The influence of lifestyles to cope with stress over mental health in pregnant and postpartum women during the COVID-19 pandemic

Diego Gómez-Baya, Irene Gómez-Gómez, Sara Domínguez-Salas, Carmen Rodríguez-Domínguez, Emma Motrico, Diego Gómez-Baya, Irene Gómez-Gómez, Sara Domínguez-Salas, Carmen Rodríguez-Domínguez, Emma Motrico

Abstract

The COVID-19 pandemic affected daily life routines and lifestyles of pregnant and postpartum women and increased their stress and risk of suffering from mental health problems. The aim of this study was to analyse which sociodemographic variables, COVID-19 exposure variables and lifestyles to cope with stress variables predicted anxiety, depression, and PTSD symptoms in pregnant and postpartum women during the COVID-19 pandemic. A cross-sectional design was performed with a sample of 3356 Spanish women participating in the Riseup-PPD-COVID-19 study. These participants completed an online survey composed of measures of anxiety (GAD-7), depression (EPDS), and PTSD related to COVID-19 (Checklist DSM-5), as well as demographics, exposure to COVID-19, and lifestyles to cope with stress. Regarding results, 47.2% showed depression and a third reported anxiety, whereas moderate scores were observed in PTSD symptoms. The most commonly used strategies to cope with stress in the COVID-19 pandemic were talking with friends and family and increasing time with social networks. Better results in mental health were associated with coping strategies such as talking with family and friends or participating in family activities, physical activity, sleeping well at night, eating healthier, and increasing personal care. Furthermore, poor results in mental health were observed in those participants who increased time with screens, ate fast food, reported substance use, and talked more frequently with health professionals. More symptoms were also observed in younger women, primiparous women, and those who reported more exposure to COVID-19. The results underline the need to strengthen the mental health of pregnant and postpartum women. Trial registration: ClinicalTrials.gov Identifier: NCT04595123.

Keywords: Coping strategies; Covid-19 pandemic; Lifestyles; Mental health; Pregnant and postpartum women.

Conflict of interest statement

Competing interestsThe authors declare no competing interests.Conflict of interestThe authors declare no conflict of Interest.

© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022.

References

    1. Ahmad, M., & Vismara, L. (2021). The psychological impact of COVID-19 pandemic on women’s mental health during pregnancy: A rapid evidence review. International Journal of Environmental Research and Public Health, 18(13). 10.3390/ijerph18137112
    1. Allotey, J., Stallings, E., Bonet, M., Yap, M., Chatterjee, S., Kew, T., Debenham, L., Llavall, A. C., Dixit, A., Zhou, D., Balaji, R., Lee, S. I., Qiu, X., Yuan, M., Coomar, D., Sheikh, J., Lawson, H., Ansari, K., Wely, M. Van, … Thangaratinam, S. (2020). Clinical manifestations , risk factors , and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy : living systematic review and meta-analysis. 10.1136/bmj.m3320
    1. Angelini CR, Pacagnella RC, Parpinelli MA, Silveira C, Andreucci CB, Ferreira EC, Santos JP, Zanardi DM, Souza RT, Cecatti JG. Post-traumatic stress disorder and severe maternal morbidity: Is there an association? Clinics. 2018;73(Criterion C):1–7. doi: 10.6061/clinics/2018/e309.
    1. Baker B, Yang I. Social media as social support in pregnancy and the postpartum. Sexual and Reproductive Healthcare. 2018;17(September 2017):31–34. doi: 10.1016/j.srhc.2018.05.003.
    1. Barbosa-Leiker C, Smith CL, Crespi EJ, Brooks O, Burduli E, Ranjo S, Carty CL, Hebert LE, Waters SF, Gartstein MA. Stressors, coping, and resources needed during the COVID-19 pandemic in a sample of perinatal women. BMC Pregnancy and Childbirth. 2021;21(1):171. doi: 10.1186/s12884-021-03665-0.
