Pandeminin Gebeler Üzerine Psikolojik Etkileri: Bir Gözden Geçirme

Yıl 2022, Cilt: 19 Sayı: 2, 1320 - 1325, 01.07.2022

Buket Koparal Cicek Hocaoglu

https://doi.org/10.38136/jgon.897649

Öz

Coronavirüs enfeksiyonu (COVID-19) dünyada giderek yayılarak, bir pandemiye dönüşmüştür. Hızlı yayılması, bir tedavisinin olmaması, ölümcül olması hastalığın yarattığı etkiyi arttırmaktadır. En çok etkilenen yaş grubunun üreme çağındaki kadınları içeren yaş grubu olması gebelikte hastalığın seyri, anne ve bebek açısından neler yapılabileceğini önemli hale getirmiştir. Gebelik kadınları viral enfeksiyona karşı savunmasız hale getiren, bağışıklık sisteminde kısmi baskılanmaya sebep olan bir süreçtir. Gebelikte viral enfeksiyonların morbidite ve mortalitesi genel toplum oranlarından daha yüksektir. Gebelerin hastalıklara karşı gebe olmayanlara göre daha duyarlı olmaları, benzer virüsler olan SARS-CoV ve MERS-CoV enfeksiyonlarının gebelerde yarattığı yüksek ölüm oranları yüzünden şüpheli ya da enfekte gebelerin yönetiminin bu konuda yetkin bir multidisipliner ekip tarafından yapılmasını gerektirmektedir. COVID-19 gebelerde ciddi maternal ve fetal olumsuz sonuçlara yol açabilir. COVID-19 salgının gebeler üzerine etkisi ve maternal-fetal komplikasyonları ile ilgili veriler giderek artmakta birlikte, henüz yeterli düzeyde kanıt bulunmamaktadır. COVID-19 salgını tüm gebe kadınlarda doğal olarak hem gebelikleri ile ilgili, hem de bebeklerinin virüsten etkilenmesi ile ilgili önemli korku, endişe ve stresse sebep olmaktadır. Yapılan bir ön çalışmada erken gebelik haftalarında COVID-19 pandemisinin gebelerde anksiyete ve depresyon oranını arttırdığı gösterilmiştir. Gebelerde oluşması muhtemel daha fazla stres, korku ve endişenin sebep olabileceği maternal ve fetal komplikasyonları önlemek daha da önem kazanmaktadır. Gebelikte komplikasyonlar, ekonomik zorluklar ve destek eksikliği ile sosyal izolasyon, geçmişte veya halihazırda psikiyatrik hastalığı olanlar ve pozitif aile öyküsü olanlar daha büyük risk altındadır. Uygun sağlık ve sosyal bakıma erişimin kısıtlanması, mevcut yüksek olan kaygı düzeylerini de daha da artıracaktır. Doğum öncesi psikolojik belirtiler, düşük ve erken doğum dahil olmak üzere obstetrik komplikasyon riskini artırabilir. Bu yazıda pandeminin gebeler üzerinde olan etkileri literatür bulguları ışığında ele alınacaktır.

Anahtar Kelimeler

covıd-19, gebelik, ruh sağlığı, anksiyete, depresyon

Psychological Effects of Pandemic on Pregnant Women: A review

Öz

Coronavirus infection (COVID-19) has gradually spread around the world, turning into a pandemic. Its rapid spread, lack of a cure, and being fatal increase the effect of the disease. The fact that the most affected age group includes women of reproductive age has made it important for the course of the disease in pregnancy and what can be done for mother and baby. Pregnancy is a process that makes women vulnerable to viral infection and causes partial suppression in the immune system. The morbidity and mortality of viral infections during pregnancy is higher than the general population rates. Because pregnant women are more susceptible to diseases than non-pregnant women and the high mortality rates caused by similar viruses, SARS-CoV and MERS-CoV infections in pregnant women, the management of suspicious or infected pregnant women should be carried out by a competent multidisciplinary team. COVID-19 can cause serious maternal and fetal negative consequences in pregnant women. The COVID-19 epidemic naturally causes significant fear, anxiety and stress in all pregnant women both about their pregnancy and about their babies being affected by the virus. In a preliminary study, it has been shown that the COVID-19 pandemic in the early weeks of pregnancy increases the rate of anxiety and depression in pregnant women. It becomes more important to prevent maternal and fetal complications that may be caused by more stress, fear and anxiety in pregnant women. Those with pregnancy complications, economic difficulties and lack of support, social isolation, past or current psychiatric illness, and positive family history are at greater risk. Restricting access to appropriate health and social care will further increase the existing high levels of anxiety. In this article, the effects of the pandemic on pregnant women will be discussed in the light of the literature findings.

