COVID-19-related stress in postpartum women from Argentina during the second wave in 2021: Identification of impairing and protective factors

Abstract

Objective: Postpartum women are a vulnerable population to pandemic stressors that challenge their psychological well-being. Thus, reliable and valid instruments are necessary to measure pandemic-related stress and to identify risk and protective factors. This work aimed to assess psychometric properties of the COVID-19 Pandemic-Related Stress Scale (PSS-10-C) and associations of maternal pandemic stress with demographic, reproductive and pandemic factors of Argentinian postpartum women during the second COVID-19 wave.

Design: An online cross-sectional survey was conducted from April to June 2021.

Setting: Online recruitment of postpartum women was carried out during the second wave of COVID-19 in Argentina. This study was conducted in accordance with the Declaration of Helsinki and had the corresponding ethical approval.

Participants: This study was performed on 300 women, aged 18-49 years, up to 12 months postpartum in Argentina.

Measurements and findings: Stress was assessed with PSS-10-C, with a sociodemographic questionnaire being used to collect demographic, reproductive and pandemic variables. Statistical analysis included psychometric procedures, structural equation modeling, and multiple regressions. PSS-10-C was a reliable and structurally valid instrument with two subscales, with entire scale, Stress and Coping subscales scoring 17.31 (6.52), 9.70 (4.61) and 7.61 (2.77), respectively. History of mood disorders, pregnancy loss, and unhealthy child during the pandemic predisposed to increased stress (β > 0.10, p < 0.05), whereas having work and practicing breastfeeding promoted coping to face it (β < -0.13, p < 0.05). This situation was impaired by mood changes, loss of happiness, economic changes, fear of contracting COVID-19 -own or by a loved one- (β > 0.11, p < 0.05).

Key conclusions: The study highlighted the vulnerability of postpartum women's mental health in the pandemic context, with PSS-10-C being a useful instrument for clinicians and researchers to assess perceived stress. Targeting interventions toward women at higher risk can be highly beneficial for maternal and child health.

Keywords: COVID-19; Maternal medicine; Pandemics; Postpartum; Risk factors; Stress.

Fig. 1

Distributional analysis of the Perceived Stress Scale modified for COVID-19 (PSS-10-C) in a sample of 300 Argentinian postpartum women. SW = Shapiro-Wilks's normality test.

Fig. 2

The two-factor confirmatory factor analysis model of the Perceived Stress Scale modified for COVID-19 (PSS-10-C), showing standardized estimates fitted in a sample of 300 Argentinian postpartum women. All factor loadings were significant (T > 1.96).