Mental health of pregnant and postpartum women during the third wave of the COVID-19 pandemic: a European cross-sectional study

doi:10.1136/bmjopen-2022-063391

. 2023 Jan 11;13(1):e063391.

doi: 10.1136/bmjopen-2022-063391.

Mental health of pregnant and postpartum women during the third wave of the COVID-19 pandemic: a European cross-sectional study

Fatima Tauqeer¹, Michael Ceulemans^{2

3

4}, Eva Gerbier⁵, Anneke Passier³, Alison Oliver⁶, Veerle Foulon², Alice Panchaud^{7

8

9}, Angela Lupattelli¹⁰, Hedvig Nordeng^{10

11}

Affiliations

¹ Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway fatima.tauqeer@farmasi.uio.no.
² Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
³ Teratology Information Service, Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands.
⁴ L-C&Y, KU Leuven Child & Youth Institute, Leuven, Belgium.
⁵ Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland.
⁶ UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust and the UK Health Security Agency, Newcastle upon Tyne, UK.
⁷ Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
⁸ Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁹ Materno-fetal and Obstetrics Research Unit, Department "Femme-Mère-Enfant", University Hospital, Lausanne, Switzerland.
¹⁰ Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.
¹¹ Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway.

PMID: 36631239
PMCID: PMC9835449
DOI: 10.1136/bmjopen-2022-063391

Mental health of pregnant and postpartum women during the third wave of the COVID-19 pandemic: a European cross-sectional study

Fatima Tauqeer et al. BMJ Open. 2023.

. 2023 Jan 11;13(1):e063391.

doi: 10.1136/bmjopen-2022-063391.

Authors

Fatima Tauqeer¹, Michael Ceulemans^{2

3

4}, Eva Gerbier⁵, Anneke Passier³, Alison Oliver⁶, Veerle Foulon², Alice Panchaud^{7

8

9}, Angela Lupattelli¹⁰, Hedvig Nordeng^{10

11}

Affiliations

¹ Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway fatima.tauqeer@farmasi.uio.no.
² Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.
³ Teratology Information Service, Pharmacovigilance Centre Lareb, 's-Hertogenbosch, The Netherlands.
⁴ L-C&Y, KU Leuven Child & Youth Institute, Leuven, Belgium.
⁵ Department Woman-mother-child, Lausanne University Hospital, Lausanne, Switzerland.
⁶ UK Teratology Information Service, Newcastle upon Tyne Hospitals NHS Foundation Trust and the UK Health Security Agency, Newcastle upon Tyne, UK.
⁷ Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.
⁸ Service of Pharmacy, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
⁹ Materno-fetal and Obstetrics Research Unit, Department "Femme-Mère-Enfant", University Hospital, Lausanne, Switzerland.
¹⁰ Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, and PharmaTox Strategic Research Initiative, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.
¹¹ Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway.

PMID: 36631239
PMCID: PMC9835449
DOI: 10.1136/bmjopen-2022-063391

Abstract

Objective: To describe the mental health of perinatal women in five European countries during the third pandemic wave and identify risk factors related to depressive and anxiety symptoms.

Design: A cross-sectional, online survey-based study.

Setting: Belgium, Norway, Switzerland, the Netherlands and the UK, 10 June 2021-22 August 2021.

Participants: Pregnant and up to 3 months postpartum women, older than 18 years of age.

Primary outcome measure: The Edinburgh Depression Scale (EDS) and the Generalised Anxiety Disorder scale (GAD-7) were used to assess mental health status. Univariate and multivariate generalised linear models were performed to identify factors associated with poor mental health.

Results: 5210 women participated (including 3411 pregnant and 1799 postpartum women). The prevalence of major depressive symptoms (EDS ≥13) was 16.1% in the pregnancy group and 17.0% in the postpartum . Moderate to severe generalised anxiety symptoms (GAD ≥10) were found among 17.3% of the pregnant and 17.7% of the postpartum women. Risk factors associated with poor mental health included having a pre-existing mental illness, a chronic somatic illness, having had COVID-19 or its symptoms, smoking, unplanned pregnancy and country of residence. Among COVID-19 restrictive measures specific to perinatal care, pregnant and postpartum women were most anxious about not having their partner present at the time of delivery, that their partner had to leave the hospital early and to be separated from their newborn after the delivery.

