Pandemic-related stressors and mental health among women with a live birth in 2020

Abstract

The objective of this analysis was to assess the associations between pandemic-related stressors and feeling more anxious/depressed, among women with a live birth. We analyzed data from the Pregnancy Risk Assessment Monitoring System (PRAMS) COVID-19 maternal experiences supplement, implemented in 29 U.S. jurisdictions from October 2020-June 2021, among women with a live birth during April-December 2020. We examined stressors by type (economic, housing, childcare, food insecurity, partner, COVID-19 illness) and score (number of stressor types experienced [none, 1-2, 3-4, or 5-6]). Outcomes were feeling 1) more anxious and 2) more depressed than usual due to the pandemic. We calculated adjusted prevalence ratios estimating associations between stressors and outcomes. Among 12,525 respondents, half reported feeling more anxious and 28% more depressed than usual. The prevalence of stressor types was 50% economic, 41% childcare, 18% partner, 17% food insecurity, 12% housing, and 10% COVID-19 illness. Respondents who experienced partner stressors (anxious aPR: 1.81, 95% CI: 1.73-1.90; depressed aPR: 3.01, 95% CI: 2.78-3.25) and food insecurity (anxious aPR: 1.79, 95% CI: 1.71-1.88; depressed aPR: 2.32, 95% CI: 2.13-2.53) had the largest associations with feeling more anxious and depressed than usual. As stressor scores increased, so did the aPRs for feeling more anxious and more depressed due to the pandemic. COVID-19 stressors, not COVID-19 illness, were found to be significantly associated with feeling more anxious and depressed. Pregnant and postpartum women might benefit from access to supports and services to address pandemic-related stressors/social-determinants and feelings of anxiety and depression.

Keywords: COVID-19; Mental health; Pandemic; Recent live birth; Reproductive health.

Fig. 1

The percentage of women with a live birth in 2020 experiencing selected pandemic-related stressor types by race/ethnicity, 29 Sites.^a, Pregnancy Risk Assessment Monitoring System, April 2020–December 2020. Abbreviations: Economic = Economic stressor (household member lost job, cut hours, trouble paying bills); Childcare = Childcare stressor (loss of childcare, increased care-taking responsibilities); Partner = Partner stressor (increased arguments or aggression); Food Insecurity = Food insecurity stressor (worried food would run out); Housing = Housing stressor (moved/relocated or homeless); COVID-19 = COVID-19 illness stressor (respondent or household member told they had COVID-19 during pregnancy); NH = non-hispanic..^aPuerto Rico (births April–December 2020); Alaska, Connecticut, District of Columbia, Iowa, Maryland, Massachusetts, Missouri, Nebraska, Pennsylvania (Births June–December 2020); Arizona, Illinois, Louisiana, New Jersey, New York City, Oregon, South Dakota, Tennessee, Utah, Vermont, Virginia, West Virginia, Wyoming (births July–December 2020); Delaware (births August–December 2020); Arkansas, Georgia, Florida, Michigan, North Dakota (births October–December 2020)