Türkiye’de Gebelikte COVID-19 Enfeksiyonu Geçiren Annelerde Doğum Sonrası Bağlanma, Anksiyete ve Depresyonun Değerlendirilmesi

Öz

Amaç: Türkiyede gebelikleri sırasında COVID-19 geçiren annelere doğum sonrası Maternal Bağlanma Ölçeği, Edinburgh Doğum Sonrası Depresyon Ölçeği ve Doğum Sonrası Spesifik Anksiyete Ölçeği kullanılarak COVID-19'un anne bebek bağlanmasına etkilerini değerlendirmeyi amaçladık. Gereç ve Yöntem: 180 hasta üzerinde Maternal Bağlanma Ölçeği, Edinburgh Doğum Sonrası Depresyon Ölçeği ve Doğum Sonrası Spesifik Anksiyete Ölçeği kullanılarak yapılmıştır Bulgular: Maternal Bağlanma Ölçeği, Edinburgh Doğum Sonrası Depresyon Ölçeği ve Doğum Sonrası Spesifik Anksiyete Ölçeği puanları açısından gruplar arasında anlamlı fark yoktu. Asemptomatik grupta hastalığın tanı konulduğu gebelik haftası anlamlı olarak daha yüksek izlendi (p=0,04) ve semptomatik grupta bilgisayarlı tomografi ile görüntülenen toraks tutulumu açısından anlamlı fark vardı (p<0.001). Tüm hastaların sadece %1,6'sında depresyon semptomlarında artış gözlendi. Hastaların %44,4'ünde orta derecede artmış anksiyete belirtileri gözlendi. Sonuç: COVID-19 pandemisi tüm bireyler üzerinde bir çok açıdan psikolojik yük oluşturan stres faktörü olmuştur. Bulgularımıza göre pandemi, gebe nüfusta kaygı düzeylerini orta düzeyde artırdı ve anne bebek bağlanmasını önemli ölçüde olumsuz yönde etkiledi.

Anahtar Kelimeler

• Anksiyete
• COVID-19
• Depresyon
• Maternal bağlanma

Etik Beyan

Çalışma için 29/06/2020 tarihinde İstanbul Kanuni Sultan Suleyman Eğitim ve Araştırma Hastanesi Klinik Araştırmalar Etik Kurulu’ndan onay alınmıştır. Karar no: 2020.06.111

Evaluating Postpartum Attachment, Anxiety, and Depression Following Covid-19 Infection During Pregnancy Among a Turkish Cohort

Öz

Objective: To evaluate the effects of COVID-19 on mother-infant bonding by using the Maternal Attachment Inventory, Edinburgh Postnatal Depression Scale, and Postpartum Specific Anxiety Scale on postpartum women who had COVID-19 during their pregnancies in Türkiye. Material and Method: This study was conducted on 180 patients using the Maternal Attachment Inventory, Edinburgh Postnatal Depression Scale, and Postpartum Specific Anxiety Scale. Results: There was no significant difference in terms of the Maternal Attachment Inventory, Edinburgh Postnatal Depression Scale, and Postpartum Specific Anxiety Scale scores in groups. There was a significant difference regarding the gestational week in which the disease was diagnosed, which was significantly higher in the asymptomatic group (p=0.04) and there was a significant difference in the symptomatic group in terms of thoracic involvement visualized with computer tomography scan (p<0.001). An increase in depression symptoms was observed in only 1.6% of all patients. Moderately increased anxiety symptoms were observed in 44.4% of the patients. Conclusion: The COVID-19 pandemic has been a stress factor on all individuals causing a psychological burden on many aspects. According to our results, pandemic moderately increased anxiety levels among the pregnant population and it affected mother-infant bonding significantly in a negative manner.

Anahtar Kelimeler

• Anxiety
• COVID-19
• Depression
• Maternal attachment

Etik Beyan

Approval for the study was obtained from the Istanbul Kanuni Sultan Suleyman Training and Research Hospital Clinical Research Ethics Committee on 29/06/2020. Decision no: 2020.06.111.