Conclusion: Approximately one in six pregnant or postpartum women reported major depression or anxiety symptoms during the third wave of the pandemic. These findings suggest a continued need to monitor depression and anxiety in pregnancy and postpartum populations throughout and in the wake of the pandemic. Tailored support and counselling are essential to reduce the burden of the pandemic on perinatal and infant mental health.

Keywords: COVID-19; anxiety disorders; depression & mood disorders; mental health.

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Conflict of interest statement

Competing interests: None declared.

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References

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1. Feduniw S, Modzelewski J, Kajdy A, et al. . Anxiety of pregnant women in time of catastrophic events, including COVID-19 pandemic: a systematic review and meta-analysis. J Psychosom Obstet Gynaecol 2022;43:1–11. 10.1080/0167482X.2021.1985453 - DOI - PubMed
1. Iyengar U, Jaiprakash B, Haitsuka H, et al. . One year into the pandemic: a systematic review of perinatal mental health outcomes during COVID-19. Front Psychiatry 2021;12:674194. 10.3389/fpsyt.2021.674194 - DOI - PMC - PubMed
1. Wu T, Jia X, Shi H, et al. . Prevalence of mental health problems during the COVID-19 pandemic: a systematic review and meta-analysis. J Affect Disord 2021;281:91–8. 10.1016/j.jad.2020.11.117 - DOI - PMC - PubMed
1. Demissie DB, Bitew ZW. Mental health effect of COVID-19 pandemic among women who are pregnant and/or lactating: a systematic review and meta-analysis. SAGE Open Med 2021;9:2050312121102619510.1177/20503121211026195 - DOI - PMC - PubMed

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[1] Howard LM, Khalifeh H. Perinatal mental health: a review of progress and challenges. World Psychiatry 2020;19:313–27. 10.1002/wps.20769 - DOI - PMC - PubMed

[2] Howard LM, Khalifeh H. Perinatal mental health: a review of progress and challenges. World Psychiatry 2020;19:313–27. 10.1002/wps.20769 - DOI - PMC - PubMed

[3] Feduniw S, Modzelewski J, Kajdy A, et al. . Anxiety of pregnant women in time of catastrophic events, including COVID-19 pandemic: a systematic review and meta-analysis. J Psychosom Obstet Gynaecol 2022;43:1–11. 10.1080/0167482X.2021.1985453 - DOI - PubMed

[4] Feduniw S, Modzelewski J, Kajdy A, et al. . Anxiety of pregnant women in time of catastrophic events, including COVID-19 pandemic: a systematic review and meta-analysis. J Psychosom Obstet Gynaecol 2022;43:1–11. 10.1080/0167482X.2021.1985453 - DOI - PubMed

[5] Iyengar U, Jaiprakash B, Haitsuka H, et al. . One year into the pandemic: a systematic review of perinatal mental health outcomes during COVID-19. Front Psychiatry 2021;12:674194. 10.3389/fpsyt.2021.674194 - DOI - PMC - PubMed

[6] Iyengar U, Jaiprakash B, Haitsuka H, et al. . One year into the pandemic: a systematic review of perinatal mental health outcomes during COVID-19. Front Psychiatry 2021;12:674194. 10.3389/fpsyt.2021.674194 - DOI - PMC - PubMed

[7] Wu T, Jia X, Shi H, et al. . Prevalence of mental health problems during the COVID-19 pandemic: a systematic review and meta-analysis. J Affect Disord 2021;281:91–8. 10.1016/j.jad.2020.11.117 - DOI - PMC - PubMed

[8] Wu T, Jia X, Shi H, et al. . Prevalence of mental health problems during the COVID-19 pandemic: a systematic review and meta-analysis. J Affect Disord 2021;281:91–8. 10.1016/j.jad.2020.11.117 - DOI - PMC - PubMed

[9] Demissie DB, Bitew ZW. Mental health effect of COVID-19 pandemic among women who are pregnant and/or lactating: a systematic review and meta-analysis. SAGE Open Med 2021;9:2050312121102619510.1177/20503121211026195 - DOI - PMC - PubMed

[10] Demissie DB, Bitew ZW. Mental health effect of COVID-19 pandemic among women who are pregnant and/or lactating: a systematic review and meta-analysis. SAGE Open Med 2021;9:2050312121102619510.1177/20503121211026195 - DOI - PMC - PubMed

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Mental health of pregnant and postpartum women during the third wave of the COVID-19 pandemic: a European cross-sectional study

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Mental health of pregnant and postpartum women during the third wave of the COVID-19 pandemic: a European cross-sectional study

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