    1. Battulga, B., Benjamin, M. R., Chen, H., & Bat-Enkh, E. (2021). The Impact of Social Support and Pregnancy on Subjective Well-Being: A Systematic Review. Frontiers in Psychology, 12(September). 10.3389/fpsyg.2021.710858
    1. Bedaso A, Adams J, Peng W, Sibbritt D. The relationship between social support and mental health problems during pregnancy: A systematic review and meta-analysis. Reproductive Health. 2021;18(1):1–23. doi: 10.1186/s12978-021-01209-5.
    1. Bener, A., Sheikh, & Gerber. (2012). Prevalence of psychiatric disorders and associated risk factors in women during their postpartum period: a major public health problem and global comparison. International Journal of Women’s Health, 191. 10.2147/IJWH.S29380
    1. Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: A systematic review. Journal of Affective Disorders. 2016;191:62–77. doi: 10.1016/j.jad.2015.11.014.
    1. Biviá-Roig G, La Rosa VL, Gómez-Tébar M, Serrano-Raya L, Amer-Cuenca JJ, Caruso S, Commodari E, Barrasa-Shaw A, Lisón JF. Analysis of the impact of the confinement resulting from covid-19 on the lifestyle and psychological wellbeing of spanish pregnant women: An internet-based cross-sectional survey. International Journal of Environmental Research and Public Health. 2020;17(16):1–14. doi: 10.3390/ijerph17165933.
    1. Boekhorst, M. G. B. M., Muskens, L., Hulsbosch, L. P., Van Deun, K., Bergink, V., Pop, V. J. M., & van den Heuvel, M. I. (2021). The COVID-19 outbreak increases maternal stress during pregnancy, but not the risk for postpartum depression. Archives of Women’s Mental Health, 0123456789. 10.1007/s00737-021-01104-9
    1. Bogaerts AFL, Devlieger R, Nuyts E, Witters I, Gyselaers W, Van Den Bergh BRH. Effects of lifestyle intervention in obese pregnant women on gestational weight gain and mental health: A randomized controlled trial. International Journal of Obesity. 2013;37(6):814–821. doi: 10.1038/ijo.2012.162.
    1. Chapman SLC, Wu L-T. Postpartum Substance Use and Depressive Symptoms: A Review. Women & Health. 2013;53(5):479–503. doi: 10.1080/03630242.2013.804025.
    1. Chojenta C, William J, Martin MA, Byles J, Loxton D. The impact of a history of poor mental health on health care costs in the perinatal period. Archives of Women’s Mental Health. 2019;22(4):467–473. doi: 10.1007/s00737-018-0912-4.
    1. Cox JL, Holden JM, Sagovsky R. Detection of Postnatal Depression. British Journal of Psychiatry. 1987;150(6):782–786. doi: 10.1192/bjp.150.6.782.
    1. Demissie DB, Bitew ZW. Mental health effect of COVID-19 pandemic among women who are pregnant and/or lactating: A systematic review and meta-analysis. SAGE Open Medicine. 2021;9:205031212110261. doi: 10.1177/20503121211026195.
    1. Dennis CL, Falah-Hassani K, Shiri R. Prevalence of antenatal and postnatal anxiety: Systematic review and meta-analysis. British Journal of Psychiatry. 2017;210(5):315–323. doi: 10.1192/bjp.bp.116.187179.
    1. Esteban-Gonzalo S, Caballero-Galilea M, González-Pascual JL, Álvaro-Navidad M, Esteban-Gonzalo L. Anxiety and Worries among Pregnant Women during the COVID-19 Pandemic: A Multilevel Analysis. International Journal of Environmental Research and Public Health. 2021;18(13):6875. doi: 10.3390/ijerph18136875.
    1. Farrell T, Reagu S, Mohan S, Elmidany R, Qaddoura F, Ahmed EE, Corbett G, Lindow S, Abuyaqoub SM, Alabdulla MA. The impact of the COVID-19 pandemic on the perinatal mental health of women. Journal of Perinatal Medicine. 2020;48(9):971–976. doi: 10.1515/jpm-2020-0415.
    1. Fisher J, de Mello MC, Patel V, Rahman A, Tran T, Holton S, Holmesf W. Prevalence and determinants of common perinatal mental disorders in women in low-and lower-middle-income countries: A systematic review. Bulletin of the World Health Organization. 2012;90(2):139–149. doi: 10.2471/BLT.11.091850.
