Thursday, April 1, 2021

Maternal Depression, Anxiety Worsened During Pandemic, Meta-Analysis Suggests

Postnatal depression and maternal anxiety appear to have increased worldwide during the COVID-19 pandemic, according to a meta-analysis published Wednesday in The Lancet Global Health.

“It is clear that pregnant individuals and babies have been subjected to harm during the pandemic, and the onus is on the academic community, health care providers, and policymakers to learn from it,” wrote Asma Khalil, M.D., of St. George’s University of London and colleagues.

Khalil and colleagues searched MEDLINE and Embase for studies published from January 1, 2020, to January 8, 2021, that compared maternal, fetal, and infant health outcomes before and during the pandemic. Studies that only included women infected with COVID-19 were excluded.

Of the 3,592 abstracts the authors screened, 40 studies from 17 countries were included in the analysis. Overall, the studies indicated increased maternal mortality, stillbirth, and maternal stress during the pandemic compared with before, with a particularly disproportionate impact on low- and middle-income countries.

Eleven studies compared maternal mental health outcomes before and during the pandemic, using such measurements as the Generalized Anxiety and Depression Scale, Inventory of Depression and Anxiety Symptoms, the Generalized Anxiety Disorder 7-item (GAD-7) Questionnaire, and the Edinburgh Postnatal Depression Scale, among others. Seven of these studies reported a statistically significant increase in postnatal depression, maternal anxiety, or both.

The authors hypothesized that the increase in adverse pregnancy outcomes could be attributed to reduced access to care. “Although maternal anxiety was consistently shown to [have] increased during the pandemic, health care providers around the world have reported reduced attendance for routine and unscheduled pregnancy care,” the authors wrote. “This reduction could be driven by concern about the risk of acquiring COVID-19 in health care settings, governmental advice to stay at home, or reduced public transport and childcare access during lockdowns.”

Other changes during the pandemic—including the reported increase in intimate partner violence, a rise in unemployment among women, and a greater burden of childcare responsibilities due to school closures—may also play a role in these adverse outcomes, the authors noted.

“Women’s health care is often adversely affected in humanitarian disasters and our findings highlight the central importance of planning for robust maternity services in any emergency response,” the authors concluded.

For related information, see the Psychiatric News articles “Addressing Maternal Mental Health: Progress, Challenges, and Potential Solutions” and “Pandemic Has Compromised Mental Health of New Moms.”

(Image: iStock/FatCamera)

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