analysis. Children's presence, workload, the
efficiency of the local healthcare system during the pandemic, and the woman's
own experience with social support were all examined.
The woman's awareness of
SARS-CoV-2 transmission, the existence of suspicious symptoms, and a family
history of the illness were all evaluated at this point. We also enquired about
the woman's health and how exposed she felt to the illness.
The survey also asked
about other issues relating to medical consultations during the first lockdown,
such as doctor cancellations or postponements of appointments, conversations
with healthcare professionals about the pandemic and their pregnancy, and receiving
prescriptions for sleeping pills for sleep disorders or mood swings during the
pandemic.
Ø Findings
The average age of the
participants was 31, the majority had at least a high school diploma, and a
third were unemployed or students. A little over a third had low-paying
occupations, and nearly the same percentage struggled to make ends meet
financially. Financial hardship affected one in five people.
About 45% of respondents
claimed that the healthcare system had overloaded their area. Less than half had
small children at home during the lockdown, and one in three said that family
or acquaintances had a history of COVID-19. A third reported that there was
violence or serious arguments present throughout the lockdown, and about a
fifth reported having little to no assistance.
More than half of the
women reported that the lockdown had negatively impacted their mental health,
and one in five claimed that their formerly strong psychological condition had
deteriorated. This was mostly attributed to a lack of social support, overwork,
and ambiguity regarding the propagation and manifestation of the infection.
One in five people who
experienced mental health problems because of the lockdown wished they had
access to psychiatric or psychological care, but less than 10% of them were
able to get it. Despite their mental health deteriorating, three out of four
women claimed they did not require this kind of assistance.
Women reported feeling
more helpless, frustrated, and afraid than usual during the lockdown, with the
majority of them checking off three or more of these negative emotions.
About one or more
pregnancy complications, an elevated body mass index (BMI), young children
(under 6 years old) in the home, family members or friends with suspected or
confirmed COVID-19, and a lack of social support during the lockdown, about one
in seven people experienced anxiety symptoms. Women who attempted to
communicate with their healthcare providers but were unable were more likely to
experience anxiety than those who were successful. In comparison to those who
didn't require such medication, so were those who attempted to purchase
sleeping medications or antidepressants.
Ø Implications
According to the study's
findings, the initial lockout caused the mental health of half of the women in
the study group to deteriorate. A fifth of them claimed that during this time,
their mental health deteriorated from good to worse. The research also
identified several risk factors linked to this deterioration, including
inadequate support, overwork (as when there are young children at home and a
job is also required), and inadequate understanding of how the virus was
transmitted and, thus, of how this could happen.
This could explain the
anxiety, helplessness, and frustration that the majority of women experienced
at this time. Additional established risk factors for anxiety and poorer mental
health in the peripartum period include obesity, chronic illness, poor health,
and pregnancy problems. The well-known link between greater body mass and a
more severe COVID-19 may have also hurt these ladies.
Overall, among pregnant
women, a deterioration in mental health was substantially more common (21%). In
contrast, the incidence was 8% in the Coviprev study of women in the
reproductive age group in the broader French population during the same period.
This supports earlier research conducted during earlier quarantines.
Certain different
factors, which were once more connected to those circumstances that led to a
worsening of mental health, were linked to the persistence of anxiety symptoms.
However, the actual prevalence of these symptoms was lower or on par with that in
other nations before the pandemic.
In actuality, CoviPrev
revealed that women of reproductive age had a higher frequency of anxiety
symptoms. The causes of this are still a mystery.
These investigations, as
well as the current research, have demonstrated the advantages of correctly
educating pregnant women about the virus's transmission mechanisms to protect
their mental health. Additionally, care must be taken to ensure that pregnant
women have access to healthcare, that they receive psychological and social
support, that they have opportunities to ask medical professionals about their
pregnancies and their hospitalization for labor and delivery, and that those
who require childcare are provided with it.