According to a new study, stress related to COVID-19 had a greater impact on the mental health of pregnant women than those who were not. Dr Susanne Schweizer of UNSW Science and colleagues from Europe and the United States collected data on mental health during and after pregnancy in a longitudinal study of 742 pregnant women.
COVID-19 in the postpartum period
Their analysis found that stress related to COVID-19 had the greatest impact on pregnant ladies who tended to worry, felt lonely or had a low tolerance for uncertainty. A follow-up study, published today in JAMA Network Open, looked at stress related to COVID-19 in the postpartum period, 1.5 years after the initial investigation. The team found that feeling stressed by the pandemic during pregnancy not only had a lasting effect on the participants’ own mental health, but was also associated with an increase in negative moods in their infants.
Dr Schweizer says “The Centers for Disease Control identifies pregnant women as a vulnerable group in terms of physical health during pandemics and disease outbreaks, Based on these findings and those of others, we should also identify pregnant women as a vulnerable group in terms of mental health”.
Mental health vulnerability factors Importantly, the research team compared the pregnant women who took part in the study to sex-, age- and country-matched controls. “So you have someone who is as close as possible but not pregnant at the time. And we looked at the effects of pandemic-related stress on their mental health,” says Dr Schweizer.
Pandemic stress was measured using the Pandemic Anxiety Scale, which measures individuals’ concerns about the pandemic, including concerns about contracting the virus, having enough food, and work-related impacts. Unsurprisingly, stress related to COVID-19 was associated with more mental health problems in both women who were pregnant and those who weren’t.
Dr Schweizer also says “But not all women were affected in the same way. There were vulnerability factors such as lack of social support, increased loneliness, fear and intolerance of uncertainty that had a greater impact on mental health in the context of pandemic-related stress in pregnant women compared to their non-pregnant counterparts”.
Effect on Infant Behavior At the final time point, an average of 18 months after the initial assessment, the team administered the same set of measures to the cohort.
Harming The Child
However, this time we also administered measures of postpartum anxiety, which capture mental health symptoms that are related to the postpartum period, such as are thoughts of harming the child, and we also measured the infant’s mood and behavior.
A follow-up study found that stress related to COVID-19 during pregnancy, captured in the first article, was significantly associated with poor maternal mental health outcomes after childbirth. “The best predictor of your mental health is always your mental health at a previous point in time,” says Dr. Schweizer.
Surprised that pandemic-related stress during pregnancy adversely affected mothers’ depression, anxiety, and distress so far into the future, even when we controlled for their previous levels of mental well-being. But it wasn’t just mothers who were negatively affected. Those who were stressed by the pandemic were more likely to have what the researchers call “negative affectivity” in their infants. Negative affectivity includes the child crying more often and having a harder time settling down, as well as being less likely to venture into unfamiliar situations.
Negative affectivity is a measure of a child’s mood. But it was associated with a range of behavioral problems, and importantly, cognition. It was also associated with developmental outcomes across the lifespan.
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