Postpartum Depression in Women Gave Birth in the Shadow of the Pandemic

Abstract

Objective: This study aimed to evaluate the level of postpartum depression and related factors in women who gave birth during the COVID-19 epidemic. Materials and Methods: This is a descriptive cross-sectional study. The study was carried out between January and April 2021 with 351 participants. Data collection instruments included an information form, Coronavirus Anxiety Scale (CAS), Obsession with COVID-19 Scale (OCS), and Edinburgh Postnatal Depression Scale (EPDS). Results: The average age of the participants was 28.37±6.74. The number of pregnancies was 2.68±1.48. Primary school graduates were 47.3%, and 92% were not working. 7% of the participants had an EPDS cut-off score of 10 or above. A difference was found between the groups in terms of education level, smoking, COVID-19 experience relative to COVID-19 status and CAS and OCS score average (p<0.05). Additionally, there was a difference between the groups' employment status, spouse's employment status, income status, smoking, unplanned pregnancy, type of birth and the baby's need for intensive care, and the average EPDS score (p<0.05). Conclusions: Those with a high level of education, smokers, and those whose close relatives have had COVID-19 may be at risk for COVID-19 anxiety and obsession. Starting in pregnancy, anxiety and depressive symptoms should be reduced in at-risk groups.

Keywords

• Anxiety
• COVID-19
• obsessive behavior
• pandemics
• postpartum depression

Pandemi Gölgesinde Doğum Yapan Kadınlarda Postpartum Depresyon

Öz

Amaç: Bu çalışma, COVID-19 pandemisinde doğum yapan gebelerin postpartum depresyonla ilişkili faktörlerini değerlendirmeyi amaçlamıştır. Materyal ve Metot: Tanımlayıcı kesitsel tipte olan bu çalışma, Ocak ve Nisan 2021 tarihleri arasında 351 katılımcı ile gerçekleştirildi. Veri toplama araçları olarak Bilgi Formu, Koronavirüs Anksiyete Ölçeği (CAS), COVID-19 Takıntısı Ölçeği (OCS) ve Edinburgh Postnatal Depresyon Ölçeği (EPDS) kullanıldı. Bulgular: Katılımcıların yaş ortalaması 28,37±6,74 idi. Gebelik sayısı 2,68±1,48 idi. İlkokul mezunlarının oranı %47,3 olup, %92'si çalışmıyordu. Katılımcıların %7'sinin EPDS kesme puanı 10 ve üzerindeydi. Gruplar arasında eğitim düzeyi, sigara kullanımı, COVİD-19 deneyimine göre COVİD-19 durumu ve CAS ve OCS puan ortalamaları açısından farklılık bulundu (p<0,05). Ayrıca grupların çalışma durumu, eşin çalışma durumu, gelir durumu, sigara içme, planlanmamış gebelik, doğum şekli ve bebeğin yoğun bakıma ihtiyaç duyma durumu ve ortalama EPDS puanı arasında da farklılık vardı (p<0,05). Sonuç: Eğitim düzeyi yüksek olanlar, sigara içenler ve yakın akrabasında COVİD-19 geçirenler, COVİD-19 kaygısı ve takıntısı açısından risk altında olabilir. Risk altındaki gruplarda gebelikten itibaren anksiyete ve depresif belirtilerin azaltılması gerekmektedir.

Anahtar Kelimeler

• Anksiyete
• COVİD-19
• pandemi
• postpartum depresyon
• takıntı

Kaynakça

1. World Health Organization. Coronavirus disease (COVID-19) pandemic. https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed June 16, 2021.
2. Holmes EA, O’Connor RC, Perry VH, et al. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. The Lancet Psychiatry. 2020;7(6):547-560. doi:10.1016/S2215-0366(20)30168-1
3. Wang C, Pan R, Wan X, 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 Public Health. 2020;17(5)(1729):1-25. doi:10.3390/ijerph17051729
4. Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. The Lancet Psychiatry. 2020;7(4):300-302. doi:10.1016/S2215-0366(20)30073-0
5. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatry. 2020;33(2):e100213. doi:10.1136/gpsych-2020-100213
6. Talevi D, Socci V, Carai M, et al. Mental health outcomes of the COVID-19 pandemic. Riv Psichiatr. 2020;55(3):137-144. doi:10.1708/3382.33569
7. Rubin GJ, Wessely S. The psychological effects of quarantining a city. BMJ. 2020;368:m313. doi:10.1136/bmj.m313
8. Brooks SK, Webster RK, Smith LE, et al. The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet. 2020;395(10227):912-920. doi:10.1016/S0140-6736(20)30460-8

