Psychological Well-Being of Pregnant Women in the COVID-19 Pandemic

Öz

Aim: The COVID-19 pandemic has caused health problems but also causing negative socioeconomic consequences and restrictions in the daily life of people due to the limitations taken at the social level. Our aim is to investigate the prevalence of maternal anxiety and depression in the COVID-19 pandemic, which causes global and national negative consequences, and to determine the factors that affect anxiety and depression. Materials and Method: Pregnants who applied to our clinic for control between July-November 2020 were evaluated within the scope of the study. Pregnant women included in the study were asked to answer questions about their behavior and demographic characteristics during the pandemic period. Participants' depression and anxiety levels were investigated using Beck depression and Beck anxiety scales. Factors affecting anxiety and depression were evaluated by multiple logistic regression analysis. Results: 310 pregnants were evaluated within the scope of the study. The median age of the participants was 29 (25th-75th Percentile; 25-33). Anxiety was detected in 198 (63.9%) cases, and depression was detected in 86 (27.7%) cases. In the COVID-19 pandemic, the anxiety risk increases with living in the city center (OR: 10,269 95% CI: 5,676-18,580, P <0.001); the risk of depression also includes living in the city center (0R: 7,818, 95% CI: 2,695-22,679, P <0.001), actively working (OR: 2,331 95% CI: 1,325-4,101, P = 0.003) and with high-risk pregnancy (OR: 2,931 95% CI: 1,507-5,699, P = 0.002). Conclusion: In order to reduce the risk of anxiety and depression during the COVID-19 pandemic in pregnants, psychological support should be encouraged to pregnants who work actively, live in the city center and have high-risk pregnancies.

Anahtar Kelimeler

• COVID-19
• Coronavirus
• Pregnancy
• Perinatology
• Psychiatry

COVID-19 Pandemisinde Gebelerin Psikolojik İyilik Halleri

Öz

Amaç: COVID-19 pandemisi, sağlık sorunlarına neden olduğu gibi toplumsal düzeyde alınan önlemler nedeniyle de olumsuz sosoyoekonomik sonuçlara, insanların günlük yaşamında da kısıtlamalara yol açmıştır. Amacımız, global ve ulusal olumsuz sonuçlara yol açan COVID-19 pandemisinde maternal anksiyete ve depresyonun prevelansının araştırılması, anksiyete ve depresyona etki eden faktörlerin belirlenmesidir. Gereçler ve yöntem: Temmuz-Kasım 2020 tarihlerinde kliniğimize kontrol amaçlı başvuran gebeler çalışma kapsamında değerlendirilmiştir. Çalışmaya dâhil edilen gebelerden pandemi döneminde davranışlarını ve demografik özelliklerini içeren sorulara yanıt vermeleri istenmiştir. Katılımcıların depresyon ve anksiyete seviyeleri, Beck depresyon ve Beck anksiyete ölçekleri ile araştırılmıştır. Anksiyete ve depresyona etki eden faktörler multipl lojistik regresyon analizi ile değerlendirilmiştir. Bulgular: 310 gebe çalışma kapsamında değerlendirildi. Katılımcıların medyan yaşı 29 (25.-75. Yüzdelik; 25-33) olarak bulundu. 198 (%63,9) olguda anksiyete tespit edilirken, 86 (%27,7 )olguda depresyon tespit edildi. COVID-19 pandemisinde anksiyete riskinin şehir merkezinde yaşama ile arttığı (OR: 10,269 95% CI: 5,676-18,580, P<0.001); depresyon riskinin de şehir merkezinde yaşama (0R: 7,818, 95% CI:2,695-22,679, P<0.001), aktif çalışma (OR: 2,331 95% CI: 1,325-4,101, P=0.003) ve yüksek riskli gebelik mevcuyeti (OR: 2,931 95% CI: 1,507-5,699, P=0.002) ile arttığı tespit edilmiştir. Sonuç: COVID-19 pandemi döneminde anksiyete ve depresyon riskinin azaltılması amacıyla özellikle mesleki olarak çalışan, şehir merkezinde yaşayan ve yüksek riskli gebeliğe sahip gebelerin psikolojik destek alması sağlanmalıdır.