    1. García-Campayo, J., Zamorano, E., Ruiz, M. A., Pardo, A., Pérez-Páramo, M., López-Gómez, V., et al. (2010). Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool. Health and Quality of Life Outcomes,8(11), 8. 10.1186/1477-7525-8-8
    1. Garcia-Esteve L, Ascaso C, Ojuel J, Navarro P. Validation of the Edinburgh Postnatal Depression Scale (EPDS) in Spanish mothers. Journal of Affective Disorders. 2003;75(1):71–76. doi: 10.1016/S0165-0327(02)00020-4.
    1. George, A., Luz, R. F., De Tychey, C., Thilly, N., & Spitz, E. (2013). Anxiety symptoms and coping strategies in the perinatal period. BMC Pregnancy and Childbirth, 13. 10.1186/1471-2393-13-233
    1. Ghaedrahmati M, Kazemi A, Kheirabadi G, Ebrahimi A, Bahrami M. Postpartum depression risk factors: A narrative review. Journal of Education and Health Promotion. 2017;6(January):60. doi: 10.4103/jehp.jehp_9_16.
    1. Gutiérrez-Zotes A, Labad J, Martín-Santos R, García-Esteve L, Gelabert E, Jover M, Guillamat R, Mayoral F, Gornemann I, Canellas F, Gratacós M, Guitart M, Roca M, Costas J, Luis Ivorra J, Navinés R, de Diego-Otero Y, Vilella E, Sanjuan J. Coping strategies and postpartum depressive symptoms: A structural equation modelling approach. European Psychiatry. 2015;30(6):701–708. doi: 10.1016/j.eurpsy.2015.06.001.
    1. Hether HJ, Murphy ST, Valente TW. A social network analysis of supportive interactions on prenatal sites. Digital Health. 2016;2:205520761662870. doi: 10.1177/2055207616628700.
    1. Hewitt CE, Gilbody SM, Mann R, Brealey S. Instruments to identify post-natal depression: Which methods have been the most extensively validated, in what setting and in which language? International Journal of Psychiatry in Clinical Practice. 2010;14(1):72–76. doi: 10.3109/13651500903198020.
    1. Iyengar, U., Jaiprakash, B., Haitsuka, H., & Kim, S. (2021). One Year Into the Pandemic: A Systematic Review of Perinatal Mental Health Outcomes During COVID-19. Frontiers in Psychiatry, 12(June). 10.3389/fpsyt.2021.674194
    1. Khan S, Peng L, Siddique R, Nabi G, Nawsherwan, Xue M, Liu J, Han G. Impact of COVID-19 infection on pregnancy outcomes and the risk of maternal-to-neonatal intrapartum transmission of COVID-19 during natural birth. Infection Control and Hospital Epidemiology. 2020;41(6):748–750. doi: 10.1017/ice.2020.84.
    1. Khoury, J. E., Atkinson, L., Bennett, T., Jack, S. M., & Gonzalez, A. (2021). Coping strategies mediate the associations between COVID-19 experiences and mental health outcomes in pregnancy. Archives of Women’s Mental Health, 0123456789. 10.1007/s00737-021-01135-2
    1. Kinser PA, Jallo N, Amstadter AB, Thacker LR, Jones E, Moyer S, Rider A, Karjane N, Salisbury AL. Depression, Anxiety, Resilience, and Coping: The Experience of Pregnant and New Mothers During the First Few Months of the COVID-19 Pandemic. Journal of Women’s Health. 2021;30(5):654–664. doi: 10.1089/jwh.2020.8866.
    1. Lakey B, Orehek E. Relational regulation theory: A new approach to explain the link between perceived social support and mental health. Psychological Review. 2011;118(3):482–495. doi: 10.1037/a0023477.
    1. Lambelet V, Ceulemans M, Nordeng H, Favre G, Horsch A, Stojanov M. Impact of the COVID-19 pandemic on Swiss pregnant and breastfeeding women – a cross-sectional study covering the first pandemic wave. Swiss Medical Weekly. 2021;151(37–38):1–10. doi: 10.4414/smw.2021.w30009.
