Parenting stress, maternal depression and child mental health in a Melbourne cohort before and during the COVID-19 pandemic

Abstract

Aim: This paper aims to examine the maternal and child mental health and parenting outcomes in the context of COVID-19 pandemic conditions using a sample from Melbourne, Australia - a city exposed to one of the longest lockdowns world-wide in response to the pandemic.

Methods: This study utilises observational data from a prospective, pregnancy cohort, Mercy Pregnancy Emotional Wellbeing Study and includes 468 women and their children followed up in Melbourne to 3-4 years postpartum pre-COVID pandemic and compared to those followed up during the COVID-19 pandemic.

Results: When compared to mothers followed up at 3-4 years postpartum pre-pandemic, those followed up during the COVID-19 pandemic showed higher depressive symptoms with a steep incline in their symptom trajectory (EMM_difference = 1.72, Bonferroni-corrected P < 0.01, d = 0.35) and had a three times higher risk of scoring 13 or above on the EPDS (aRR = 3.22, Bonferroni-corrected P < 0.01). Although this increase was not associated with the variation in the duration of exposure to pandemic conditions, the steep increase in depressive symptoms was more pronounced in those with pre-existing depressive disorders. There was no difference in parenting stress or adjusted childhood mental health symptoms or disorder.

Conclusions: Our findings highlight the vulnerability of those with pre-existing clinical mental health disorders and the need for adequate clinical care for this vulnerable group. Equally, our study indicates the possibility that parenting and early childhood mental health outcomes, at least in the short term, may be resilient.

Keywords: COVID-19; childhood mental disorders; depression; pandemic; parenting.

Fig. 1

Model‐estimated maternal outcomes for (a) EPDS, (b) EPDS ≥13, (c) PSI P‐CDI and (d) PSI DC by exposure to COVID‐19 pandemic conditions exclusively at 3–4 years. Estimates in (a) and (b) are adjusted for the following covariates: depressive disorder at recruitment, maternal age, parity, university education and sum of time‐varying stressful life events. Estimates in (c) and (d) are adjusted for the following covariates: depressive disorder at recruitment, maternal age, parity, university education, and time‐varying EPDS and sum of stressful life events. Shaded area displays the 95% CI around point estimates. ^Denotes Wave when exposure to COVID‐19 pandemic conditions occurred. EPDS, Edinburgh Postnatal Depression Scale; PAPA, Preschool Age Psychiatric Assessment. () Before COVID‐19 and () During COVID‐19.

Fig. 2

Model‐estimated maternal outcomes for (a) CBCL problem scores and the (b) psychiatric disorders by exposure to COVID‐19 pandemic conditions at 3–4 years. Estimates are adjusted for the following covariates: depressive disorder at recruitment, parity, university education, employment and infant age at assessment and sex. Error bars display standard error around point estimates. CBCL, Child Behaviour Checklist. () Before COVID‐19 and () During COVID‐19.