Anahtar Kelimeler

covıd-19, pregnancy, mental health, anxiety, depression

Kaynakça

• Akgor U, Fadıloglu E, Soyak B, Unal C, Cagan M, Temiz BE, et al. Anxiety, depression and concerns of pregnant women during the COVID-19 pandemic. Archives of Gynecology and Obstetrics.1-6.
• Alfaraj SH, Al-Tawfiq JA, Memish ZA. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection during pregnancy: Report of two cases & review of the literature. 2019.
• Wong SF, Chow KM, Leung TN, Ng WF, Ng TK, Shek CC, et al. Pregnancy and perinatal outcomes of women with severe acute respiratory syndrome. American journal of obstetrics and gynecology. 2004;191(1):292-7.
• Di Mascio D, Khalil A, Saccone G, Rizzo G, Buca D, Liberati M, et al. Outcome of coronavirus spectrum infections (SARS, MERS, COVID-19) during pregnancy: a systematic review and meta-analysis. American journal of obstetrics & gynecology MFM. 2020;2(2):100107.
• Wastnedge EA, Reynolds RM, van Boeckel SR, Stock SJ, Denison FC, Maybin JA, et al. Pregnancy and COVID-19. Physiological reviews. 2021;101(1):303-18.
• Özcan H, Elkoca A, YALÇIN Ö. COVID-19 enfeksiyonu ve gebelik üzerindeki etkileri. Anadolu Kliniği Tıp Bilimleri Dergisi. 2020;25(Special Issue on COVID 19):43-50.
• Knight M, Bunch K, Vousden N, Morris E, Simpson N, Gale C, et al. Characteristics and outcomes of pregnant women admitted to hospital with confirmed SARS-CoV-2 infection in UK: national population based cohort study. bmj. 2020;369.
• Mahase E. China coronavirus: what do we know so far? : British Medical Journal Publishing Group; 2020.
• Favre G, Pomar L, Musso D, Baud D. 2019-nCoV epidemic: what about pregnancies? Lancet (London, England). 2020;395(10224):e40.
• Hassanipour S, Faradonbeh SB, Momeni K, Heidarifard Z, Khosousi M-J, Khosousi L, et al. A systematic review and meta-analysis of pregnancy and COVID-19: Signs and symptoms, laboratory tests, and perinatal outcomes. International journal of reproductive biomedicine. 2020;18(12):1005.
• Zaigham M, Andersson O. Maternal and perinatal outcomes with COVID‐19: a systematic review of 108 pregnancies. Acta obstetricia et gynecologica Scandinavica. 2020;99(7):823-9.
• Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: a retrospective, single-centre, descriptive study. The Lancet Infectious Diseases. 2020;20(5):559-64.
• Ellington S, Strid P, Tong VT, Woodworth K, Galang RR, Zambrano LD, et al. Characteristics of women of reproductive age with laboratory-confirmed SARS-CoV-2 infection by pregnancy status—United States, January 22–June 7, 2020. Morbidity and Mortality Weekly Report. 2020;69(25):769.
• Takemoto ML, Menezes MdO, Andreucci CB, Nakamura‐Pereira M, Amorim MM, Katz L, et al. The tragedy of COVID‐19 in Brazil: 124 maternal deaths and counting. International Journal of Gynecology & Obstetrics. 2020;151(1):154-6.
• Wang C-L. Impact of COVID-19 on Pregnancy. International journal of medical sciences. 2021;18(3):763.
• Zhu H, Wang L, Fang C, Peng S, Zhang L, Chang G, et al. Clinical analysis of 10 neonates born to mothers with 2019-nCoV pneumonia. Translational pediatrics. 2020;9(1):51.
• Rees S, Channon S, Waters CS. The impact of maternal prenatal and postnatal anxiety on children’s emotional problems: a systematic review. European child & adolescent psychiatry. 2019;28(2):257-80.
• Hawryluck L, Gold WL, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerging infectious diseases. 2004;10(7):1206.
• Lee S, Chan LY, Chau AM, Kwok KP, Kleinman A. The experience of SARS-related stigma at Amoy Gardens. Social science & medicine. 2005;61(9):2038-46.
• DiGiovanni C, Conley J, Chiu D, Zaborski J. Factors influencing compliance with quarantine in Toronto during the 2003 SARS outbreak. Biosecurity and bioterrorism: biodefense strategy, practice, and science. 2004;2(4):265-72.
• Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry research. 2020;288:112954.
• Moccia L, Janiri D, Pepe M, Dattoli L, Molinaro M, De Martin V, et al. Affective temperament, attachment style, and the psychological impact of the COVID-19 outbreak: an early report on the Italian general population. Brain, behavior, and immunity. 2020;87:75-9.