    1. Lega, I., Bramante, A., Lauria, L., Grussu, P., Dubini, V., Falcieri, M., Ghiani, M. C., Giordano, A., Guidomei, S., Mignuoli, A. D., Paris, S., Bettinelli, M. E., Proietti, P., Andreozzi, S., Brenna, V., Bucciarelli, M., Martelli, G., Ferraro, C., Torrisi, M., … Donati, S. (2022). The Psychological Impact of COVID-19 among Women Accessing Family Care Centers during Pregnancy and the Postnatal Period in Italy. International Journal of Environmental Research and Public Health, 19(4), 1983. 10.3390/ijerph19041983
    1. Lin D, Friedman DB, Qiao S, Tam CC, Li X, Li X. Information uncertainty: A correlate for acute stress disorder during the COVID-19 outbreak in China. BMC Public Health. 2020;20(1):1–9. doi: 10.1186/s12889-020-09952-3.
    1. Liu CH, Erdei C, Mittal L. Risk factors for depression, anxiety, and PTSD symptoms in perinatal women during the COVID-19 Pandemic. Psychiatry Research. 2021;295(October 2020):113552. doi: 10.1016/j.psychres.2020.113552.
    1. López-Morales H, del Valle MV, Canet-Juric L, Andrés ML, Galli JI, Poó F, Urquijo S. Mental health of pregnant women during the COVID-19 pandemic: A longitudinal study. Psychiatry Research. 2021;295(January):113567. doi: 10.1016/j.psychres.2020.113567.
    1. McPherson S. Stress and coping in accident and emergency senior house officers. Emergency Medicine Journal. 2003;20(3):230–231. doi: 10.1136/emj.20.3.230.
    1. Meraya AM, Syed MH, Yasmeen A, Mubaraki AA, Kariry HD, Maabouj W, Moraya D, Makeen HA. COVID-19 related psychological distress and fears among mothers and pregnant women in Saudi Arabia. PLoS ONE. 2021;16(8):e0256597. doi: 10.1371/journal.pone.0256597.
    1. Molgora S, Accordini M. Motherhood in the Time of Coronavirus: The Impact of the Pandemic Emergency on Expectant and Postpartum Women’s Psychological Well-Being. Frontiers in Psychology. 2020;11(October):1–16. doi: 10.3389/fpsyg.2020.567155.
    1. Mortazavi F, Mehrabad M, KiaeeTabar R. Pregnant Women ’ s Well-being and Worry During the COVID-19 Pandemic : A Comparative Study. BMC Pregnancy and CHildbirth. 2021;4(21):1–22.
    1. Motrico, E., Bina, R., Domínguez-Salas, S., Mateus, V., Contreras-García, Y., Carrasco-Portiño, M., Ajaz, E., Apter, G., Christoforou, A., Dikmen-Yildiz, P., Felice, E., Hancheva, C., Vousoura, E., Wilson, C. A., Buhagiar, R., Cadarso-Suárez, C., Costa, R., Devouche, E., Ganho-Ávila, A., … Mesquita, A. (2021). Impact of the Covid-19 pandemic on perinatal mental health (Riseup-PPD-COVID-19): protocol for an international prospective cohort study. BMC Public Health, 21(1), 368. 10.1186/s12889-021-10330-w
    1. Obrochta CA, Chambers C, Bandoli G. Psychological distress in pregnancy and postpartum. Women and Birth. 2020;33(6):583–591. doi: 10.1016/j.wombi.2020.01.009.
    1. Omidvar S, Faramarzi M, Hajian-Tilak K, Amiri FN. Associations of psychosocial factors with pregnancy healthy life styles. PLoS ONE. 2018;13(1):1–13. doi: 10.1371/journal.pone.0191723.
    1. Opie RS, Uldrich AC, Ball K. Maternal Postpartum Diet and Postpartum Depression: A Systematic Review. Maternal and Child Health Journal. 2020;24(8):966–978. doi: 10.1007/s10995-020-02949-9.