9. United Nations Women. Surveys show that COVID-19 has gendered effects in Asia and the Pacific. https://data.unwomen.org/resources/surveys-show-covid-19-has-gendered-effects-asia-and-pacific. Accessed June 15, 2021.
10. Yehuda R, Hoge CW, McFarlane AC, et al. Post-traumatic stress disorder. Nat Rev Dis Prim. 2015;1(15057):1-22. doi:10.1038/nrdp.2015.57
11. Dennis CL, Fung K, Grigoriadis S, Robinson GE, Romans S, Ross L. Traditional postpartum practices and rituals: A qualitative systematic review. Women’s Heal. 2007;3(4):487-502. doi:10.2217/17455057.3.4.487
12. 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.e1-240.e9. doi:10.1016/j.ajog.2020.05.009
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;48(9):971-976. doi:10.1515/jpm-2020-0415
14. Durankuş F, Aksu E. Effects of the COVID-19 pandemic on anxiety and depressive symptoms in pregnant women: a preliminary study. J Matern Neonatal Med. 2022;35(2):205-211. doi:10.1080/14767058.2020.1763946
15. Markiewicz-Gospodarek A, Górska A, Markiewicz R, et al. The relationship between mental disorders and the COVID-19 pandemic—course, risk factors, and potential consequences. Int J Environ Res Public Health. 2022;19(15):9573. doi:10.3390/ijerph19159573
16. Lee SA, Mathis AA, Jobe MC, Pappalardo EA. Clinically significant fear and anxiety of COVID-19: A psychometric examination of the Coronavirus Anxiety Scale. Psychiatry Res. 2020;290:113112. doi:10.1016/j.psychres.2020.113112
17. Evren C, Evren B, Dalbudak E, Topcu M, Kutlu N. Measuring anxiety related to COVID-19: A Turkish validation study of the Coronavirus Anxiety Scale. Death Stud. 2022;46(5):1052-1058. doi:10.1080/07481187.2020.1774969
18. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Br J Psychiatry. 1987;150(6):782-786. doi:10.1192/bjp.150.6.782
19. Aydin N, Inandi T, Yigit A, Hodoglugil NNS. 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. doi:10.1007/s00127-004-0770-4
20. Van Rheenen TE, Meyer D, Neill E, et al. Mental health status of individuals with a mood-disorder during the COVID-19 pandemic in Australia: Initial results from the COLLATE project. J Affect Disord. 2020;275:69-77. doi:10.1016/j.jad.2020.06.037
21. Lange KW. Coronavirus disease 2019 (COVID-19) and global mental health. Glob Heal J. 2021;5(1):31-36. doi:10.1016/j.glohj.2021.02.004
22. Organisation for Economic Co-operation and Development. The impact of the COVID-19 pandemic on jobs and incomes in G20 economies 2020. https://www.ilo.org/ wcmsp5/groups/public/dgreports/cabinet/documents/publication/wcms_756331.pdf. Accessed June 10, 2023.
23. Employment Working Group. The impact of the COVID-19 pandemic on jobs and incomes in G20 economies. https://www.ilo.org/global/about-the-ilo/how-the-ilo-works/multilateral-system/g20/reports/WCMS_756331/lang--en/index.htm. Accessed October 11, 2023.
24. Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. J Affect Disord. 2020;277:5-13. doi:10.1016/j.jad.2020.07.126
25. Ravaldi C, Wilson A, Ricca V, Homer C, Vannacci A. Pregnant women voice their concerns and birth expectations during the COVID-19 pandemic in Italy. Women and Birth. 2021;34(4):335-343. doi:10.1016/j.wombi.2020.07.002
26. Hanach N, Radwan H, Fakhry R, et al. Prevalence and risk factors of postpartum depression among women living in the United Arab Emirates. Soc Psychiatry Psychiatr Epidemiol. 2023;58(3):395-407. doi:10.1007/s00127-022-02372-1
27. Wang Z, Liu J, Shuai H, et al. Correction: Mapping global prevalence of depression among postpartum women. Transl Psychiatry. 2021;11(1):640. doi:10.1038/s41398-021-01692-1
28. Faisal-Cury A, Menezes PR, D’Oliveira AFPL, Schraiber LB, Lopes CS. Temporal relationship between intimate partner violence and postpartum depression in a sample of low income women. Matern Child Health J. 2013;17(7):1297-1303. doi:10.1007/s10995-012-1127-3