Depression, Anxiety, and Coping In Peripartum Women During Covid-19 Pandemic

Abstract Background and Objectives The World Health Organization declared pregnant women and mothers of infants to be among the most vulnerable groups during the COVID-19 pandemic. This study, a part of a large international prospective study, aimed to 1) evaluate the levels of perinatal depression and anxiety, 2) determine the risk and protective factors that predict perinatal mental health outcomes, and 3) ascertain the possible effects of different behavioral coping strategies to overcome stress and challenges during Covid-19 lockdowns and restrictions. Materials and Methods This is a comparative cross sectional, non-interventional study of non-clinical population of peripartum women (N = 328, 62% pregnant, 38% mothers of infants). Participants completed the adapted Bulgarian version of Coronavirus Perinatal Experiences – Impact Survey (COPE–IS), which includes self-assessment scales of depression (Edinburgh Postnatal Depression Scale, EPDS) and anxiety (Generalized Anxiety Disorder Screener, GAD-7), preferred coping strategies and social support questions. Results 24.8% of pregnant women and 23% of mothers of infants showed very high (> 13) EPDS score, while 22.8% of pregnant women and 18.3% of mothers of infants presented severe (> 10) GAD-7 symptoms. Several hierarchical linear regression analyses revealed that: 1) history of previous mood disorders of the mother was a predictor of depression and anxiety peripartum, 2) perceived social support and decreased time on social media were protective factors postnatally, 3) family time had beneficial effect on mental health outcomes for both periods, 4) coping strategies and the risk and protective factors predicting mental health outcomes in peripartum women appear in different configurations in the two studied periods – pregnancy and postpartum. Conclusions: Tailoring interventions to address behavioral coping strategies, while taking into account the different stages of pregnancy and early motherhood, holds promise for optimizing mental health outcomes in this vulnerable population, especially during critical periods of global or local crises.