    1. Padmapriya, N., Bernard, J. Y., Liang, S., Loy, S. L., Shen, Z., Kwek, K., Godfrey, K. M., Gluckman, P. D., Chong, Y. S., Saw, S. M., Meaney, M. J., Chen, H., Müller-Riemenschneider, F., Agarwal, P., Biswas, A., Bong, C. L., Broekman, B. F. P., Cai, S., Chan, J. K. Y., … Yeo, G. S. H. (2016). Association of physical activity and sedentary behavior with depression and anxiety symptoms during pregnancy in a multiethnic cohort of Asian women. Archives of Women’s Mental Health, 19(6), 1119–1128. 10.1007/s00737-016-0664-y
    1. Perzow SED, Hennessey EP, Hoffman MC, Grote NK, Poggi E, Hankin BL. Mental health of pregnant and postpartum women in response to the COVID-19 pandemic. Journal of Affective Disorders Reports. 2021;4(February):100123. doi: 10.1016/j.jadr.2021.100123.
    1. Prabhu M, Cagino K, Matthews KC, Friedlander RL, Glynn SM, Kubiak JM, Yang YJ, Zhao Z, Baergen RN, DiPace JI, Razavi AS, Skupski DW, Snyder JR, Singh HK, Kalish RB, Oxford CM, Riley LE. Pregnancy and postpartum outcomes in a universally tested population for SARS-CoV-2 in New York City: a prospective cohort study. BJOG: An International Journal of Obstetrics and Gynaecology. 2020;127(12):1548–1556. doi: 10.1111/1471-0528.16403.
    1. Razurel C, Kaiser B, Sellenet C, Epiney M. Relation Between Perceived Stress, Social Support, and Coping Strategies and Maternal Well-Being: A Review of the Literature. Women and Health. 2013;53(1):74–99. doi: 10.1080/03630242.2012.732681.
    1. Saccone G, Florio A, Aiello F, Venturella R, De Angelis MC, Locci M, Bifulco G, Zullo F, Di SpiezioSardo A. Psychological impact of coronavirus disease 2019 in pregnant women. American Journal of Obstetrics and Gynecology. 2020;223(2):293–295. doi: 10.1016/j.ajog.2020.05.003.
    1. Saleh L, Canclini S, Greer K, Mathison C, Combs SM, Dickerson B, Collins K. Mothers’ Experiences of Pregnancy, Labor and Birth, and Postpartum During COVID-19 in the United States. Journal of Perinatal & Neonatal Nursing. 2022;36(1):55–67. doi: 10.1097/JPN.0000000000000624.
    1. Shorey S, Chee CYI, Ng ED, Chan YH, Tam WWS, Chong YS. Prevalence and incidence of postpartum depression among healthy mothers: A systematic review and meta-analysis. Journal of Psychiatric Research. 2018;104(August):235–248. doi: 10.1016/j.jpsychires.2018.08.001.
    1. Simon NM, Saxe GN, Marmar CR. Mental Health Disorders Related to COVID-19–Related Deaths. JAMA. 2020;324(15):1493. doi: 10.1001/jama.2020.19632.
    1. Simpson W, Glazer M, Michalski N, Steiner M, Frey BN. Comparative Efficacy of the Generalized Anxiety Disorder 7-Item Scale and the Edinburgh Postnatal Depression Scale as Screening Tools for Generalized Anxiety Disorder in Pregnancy and the Postpartum Period. The Canadian Journal of Psychiatry. 2014;59(8):434–440. doi: 10.1177/070674371405900806.
    1. Smith M, Mitchell AS, Townsend ML, Herbert JS. The relationship between digital media use during pregnancy, maternal psychological wellbeing, and maternal-fetal attachment. PLoS ONE. 2020;15(12 December):1–15. doi: 10.1371/journal.pone.0243898.
    1. Smith V, Seo D, Warty R, Payne O, Salih M, Chin KL, Ofori-Asenso R, Krishnan S, Da Silva Costa F, Vollenhoven B, Wallace E. Maternal and neonatal outcomes associated with COVID-19 infection: A systematic review. PLoS ONE. 2020;15(6):1–13. doi: 10.1371/journal.pone.0234187.
    1. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine. 2006;166(10):1092–1097. doi: 10.1001/archinte.166.10.1092.