Anahtar Kelimeler

• COVID-19
• Koronovirüs
• Gebelik
• Perinatoloji
• Psikiyatri

Kaynakça

1. 1. Liao X, Wang B, Kang Y. Novel coronavirus infection during the 2019–2020 epidemic: preparing intensive care units—the experience in Sichuan Province, China. Intensive Care Med 2020;46:357-60.
2. 2. World Health Organization. C archived: WHO timeline—COVID‐19. 2020. http://www.who.int/news-room/detail/27-04-2020-whotimeline—covid-19.
3. 3. TC Sağlık Bakanlığı Türkiye’de COVID-19 hasta tablosu. https://covid19.saglik.gov.tr/. Erişim tarihi 23. 01. 2020.
4. 4. TC Sağlık Bakanlığı COVID-19 Pandemisinde Sağlık Kurumlarında Çalışma Rehberi ve Enfeksiyon Kontrol Önlemleri https://covid19.saglik.gov.tr/Eklenti/39606/0/covid- 19saglikkurumlarindacalismarehberiveenfeksiyonkontrolonlemleripdf.pdf
5. 5. Gebelikte Coronavirüs Enfeksiyonu (COVID-19) Hakkında Görüş (3. Bilgilendirme, 03.04.2020). Maternal Fetal Tıp ve Perinatoloji Derneği https://www.tmftp.org/files/Duyurular/3.bilgilendirme.pdf.
6. 6. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Publ Health 2020;17:1729.
7. 7. Liu CH, Zhang E, Wong GTF, Hyun S, Hahm H. Factors Associated with Depression, Anxiety, and PTSD Symptomatology During the COVID-19 Pandemic: Clinical Implications for U.S. Young Adult Mental Health. Psychiatry Res 2020; 113172. https://doi.org/10.1016/j.psychres.2020.113172.
8. 8. Rajkumar, R.P., 2020. COVID-19 and mental health: A review of the existing literature. Asian J. Psychiatry 52, 102066. https://doi.org/10.1016/j.ajp.2020.102066.