Kaynakça

1. Nath S, Pearson RM, Moran P, et al. The association between prenatal maternal anxiety disorders and postpartum perceivedand observed mother-infant relationship quality. J Anxiety Disord 2019;68:102148.
2. Edhborg M, Nasreen HE, Kabir ZN. Impact of postpartum depressive and anxiety symptoms on mothers’ emotional tie to their infants 2-3 months postpartum: a population-based study from rural Bangladesh. Arch Womens Ment Health 2011;14(4):307-316.
3. Bowlby J. The making and breaking of affectional bonds. I. Aetiology and psychopathology in the light of attachment theory. An expanded version of the Fiftieth Maudsley Lecture, delivered before the Royal College of Psychiatrists, 19 November 1976. Br J Psychiatry 1977;130:201-210.
4. Tolja R, Nakić Radoš S, Anđelinović M. The role of maternal mental health, infant temperament, and couple’s relationship quality for mother-infant bonding. J Reprod Infant Psychol 2020;38(4):395-407.
5. Farré-Sender B, Torres A, Gelabert E, et al. Mother-infant bonding in the postpartum period: assessment of the impact of pre-delivery factors in a clinical sample. Arch Womens Ment Health 2018;21(3):287-297.
6. Kerstis B, Aarts C, Tillman C, et al. Association between parental depressive symptoms and impaired bonding with the infant. Arch Womens Ment Health 2016;19(1):87-94.
7. Dubber S, Reck C, Müller M, Gawlik S. Postpartum bonding: the role of perinatal depression, anxiety and maternal-fetal bonding during pregnancy. Arch Womens Ment Health 2015;18(2):187-195.
8. Kinsey CB, Baptiste-Roberts K, Zhu J, Kjerulff KH. Birthrelated, psychosocial, and emotional correlates of positive maternal-infant bonding in a cohort of first-time mothers. Midwifery 2014;30(5):e188-194.

9. Tietz A, Zietlow AL, Reck C. Maternal bonding in mothers with postpartum anxiety disorder: the crucial role of subclinical depressive symptoms and maternal avoidance behaviour. Arch Womens Ment Health 2014;17(5):433-442.
10. Hopkins J, Miller JL, Butler K, Gibson L, Hedrick L, Boyle DA. The relation between social support, anxiety and distress symptoms and maternal fetal attachment. J Reprod Infant Psychol 2018;36(4):381-392.
11. Andersson L, Sundström-Poromaa I, Wulff M, Aström M, Bixo M. Depression and anxiety during pregnancy and six months postpartum: a follow-up study. Acta Obstet Gynecol Scand 2006;85(8):937-944.
12. Gavin NI, Gaynes BN, Lohr KN, Meltzer-Brody S, Gartlehner G, Swinson T. Perinatal depression: a systematic review of prevalence and incidence. Obstet Gynecol 2005;106(5 Pt 1):1071-1083.
13. Ali E. Women’s experiences with postpartum anxiety disorders: a narrative literature review. Int J Womens Health 2018;10:237-249.
14. Pereira PK, Lima LA, Legay LF, de Cintra Santos JF, Lovisi GM. Maternal mental disorders in pregnancy and the puerperium and risks to infant health. World J Clin Pediatr 2012;1(4):20-23.
15. Schwartz DA. An Analysis of 38 Pregnant Women With COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes. Arch Pathol Lab Med 2020;144(7):799-805.
16. Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet 2020;395(10226):809-815.
17. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry 1987;150:782-786.
18. Aydin N, Inandi T, Yigit A, Hodoglugil NN. Validation of the Turkish version of the Edinburgh Postnatal Depression Scale among women within their first postpartum year. Soc Psychiatry Psychiatr Epidemiol 2004;39(6):483-486.
19. Bergink V, Kooistra L, Lambregtse-van den Berg MP, et al. Validation of the Edinburgh Depression Scale during pregnancy. J Psychosom Res 2011;70(4):385-389.
20. Fallon V, Halford JCG, Bennett KM, Harrold JA. The Postpartum Specific Anxiety Scale: development and preliminary validation. Arch Womens Ment Health 2016;19(6):1079-1090.
21. Duran S. Postpartum Specific Anxiety Scale (PSAS): Reliability and validity of the Turkish version. Perspect Psychiatr Care 2020;56(1):95-101.
22. Müller ME. A questionnaire to measure mother-to-infant attachment. J Nurs Meas 1994;2(2):129-41.
23. Kavlak O, Şirin A. The Turkish version of maternal attachment inventory. Journal of Human Sciences 2009;6(1):188-202.
24. Gao S, Su S, Zhang E, et al. Psychological health status in postpartum women during COVID-19 pandemic: A systematic review and meta-analysis. J Affect Disord 2022;319:99-111.
25. Taubman-Ben-Ari O, Chasson M, Abu Sharkia S, Weiss E. Distress and anxiety associated with COVID-19 among Jewish and Arab pregnant women in Israel. J Reprod Infant Psychol 2020;38(3):340-348.
26. Saccone G, Florio A, Aiello F, et al. Psychological impact of coronavirus disease 2019 in pregnant women. Am J Obstet Gynecol 2020;223(2):293-295.
27. Wu Y, Zhang C, Liu H, et al. Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China. Am J Obstet Gynecol 2020;223(2):240.e1-.e9.
28. Yassa M, Yassa A, Yirmibeş C, et al. Anxiety levels and obsessive compulsion symptoms of pregnant women during the COVID-19 pandemic. Turk J Obstet Gynecol 2020;17(3):155-160.
29. Oskovi-Kaplan ZA, Buyuk GN, Ozgu-Erdinc AS, Keskin HL, Ozbas A, Moraloglu Tekin O. The Effect of COVID-19 Pandemic and Social Restrictions on Depression Rates and Maternal Attachment in Immediate Postpartum Women: a Preliminary Study. Psychiatr Q 2021;92(2):675-682.