Women's Depressive Symptoms during the COVID-19 Pandemic: The Role of Pregnancy

Abstract

The Coronavirus Disease 2019 (COVID-19) pandemic has multiple ramifications for pregnant women. Untreated depression during pregnancy may have long-term effects on the mother and offspring. Therefore, delineating the effects of pregnancy on the mental health of reproductive-age women is crucial. This study aims to determine the risk for depressive symptoms in pregnant and non-pregnant women during COVID-19, and to identify its bio-psycho-social contributors. A total of 1114 pregnant and 256 non-pregnant women were recruited via social media in May 2020 to complete an online survey that included depression and anxiety questionnaires, as well as demographic, obstetric and COVID-19-related questionnaires. Pregnant women also completed the Pandemic-Related Pregnancy Stress Scale (PREPS). Pregnant women reported fewer depressive symptoms and were less concerned that they had COVID-19 than non-pregnant women. Among pregnant women, risk factors for depression included lower income, fewer children, unemployment, thinking that one has COVID-19, high-risk pregnancy, earlier gestational age, and increased pregnancy-related stress. Protective factors included increased partner support, healthy behaviors, and positive appraisal of the pregnancy. Thus, being pregnant is associated with reduced risk for depressive symptoms during the pandemic. Increased social support, engaging in health behaviors and positive appraisal may enhance resilience. Future studies of pregnant versus non-pregnant women could clarify the role of pregnancy during stressful events, and clarify aspects of susceptibility and resilience during pregnancy.

Keywords: COVID-19; depression; experiment; pregnancy; resilience.

Figure 1

Mental health resiliency in pregnant women. (a) Pregnant women show fewer depressive symptoms than non-pregnant women. Depression symptoms were measured using the Patient Health Questionnaire-2 (PHQ-2), which inquires about the frequency of depressed mood and anhedonia over the past two weeks. (b) Pregnant women are less concerned that they have COVID-19, even without being diagnosed, compared to non-pregnant women. Note: PHQ-2 = Patient Health Questionnaire-2. * p < 0.05, *** p < 0.001.