Reducing pandemic-related stress in antenatal period may improve maternal and infant outcomes: JAMA

Antenatal stress is a significant risk factor for poor postpartum mental health. The association of pandemic-related stress with postpartum outcomes among mothers and infants is, however, less well understood.

A study was done to examine the association of antenatal COVID-19–related stress with postpartum maternal mental health and infant outcomes.

This cohort study was conducted among 318 participants in the COVID-19 Risks Across the Lifespan study, which took place in Australia, the UK, and the US. Eligible participants reported being pregnant at the first assessment wave between May 5 and September 30, 2020, and completed a follow-up assessment between October 28, 2021, and April 24, 2022.

COVID-19–related stress was assessed with the Pandemic Anxiety Scale (score range, 0-4, with higher scores indicating greater COVID-19–related stress). The 8-item Patient Health Questionnaire (score range, 0-3, with higher scores indicating more frequent symptoms of depression) was used to measure maternal depression at each time point, and the 7-item General Anxiety Disorder scale (score range, 0-3, with higher scores indicating more frequent symptoms of anxiety) was used to measure generalized anxiety at each time point. At follow-up, postpartum distress was assessed with the 10-item Postpartum Distress Measure (score range, 0-3, with higher scores indicating greater postpartum distress), and infant outcomes (negative and positive affectivity and orienting behavior) were captured with the Infant Behavior Questionnaire (score range, 1-7, with higher scores indicating that the infant exhibited that affect/behavior more frequently).

Results

The study included 318 women from Australia

Antenatal COVID-19–related stress was significantly associated with maternal postpartum distress, depression, and generalized anxiety, as well as infant negative affectivity. The findings remained consistent across a range of sensitivity analyses.

The findings of this cohort study suggest that targeting pandemic-related stressors in the antenatal period may improve maternal and infant outcomes. Pregnant individuals should be classified as a vulnerable group during pandemics and should be considered a public health priority, not only in terms of physical health but also mental health.

Reference:

Schweizer S, Andrews JL, Grunewald K, Kumle L, COVID-19 Risks Across the Lifespan (CORAL) Consortium. Association of Antenatal COVID-19–Related Stress With Postpartum Maternal Mental Health and Negative Affectivity in Infants. JAMA Netw Open. 2023;6(3):e232969. doi:10.1001/jamanetworkopen.2023.2969