Pregnancy mental health declines throughout the COVID-19 lockdown


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.

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