Mothers with postpartum depression ‘highly vulnerable’ during pandemic

Rates and severity of postpartum depression and anxiety symptoms among women who sought treatment for postpartum depression worsened during the COVID-19 pandemic.

Researchers reported these findings in a study conducted in Canada and published in Journal of Clinical Psychiatry.

“Mothers with mental health concerns during the COVID-19 pandemic are a highly vulnerable group, and women seeking treatment for these problems after delivery may be at the greatest risk,” Haley Layton, MPH, of the Health Research Methodology Graduate Program at McMaster University in Canada, and colleagues wrote. “However, very little work has explored the impact of the pandemic on this group. Most research examining the impact of COVID-19 on maternal mental health has focused on general population samples of pregnant or postpartum women, some of which have even excluded women with previous or existing mental health problems.”

In the current study, the researchers sought to assess the effects of the COVID-19 pandemic on depression, anxiety and mother-infant bonding among women who sought treatment for postpartum depression (PPD). They compared baseline data collected via two separate randomized controlled trials of a psychoeducational PPD intervention in the same geographic region. One trial occurred in the year before the COVID-19 pandemic, and the other occurred between April 2020 and October 2020. Participants had an Edinburgh Postnatal Depression Scale (EPDS) score of 10 or higher, were aged 18 years or older, had an infant aged younger than 12 months and were fluent in English. EPDS, anxiety according to the Generalized Anxiety Disorder-7 and mother-infant relationship according to the Postpartum Bonding Questionnaire served as outcomes. The researchers continuously measured all outcomes and dichotomized them at accepted clinical cutoffs.

Layton and colleagues analyzed data of 603 participants, of whom 305 enrolled pre-pandemic and 298 during the pandemic. Results showed that mothers who enrolled during the COVID-19 pandemic had higher levels of PPD (beta = 1.35; 95% CI, 0.64-2.06; Cohen d = 0.31) and anxiety (beta = 1.52; 95% CI, 0.72-2.32; Cohen d = 0.3). Women had 65% increased risk for clinically significant levels of depression symptoms (OR = 1.65; 95% CI, 1.13-2.31) and 46% increased risk for clinically relevant anxiety symptoms (OR = 1.46; 95% CI, 1.05-2.05) during the COVID-19 pandemic; however, the researchers reported no statistically significant differences in mother-infant bonding.

“The long-term effects of the pandemic on maternal mental health and the development of their offspring are not yet known,” Layton and colleagues wrote. “Considering the difficulties women face when accessing mental health treatment, particularly during the pandemic, the problems that have emerged during COVID-19 could lead to more chronic difficulties, and so it is imperative that mothers have timely access to safe and effective treatments during the pandemic and beyond.”