A multi-center survey on the postpartum mental health of mothers and attachment to their neonates during COVID-19 in Hubei Province of China

Sicong Peng; Yi Zhang; Hongyan Liu; Xiaona Huang; Douglas James Noble; Lixia Yang; Wei Lu; Yahui Luo; Huaping Zhu; Li Cao; Chunhua Liu; Yang Chen; Pei Zhang; Shiwen Xia; Anuradha Narayan

doi:10.21037/atm-20-6115

A multi-center survey on the postpartum mental health of mothers and attachment to their neonates during COVID-19 in Hubei Province of China

Ann Transl Med. 2021 Mar;9(5):382. doi: 10.21037/atm-20-6115.

Authors

Sicong Peng^{1

2}, Yi Zhang^{1

2}, Hongyan Liu^{1

2}, Xiaona Huang³, Douglas James Noble³, Lixia Yang⁴, Wei Lu⁵, Yahui Luo⁶, Huaping Zhu^{1

2}, Li Cao¹, Chunhua Liu^{1

7}, Yang Chen¹, Pei Zhang¹, Shiwen Xia^{1

2}, Anuradha Narayan³

Affiliations

¹ Department of Neonatology, Maternal and Child Health Hospital of Hubei Province, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
² Clinical Research Center of the Neonatal Emergency Medicine of Hubei Province, Wuhan, China.
³ Health, Nutrition and WASH, UNICEF China, Beijing, China.
⁴ Department of Neonatology, Xiaochang First People's Hospital, Xiaochang, China.
⁵ Department of Neonatology, Yichang Central People's Hospital, Yichang, China.
⁶ Department of Pediatrics, Hanchuan People's Hospital, Hanchuan, China.
⁷ Wuhan University of Science and Technology, Wuhan, China.

Abstract

Background: There is an emerging literature on the mental health of both pre- and post-partum mothers during the coronavirus disease 2019 (COVID-19) pandemic.

Methods: As of April 1, 2020, 23 mothers confirmed with COVID-19, 15 mothers suspected with COVID-19 but with negative polymerase chain reaction tests, and 33 mothers without COVID-19 (Control Group) were recruited for a study from Hubei Province in China. The Maternal Postnatal Attachment Scale (MPAS), the Zung Self-rating Anxiety Scale, and the Zung Self-rating Depression Scale were applied to investigate the attachment of mothers to their neonates and the postpartum mental health of mothers within the first 3 months after delivery (between 20 to 89 days).

Results: The period of mother-child separation among the confirmed group (33.9±20.9 days) was significantly longer than that of suspected group (16.7±12.2 days) and control group (10.7±8.4 days). The total score of the MPAS in mothers confirmed with COVID-19 (45.5±4.2) was significantly lower (indicating less mother-child attachment) than that in the suspected (50.5±4.7) and control (48.8±4.6) groups. A negative correlation was noted between the mother-child separation time and the MPAS scores, including the subscale scores of attachment (MPAS acore: Spearman's ρ =-0.33, 95% CI: -0.095 to -0.538, P=0.005; Subscale score of attachment: Spearman's ρ =-0.40, 95% CI: -0.163 to -0.592, P=0.001). The incidence of postpartum anxiety in the confirmed, suspected and control groups was 4.3%, 6.7% and 12.1%, respectively; and the incidence of postpartum depression was 39.1%, 33.3% and 30.3%, respectively. No significant difference was found with regards to maternal postpartum anxiety and depression among the three groups.

Conclusions: Decreased mother-child attachment found among mothers confirmed with COVID-19, indicates that further intervention is needed to ensure mother-child interaction to appropriately develop attachment. Mother-child attachment experienced disruption due to prolonged mother-child separation necessitated by the COVID-19 management protocol, which needs to be revised to reduce prolonged mother-child separation. Additionally, mothers with and without COVID-19 suffered a high incidence of depression, which warrants further mental health investment for pregnant mothers during the COVID-19 pandemic.

Keywords: COVID-19; attachment; mental health; postnatal.