    1. Stepowicz A, Wencka B, Bieńkiewicz J, Horzelski W, Grzesiak M. Stress and anxiety levels in pregnant and post-partum women during the COVID-19 pandemic. International Journal of Environmental Research and Public Health. 2020;17(24):1–9. doi: 10.3390/ijerph17249450.
    1. Suárez-Rico BV, Estrada-Gutierrez G, Sánchez-Martínez M, Perichart-Perera O, Rodríguez-Hernández C, González-Leyva C, Osorio-Valencia E, Cardona-Pérez A, Helguera-Repetto AC, Sosa SEY, Solis-Paredes M, Reyes-Muñoz E. Prevalence of depression, anxiety, and perceived stress in postpartum mexican women during the covid-19 lockdown. International Journal of Environmental Research and Public Health. 2021;18(9):1–9. doi: 10.3390/ijerph18094627.
    1. Tang S, Xiang Z. Who suffered most after deaths due to COVID-19? Prevalence and correlates of prolonged grief disorder in COVID-19 related bereaved adults. Globalization and Health. 2021;17(1):1–9. doi: 10.1186/s12992-021-00669-5.
    1. Thomason, M. E., Graham, A., & VanTieghem, M. R. (2022). The COPE-IS: Coronavirus Perinatal Experiences – Impact Survey. Available at: . Accessed March 2021.
    1. Vargas-Terrones M, Barakat R, Santacruz B, Fernandez-Buhigas I, Mottola MF. Physical exercise programme during pregnancy decreases perinatal depression risk: A randomised controlled trial. British Journal of Sports Medicine. 2019;53(6):348–353. doi: 10.1136/bjsports-2017-098926.
    1. Vázquez MB, Míguez MC. Validation of the Edinburgh postnatal depression scale as a screening tool for depression in Spanish pregnant women. Journal of Affective Disorders. 2019;246:515–521. doi: 10.1016/j.jad.2018.12.075.
    1. Whitaker, K. M., Hung, P., Alberg, A. J., Hair, N. L., & Liu, J. (2021). Variations in health behaviors among pregnant women during the COVID-19 pandemic. Midwifery, 95(January). 10.1016/j.midw.2021.102929
    1. Woody CA, Ferrari AJ, Siskind DJ, Whiteford HA, Harris MG. A systematic review and meta-regression of the prevalence and incidence of perinatal depression. Journal of Affective Disorders. 2017;219:86–92. doi: 10.1016/j.jad.2017.05.003.
    1. World Health Organization. (2021). Health topics: Coronavirus. Available at: . Accessed March 2021.
    1. Yan, H., Ding, Y., & Guo, W. (2020). Mental Health of Pregnant and Postpartum Women During the Coronavirus Disease 2019 Pandemic: A Systematic Review and Meta-Analysis. Frontiers in Psychology, 11. 10.3389/fpsyg.2020.617001
    1. Yildiz PD, Ayers S, Phillips L. The prevalence of posttraumatic stress disorder in pregnancy and after birth: A systematic review and meta-analysis. Journal of Affective Disorders. 2017;208(October 2016):634–645. doi: 10.1016/j.jad.2016.10.009.
    1. Yin X, Sun N, Jiang N, Xu X, Gan Y, Zhang J, Qiu L, Yang C, Shi X, Chang J, Gong Y. Prevalence and associated factors of antenatal depression: Systematic reviews and meta-analyses. Clinical Psychology Review. 2020;83:101932. doi: 10.1016/j.cpr.2020.101932.
    1. Yue C, Liu C, Wang J, Zhang M, Wu H, Li C, Yang X. Association between social support and anxiety among pregnant women in the third trimester during the coronavirus disease 2019 (COVID-19) epidemic in Qingdao, China: The mediating effect of risk perception. International Journal of Social Psychiatry. 2021;67(2):120–127. doi: 10.1177/0020764020941567.
    1. Zhang Y, Ma ZF. Psychological responses and lifestyle changes among pregnant women with respect to the early stages of COVID-19 pandemic. International Journal of Social Psychiatry. 2020 doi: 10.1177/0020764020952116.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren