Effects of COVID-19 pandemic on the mental health of pregnant women

Öz

Objective: The negative consequences of coronavirus disease 2019 (COVID-19) pandemic on the mental health of pregnant women and the mental disorders it may trigger pose risks for the physical, cognitive and psychological development of infants as well as having risks in terms of the general health and functionality of the mother. This study aimed to investigate the effects of COVID-19 pandemic on the mental health of pregnant women and to evaluate the prevalence of psychiatric symptoms. Materials and Methods: The study included a total of 112 pregnant women who agreed to fill an online survey which was provided to them via e-mail. Online survey consisted of sociodemographic data form, questions related to COVID-19, Depression Anxiety Stress Scale-Short Form (DASS-21), and Posttraumatic Stress Disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-5) (PCL-5). Results: The mean age of the participants was 31.06 years. The DASS-21 subscale score for depression was 4.20 (± 3.91) whereas it was 3.75 (± 3.50) for the anxiety subscale and 5.68 (± 3.81) for the stress subscale. Total PCL-5 score was 31.29 (± 16.85). Those diagnosed with COVID-19 during the pandemic were observed to show a higher rate of anxiety symptoms. Those who believed that they needed professional support for mental health during the pandemic showed higher rates of depression, anxiety, and stress symptoms. The prevalence of PTSD symptoms were found to be higher among participants who were not health care professionals and who thought they needed professional support for mental health during the pandemic. Conclusion: Determining the effects of the COVID-19 pandemic on the mental health of pregnant women will be important to put early intervention methods in action and implement evidence-based practices.

Anahtar Kelimeler

• pregnant
• COVID-19
• mental health

COVID-19 Pandemisinin Gebe Ruh Sağlığı Üzerine Etkileri

Öz

Amaç:COVID-19 pandemisinin gebe ruh sağlığı üzerinde yaratabileceği olumsuz sonuçlar ve tetikleyebileceği ruhsal bozukluklar, annenin genel sağlığı ve işlevselliği açısından riskler barındırmasının yanında bebeklerin fiziksel, bilişsel ve psikolojik gelişimleri açısından da risk oluşturmaktadır. Bu çalışmada COVID-19 pandemisinin gebe ruh sağlığı üzerine etkilerini araştırmak ve psikiyatrik semptomların yaygınlığını değerlendirmek amaçlanmıştır. Yöntem: Çalışmaya kendilerine e-mail yolu ile iletilen online anketi doldurmayı kabul eden 112 gebe dahil edildi. Online anket; sosyodemografik form, COVID-19 ile ilgili sorular, Depresyon Anksiyete Stres Ölçeği-Kısa Form (DASS-21) ve DSM-5 için Travma Sonrası Stres Bozukluğu Kontrol Listesi ‘den (PCL-5) oluşmaktaydı. Bulgular: Katılımcıların yaş ortalaması 31.06 idi. DASS-21 depresyon alt ölçek puanı 4.20 (±3.91), anksiyete alt ölçek puanı 3.75 (±3.50), ve stres alt ölçek puanı 5.68 (±3.81), PCL-5 toplam puanı ise 31.29 (±16.85) olarak saptandı. Pandemi sırasında COVID-19 tanısı alanların daha yüksek oranda anksiyete semptomları sergiledikleri; pandemi sürecinde ruh sağlığı açısından profesyonel bir destek alma ihtiyacı olduğunu düşünenlerin ise daha yüksek oranda depresyon, anksiyete ve stres semptomları sergiledikleri saptandı. Sağlık çalışanı olmayanların ve pandemi sürecinde ruh sağlığı açısından profesyonel bir destek alma ihtiyacı olduğunu düşünenlerin daha yüksek oranda TSSB semptomları sergilediği görüldü. Sonuç: COVID-19 pandemisinin gebe ruh sağlığı üzerine etkilerini saptamak, erken müdahale yöntemlerini harekete geçirebilmek ve kanıta dayalı uygulamalar gerçekleştirebilmek adına önemli olacaktır.

Anahtar Kelimeler

• gebe
• COVID-19
• ruh sağlığı

Kaynakça

1. Taylor S. The Psychology of Pandemics: Preparing for the Next Global Outbreak of Infectious Disease. Newcastle upon Tyne: Cambridge Scholars Publishing; 2019.
2. Talevi D, Socci V, Carai M et al. Mental health outcomes of the CoViD-19 pandemic. Riv Psichiatr 2020 May-Jun;55(3):137-44.
3. Brooks SK, Webster RK, Smith LE et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. The Lancet 2020 Mar 14;395(10227).
4. Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression J Affect Disord 2017;219:86–92.
5. Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry 2017 May;210(5):315-23.
6. Grigoriadis S, Graves L, Peer M et al. Maternal Anxiety During Pregnancy and the Association With Adverse Perinatal Outcomes: Systematic Review and Meta-Analysis. J Clin Psychiatry 2018 Sep 4;79(5):17r12011.
7. Grigoriadis S, VonderPorten EH, Mamisashvili L et al. The impact of maternal depression during pregnancy on perinatal outcomes: a systematic review and meta-analysis. J Clin Psychiatry 2013 Apr;74(4):e321-41.
8. Hessami K, Romanelli C, Chiurazzi M, Cozzolino M. COVID-19 pandemic and maternal mental health: a systematic review and meta-analysis. J Matern Fetal Neonatal Med 2020 Nov 1:1-8.

9. Schwartz DA, Graham AL. Potential Maternal and Infant Outcomes from (Wuhan) Coronavirus 2019-nCoV Infecting Pregnant Women: Lessons from SARS, MERS, and Other Human Coronavirus Infections. Viruses 2020 Feb 10;12(2):194.
10. Caparros-Gonzalez RA, Alderdice F. The COVID-19 pandemic and perinatal mental health. J Reprod Infant Psychol 2020 Jul;38(3):223-5.
11. Thapa SB, Mainali A, Schwank SE, Acharya G. Maternal mental health in the time of the COVID-19 pandemic. Acta Obstet Gynecol Scand 2020 Jul;99(7):817-8.
12. Saccone G, Florio A, Aiello F et al. Psychological impact of coronavirus disease 2019 in pregnant women. Am J Obstet Gynecol 2020 Aug;223(2):293-5.
13. Farrell T, Reagu S, Mohan S et al. The impact of the COVID-19 pandemic on the perinatal mental health of women J Perinat Med. 2020 Nov 26;48(9):971-6.
14. 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 Aug;223(2):240.e1-240.e9.
15. Liu CH, Erdei C, Mittal L. Risk factors for depression, anxiety, and PTSD symptoms in perinatal women during the COVID-19 Pandemic. Psychiatry Res 2021 Jan;295:113552.
16. Berthelot N, Lemieux R, Garon-Bissonnette J, Drouin-Maziade C, Martel É, Maziade M. Uptrend in distress and psychiatric symptomatology in pregnant women during the coronavirus disease 2019 pandemic. Acta Obstet Gynecol Scand 2020 Jul;99(7):848-55.
17. Zanardo V, Manghina V, Giliberti L, Vettore M, Severino L, Straface G. Psychological impact of COVID-19 quarantine measures in northeastern Italy on mothers in the immediate postpartum period. Int J Gynaecol Obstet 2020;150(2):184-8.
18. Lovibond SH, Lovibond PF. Manual for the Depression Anxiety Stress Scales, (2nd ed.). Sydney, Australia: Pychology Foundation of Australia; 1995.
19. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories Behav Res Ther. 1995 Mar;33(3):335-43.
20. Sarıcam H. (2018). The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples JCBPR 2018;7(1):19-30.
21. Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD Checklist for DSM-5 (PCL-5). 2013. Scale available from the National Center for PTSD at www.ptsd.va.gov.
22. Boysan M, Guzel Ozdemir P, Ozdemir O, Selvi Y, Yilmaz E, Kaya N. Psychometric properties of the Turkish version of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, (PCL-5). Psychiatry and Clinical Psychopharmacology 2017; 27(3): 300-10.
23. Zhou Y, Shi H, Liu Z et al. The prevalence of psychiatric symptoms of pregnant and non-pregnant women during the COVID-19 epidemic. Transl Psychiatry 2020 Sep 19;10(1):319.
24. Spoorthy MS, Pratapa SK, Mahant S. Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review. Asian J Psychiatr 2020 Jun;51:102119.
25. Bohlken J, Schömig F, Lemke MR, Pumberger M, Riedel-Heller SG. COVID-19-Pandemie: Belastungen des medizinischen Personals [COVID-19 Pandemic: Stress Experience of Healthcare Workers - A Short Current Review]. Psychiatr Prax 2020 May;47(4):190-7.
26. Vizheh M, Qorbani M, Arzaghi SM, Muhidin S, Javanmard Z, Esmaeili M. The mental health of healthcare workers in the COVID-19 pandemic: A systematic review. J Diabetes Metab Disord 2020 Oct 26;19(2):1-12.
27. Liu D, Baumeister RF, Veilleux JC et al. Risk factors associated with mental illness in hospital discharged patients infected with COVID-19 in Wuhan, China. Psychiatry Res 2020 Oct;292:113297.
28. Bo HX, Li W, Yang Y et al. Posttraumatic stress symptoms and attitude toward crisis mental health services among clinically stable patients with COVID-19 in China. Psychol Med 2020 Mar 27:1-2.
29. Dai LL, Wang X, Jiang TC et al. Anxiety and depressive symptoms among COVID-19 patients in Jianghan Fangcang Shelter Hospital in Wuhan, China. PLoS One 2020 Aug 28;15(8):e0238416.
30. Zhou J, Liu L, Xue P, Yang X, Tang X. Mental Health Response to the COVID-19 Outbreak in China. Am J Psychiatry 2020 Jul 1;177(7):574-5.
31. Fernández-Aranda F, Casas M, Claes L et al. COVID-19 and implications for eating disorders. Eur Eat Disord Rev 2020 May;28(3):239-45.