The COVID-19 outbreak increases maternal stress during pregnancy, but not the risk for postpartum depression

Abstract

The COVID-19 pandemic affects society and may especially have an impact on mental health of vulnerable groups, such as perinatal women. This prospective cohort study of 669 participating women in the Netherlands compared perinatal symptoms of depression and stress during and before the pandemic. After a pilot in 2018, recruitment started on 7 January 2019. Up until 1 March 2020 (before the pandemic), 401 women completed questionnaires during pregnancy, of whom 250 also completed postpartum assessment. During the pandemic, 268 women filled out at least one questionnaire during pregnancy and 59 postpartum (1 March-14 May 2020). Pregnancy-specific stress increased significantly in women during the pandemic. We found no increase in depressive symptoms during pregnancy nor an increase in incidence of high levels of postpartum depressive symptoms during the pandemic. Clinicians should be aware of the potential for increased stress in pregnant women during the pandemic.

Keywords: COVID-19 pandemic; Depression; Perinatal; Pregnancy-specific stress.

Fig. 1

Flowchart of participant inclusion

Fig. 2

Mean depression and stress symptom scores during gestation for women who were pregnant pre-pandemic (blue line) compared to those pregnant during the pandemic (red line). There were no differences in depression scores but women who were pregnant during the pandemic had significantly higher stress scores compared to non-pandemic women. The axes have a different range for the EPDS and TPDS; the pandemic group completed at least one questionnaire between 1 March 2020 and 14 May 2020. Depression score pre-pandemic: N = 393 at T1, N = 350 at T2, and N = 350 at T3; depression score pandemic: N = 265 at T1, N = 203 at T2, and N = 110 at T3. Stress score pre-pandemic: N = 312 at T1, N = 313 at T2, and N = 330 at T3; Stress score pandemic: N = 265 at T1, N = 203 at T2, and N = 111 at T3