9. 9. Estes, K.D., Thompson, R.R., 2020. Preparing for the aftermath of COVID-19: Shifting risk and downstream health consequences. Psychol. Trauma Theory Res. Pract. Policy 2020; 12: 31. https://doi.org/10.1037/tra0000853.
10. 10. Chen Y, Li Z, Zhang YY, Zhao WH, Yu ZY. Maternal health care man- agement during the outbreak of coronavirus disease 2019. J Med Virol. 2020;92(7):731‐9. https://doi.org/10.1002/jmv.25787 .
11. 11. Alder J, Fink N, Bitzer J, Hösli I, Holzgreve W. Depression and anxiety during pregnancy: a risk factor for obstetric, fetal, and neonatal outcome? A critical review of the literature. J Matern Neonatal Med 2007;20:189-209.
12. 12. Snapper LA, Hart KL, Venkatesh KK, Kaimal AJ, Perlis RH. Cohort study of the relationship between individual psychotherapy and pregnancy outcomes. J Affect Disord 2018;239:253–257. https://doi.org/https://doi.org/10.1016/j.jad. 2018.05.083.
13. 13. Kramer MS, Lydon J, Seguin L, Goulet L, Kahn SR, McNamara H, et al. Stress pathways to spontaneous preterm birth: the role of stressors, psychological distress, and stress hormones. Am J Epidemiol 2009;169:1319–1326. https:// doi.org/https://doi.org/10.1093/aje/kwp061.
14. 14. Yang S, Yang R, Liang S, Wang J, Weaver NL, Hu K, et al. Symptoms of anxiety and depression during pregnancy and their association with low birth weight in Chinese women: a nested case control study. Arch Womens Ment Health 2017;20:283–290. https://doi.org/https://doi.org/10.1007/s00737-016-0697-2. 15. Ravid E, Salzer L, Arnon L, Eisner M, Wiznitzer A, Weller A, et al. Is there an association between maternal anxiety propensity and pregnancy outcomes? BMC Pregnancy Childbirth 2018;18:287. https://doi.org/10. 1186/s12884-018-1925-8.
15. 16. Kinsella MT, Monk C. Impact of maternal stress, depression, and anxiety on fetal neurobehavioral development. Clin Obstet Gynecol 2009;52:425-40.
16. 17. Hisli N. Beck Depresyon Envanteri’nin geçerliliği üzerine bir çalışma. Psikoloji Dergisi 1988;6:118-122.
17. 18. Scalzo P, Kummer A, Cardoso F, et al. Depressive symptoms and perception of quality of life in Parkinson’s disease. Arq Neuropsiquiatr 2009;67:203-8. http://dx.doi.org/10.1590/S0004-282X2009000200006.
18. 19. Ulusoy M, Sahin, N, Erkmen H. Turkish version of the Beck Anxiety Inventory; Psychometric Properties. Journal of Cognitive Psychotherapy 1998;12:163-72.
19. 20. Julian LJ. Measures of anxiety: State-Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale-Anxiety (HADS-A) Arthritis Care Res (Hoboken) 2011;63:467-72. http://dx.doi.org/10.1002/acr.20561
20. 21. National Institute for Health and Care Excellence, 2020. Antenatal and postnatal mental health: clinical management and service guidance (Clinical guideline No. CG 192). National Institute for Health and Care Excellence, United Kingdom.
21. 22. Rasul S, Bowen A, Muhajarine N. Factors that moderate or mediate pregnancy complications in women with anxiety and depression. J Preg Child Health 2017;4:360–366. https://doi.org/https://doi.org/10.4172/2376- 127X.1000360.
22. 23. Chen Y, Li Z, Zhang YY, Zhao WH, Yu ZY. Maternal health care management during the outbreak of coronavirus disease 2019. J Med Virol. 2020;92(7):731‐739. https://doi.org/10.1002/jmv.25787
23. 24. Liu X, Chen M, Wang Y, et al. Prenatal anxiety and obstetric decisions among pregnant women in Wuhan and Chongqing during the COVID‐19 outbreak: a cross‐sectional study. Intl J Obstetr Gynaecol. 2020;127:1229‐1240. https://doi.org/10.1111/1471-0528.16381
24. 25. Moyer CA, Compton SD, Kaselitz E, Muzik M. Pregnancy‐related anxiety during COVID‐19: A nationwide survey of 2,740 pregnant women. 2020. https://www.researchsquare.com/article/rs-37887/v1, https://doi.org/10.21203/rs.3.rs-37887/v1
25. 26. Nanjundaswamy MH, Shiva L, Desai G, et al. COVID‐19 related anxiety and concerns expressed by pregnant and postpartum women—a survey among obstetricians 2020. https://www.researchsquare.com/article/rs-38004/v1, https://doi.org/10.21203/rs.3.rs-38004/v1
26. 27. Sun F, Zhu J, Tao H, Ma Y, Jin W. A systematic review involving 11,187 participants evaluating the impact of COVID-19 on anxiety and depression in pregnant women. J Psychosom Obstet Gynaecol. 2020 Dec 17:1-9. doi: 10.1080/0167482X.2020.1857360. Epub ahead of print. PMID: 33327827.
27. 28. Kahyaoglu Sut, H, Kucukkaya, B. Anxiety, depression, and related factors in pregnant women during the COVID‐19 pandemic in Turkey: A web‐based cross‐sectional study. Perspect Psychiatr Care. 2020; 1‐ 9. https://doi.org/10.1111/ppc.12627
28. 29. Kassawa C, Pandey D. The prevalence of general anxiety disorder and its associated factors among women's attending at the perinatal service of Dilla University referral hospital, Dilla town, Ethiopia, April, 2020 in Covid pandemic. Perspect Psychiatr Care. 2020;1–9. DOI: 10.1111/ppc.12627.
29. 30. Xian T, Zhuo L, Dihui H, Xiaoni Z. Influencing factors for prenatal stress, anxiety, and depression in early pregnancy among women in Chongqing, China. J Affect Disord. 2019;253:292‐302. https://doi. org/10.1016/j.jad.2019.05.003
30. 31. Sinaci S, Tokalioglu EÖ, İ Ocal D, Atalay A, Yilmaz G, Keskin HL, et al. Int. J. Environ. Res. Public Health 2020;17:9450. doi:10.3390/ijerph17249450