The Impact of the COVID-19 Pandemic on Postpartum Maternal Mental Health

Lavinia De Chiara; Gloria Angeletti; Gaia Anibaldi; Chiara Chetoni; Flavia Gualtieri; Francesca Forcina; Paride Bargagna; Georgios Demetrios Kotzalidis; Tommaso Callovini; Marco Bonito; Alexia Emilia Koukopoulos; Alessio Simonetti

doi:10.3390/jpm13010056

The Impact of the COVID-19 Pandemic on Postpartum Maternal Mental Health

J Pers Med. 2022 Dec 27;13(1):56. doi: 10.3390/jpm13010056.

Authors

Lavinia De Chiara^{1

2

3}, Gloria Angeletti^{1

2

3}, Gaia Anibaldi^{1

2}, Chiara Chetoni^{1

2}, Flavia Gualtieri^{1

2}, Francesca Forcina^{1

2}, Paride Bargagna^{1

2}, Georgios Demetrios Kotzalidis^{1

3}, Tommaso Callovini⁴, Marco Bonito⁵, Alexia Emilia Koukopoulos^{3

6}, Alessio Simonetti^{3

7

8}

Affiliations

¹ Department of Neurosciences, Mental Health, and Sensory Organs (NESMOS), Sapienza University, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
² Centre for Prevention and Treatment of Women's Mental Health Problems at Sant'Andrea Hospital of Rome, Sapienza University, Via di Grottarossa 1035-1039, 00189 Rome, Italy.
³ Centro Lucio Bini, ARETÆUS Onlus, Via Crescenzio 42, 00193 Rome, Italy.
⁴ Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy.
⁵ Dipartimento Materno Infantile, San Pietro Fatebenefratelli Hospital, 00189 Rome, Italy.
⁶ Department of Human Neuroscience, Sapienza University, 00185 Rome, Italy.
⁷ Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX 77030, USA.
⁸ Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy.

Abstract

Objectives: There are reports of mental health worsening during the COVID-19 pandemic. We aimed to assess whether this occurred in women who were pregnant at baseline (late 2019) and unaware of the pandemic, and who delivered after the implementation of COVID-19 restrictions and threat (March-April 2020). To compare the pandemic period with the pre-pandemic, we capitalized on a retrospective 2014-2015 perinatal sample which had had affective symptoms assessed.

Methods: The COVID sample were administered the Postnatal Depression Scale (EPDS), Zung Self-Rating Anxiety Scale (SAS), Hypomania Checklist-32 (HCL-32), Pittsburgh Sleep Quality Index (PSQI), and Perceived Stress Scale (PSS) at T0 (pregnancy) and T1 (post-delivery). The Non-COVID sample had completed EPDS and HCL-32 at the same timepoints.

Results: The COVID sample included 72 women, aged 21-46 years (mean = 33.25 years ± 4.69), and the Non-COVID sample included 68 perinatal women, aged 21-46 years (mean = 34.01 years ± 4.68). Our study showed greater levels of mild depression in T1 among the COVID sample compared to the Non-COVID sample. No significant differences in terms of major depression and suicidal ideation were found. The levels of hypomania were significantly different between the two groups at T1, with the COVID sample scoring higher than the Non-COVID sample. This may be related to the high levels of perceived stress we found during the postpartum evaluation in the COVID sample.

Limitations: There was a relatively small sample size.

Conclusions: New mothers responded to the pandemic with less mental health impairment than expected, differently from the general population. Women delivering amidst the pandemic did not differ in depressive and anxiety symptoms from their pre-pandemic scores and from pre-pandemic women. Because stress responses have high energy costs, it is optimal for maternal animals to minimize such high metabolic costs during motherhood. Evidence suggests that reproductive experience alters the female brain in adaptive ways. This maternal brain plasticity facilitates a higher purpose, the continuation of the species. This may point to the recruitment of motherhood-related resources, for potentially overcoming the effects of the pandemic on mental health.

Keywords: COVID-19; anxiety; depression; hypomania; mania; postpartum mental health.

Grants and funding

This research received no external funding.