Caffeinated non-alcoholic beverages on the postpartum mental health related to the COVID-19 pandemic by a cross-sectional study in Argentina

Abstract

Purpose: This work aimed to study postpartum mental outcomes and determinants of the intake of caffeinated beverages during the pandemic in women from Argentina.

Methods: This cross-sectional study recruited 619 women who responded to online self-report questionnaires during the first and second waves of COVID-19, including validated instruments (Insomnia Severity Index, Perceived Stress Scale, Postpartum Depression Screening Scale, Memory Complaint Scale, and Breastfeeding Self-Efficacy Scale), and general data. Intake frequency and amount of caffeinated beverages were estimated. Multivariate regression and structural equation models identified associations and effects (p < 0.05).

Results: Women were under social restrictions for 60.39 days, with home and essential activities increasing caffeinated intake. They ingested (mL/d): yerba mate (1457.71), coffee (66.85), tea (67.61), and soft drinks (50.95), which provided 646.20 mg/d of caffeine. Intakes of coffee and yerba mate were higher than pre-pandemic ones. Coffee was positively associated with stress and insomnia, and indirectly linked to higher levels of depression and memory complaints, and lower breastfeeding self-efficacy. Tea showed a similar but weaker association. Yerba mate correlated inversely with depression (through direct pathways), insomnia, and memory complaints (through indirect pathways), promoting breastfeeding self-efficacy. Soft drinks and caffeine did not present significant associations.

Conclusion: Although findings do not imply causation, results suggest that beverages would exhibit caffeine-independent affective and cognitive roles, which might be anxiogenic in the case of coffee and tea (to a lesser extent). Yerba mate showed antidepressant potential. Given that breastfeeding might be compromised during the pandemic, yerba mate intake is promissory to protect postpartum mental health.

Keywords: Coffee; Depression; Ilex paraguariensis; Insomnia; Stress; Tea.

Graphical abstract

Fig. 1

Example of the questionnaire on caffeinated beverages consumption.

Fig. 2

Violin plots for mental health self-report instrument scores of puerperal women during the COVID-19 pandemic in Argentina. The circles denote medians and the red dotted lines represent the diagnostic cut-off point for each scale (Insomnia Severity Index = 10; Perceived Stress Scale = 20; Postpartum Depression Screening Scale‐Short Form = 17; Memory Complaint Scale = 3; Breastfeeding Self-Efficacy Scale-Short Form = 50). (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)

Fig. 3

Heat-map showing Pearson's correlation coefficients between mental health indicators of postpartum women from Argentina during COVID-19 pandemic.

Fig. 4

Structural equation model with standardized direct effects of coffee and yerba mate intakes on postpartum mental health during COVID-19 pandemic restrictions in Argentina. Red arrows indicate positive direct effects, blue arrows indicate negative direct effects, and gray arrows indicate non-significant relationships. The usage of the word “effect” corresponds to terminology associated with SEM analysis, hence the arrows in the model do not imply causation. χ²/df = chi-square value relative to the degrees of freedom; CFI = comparative fit index; TLI = Tucker Lewis index; SRMR = standardized root mean square residual; RMSEA = root mean square error of approximation. Statistically significant paths highlighted in black: *p < 0.05, **p < 0.01, ***p < 0.001. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)