• Voitsidis P, Gliatas I, Bairachtari V, Papadopoulou K, Papageorgiou G, Parlapani E, et al. Insomnia during the COVID-19 pandemic in a Greek population. Psychiatry research. 2020;289:113076.
• 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. International journal of environmental research and public health. 2020;17(5):1729.
• O'Hara MW, Wisner KL. Perinatal mental illness: definition, description and aetiology. Best practice & research Clinical obstetrics & gynaecology. 2014;28(1):3-12.
• Wu Y, Zhang C, Liu H, Duan C, Li C, Fan J, et al. Perinatal depressive and anxiety symptoms of pregnant women along with COVID-19 outbreak in China. American Journal of Obstetrics and Gynecology. 2020.
• Ceulemans M, Hompes T, Foulon V. Mental health status of pregnant and breastfeeding women during the COVID‐19 pandemic: A call for action. International Journal of Gynecology & Obstetrics. 2020;151(1):146-7.
• Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. Journal of affective disorders. 2020;277:5-13.
• Liu CH, Erdei C, Mittal L. Risk factors for depression, anxiety, and PTSD symptoms in perinatal women during the COVID-19 Pandemic. Psychiatry research. 2021;295:113552.
• Panahi L, Amiri M, Pouy S. Risks of novel coronavirus disease (COVID-19) in pregnancy; a narrative review. Archives of academic emergency medicine. 2020;8(1).
• Preis H, Mahaffey B, Heiselman C, Lobel M. Vulnerability and resilience to pandemic-related stress among US women pregnant at the start of the COVID-19 pandemic. Social Science & Medicine. 2020;266:113348.
• Nanjundaswamy MH, Shiva L, Desai G, Ganjekar S, Kishore T, Ram U, et al. COVID-19-related anxiety and concerns expressed by pregnant and postpartum women—a survey among obstetricians. Archives of women's mental health. 2020:1-4.
• Sut HK, Kucukkaya B. Anxiety, depression, and related factors in pregnant women during the COVID‐19 pandemic in Turkey: A web‐based cross‐sectional study. Perspectives in Psychiatric Care. 2020.
• Durankuş F, Aksu E. Effects of the COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: a preliminary study. The Journal of Maternal-Fetal & Neonatal Medicine. 2020:1-7.
• Sinaci S, Tokalioglu EO, Ocal D, Atalay A, Yilmaz G, Keskin HL, et al. Does having a high-risk pregnancy influence anxiety level during the COVID-19 pandemic? European Journal of Obstetrics & Gynecology and Reproductive Biology. 2020;255:190-6. Khoury JE, Atkinson L, Bennett T, Jack SM, Gonzalez A. COVID-19 and mental health during pregnancy: The importance of cognitive appraisal and social support. Journal of Affective Disorders. 2021.
• Parra‐Saavedra M, Villa‐Villa I, Pérez‐Olivo J, Guzman‐Polania L, Galvis‐Centurion P, Cumplido‐Romero Á, et al. Attitudes and collateral psychological effects of COVID‐19 in pregnant women in Colombia. International Journal of Gynecology & Obstetrics. 2020;151(2):203-8.
• Effati-Daryani F, Zarei S, Mohammadi A, Hemmati E, Yngyknd SG, Mirghafourvand M. Depression, stress, anxiety and their predictors in Iranian pregnant women during the outbreak of COVID-19. BMC psychology. 2020;8(1):1-10.
• Yan H, Ding Y, Guo W. Mental Health of Pregnant and Postpartum Women During the Coronavirus Disease 2019 Pandemic: A Systematic Review and Meta-Analysis. Frontiers in psychology. 2020;11:3324.
• Liu X, Chen M, Wang Y, Sun L, Zhang J, Shi Y, et al. Prenatal anxiety and obstetric decisions among pregnant women in Wuhan and Chongqing during the COVID‐19 outbreak: a cross‐sectional study. BJOG: An International Journal of Obstetrics & Gynaecology. 2020;127(10):1229-40.
• Moyer CA, Compton SD, Kaselitz E, Muzik M. Pregnancy-related anxiety during COVID-19: a nationwide survey of 2740 pregnant women. Archives of Women's Mental Health. 2020:1-9.
• Salehi L, Rahimzadeh M, Molaei E, Zaheri H, Esmaelzadeh‐Saeieh S. The relationship among fear and anxiety of COVID‐19, pregnancy experience, and mental health disorder in pregnant women: A structural equation model. Brain and behavior. 2020;10(11):e01835.
• Huang J-W, Zhou X-Y, Lu S-J, Xu Y, Hu J-B, Huang M-L, et al. Dialectical behavior therapy-based psychological intervention for woman in late pregnancy and early postpartum suffering from COVID-19: a case report. Journal of Zhejiang University Science B. 2020:1-6.