Pandemic, racism linked to postpartum anxiety, depression in Black mothers

The COVID-19 pandemic, in combination with systemic racism in the U.S., is associated with elevated levels of postpartum anxiety and depression among Black mothers, researchers reported in JAMA Psychiatry.

Wanjiku F. M. Njoroge, MD, the medical director of the Young Child Clinic and program director of the Child and Adolescent Psychiatry Fellowship at the Children's Hospital of Philadelphia, and colleagues reported the effects of a “syndemic,” which is defined as the aggregation of two or more endemic and epidemic conditions.

Njoroge and colleagues followed up with a total of 151 Black participants after their pregnancies between April 17, 2020, and July 8, 2020. The mean age of participants was 30.18 years, and the mean gestational age at follow-up was 25.3 weeks.

The researchers created composite variables that captured negative experiences of the COVID-19 pandemic and racism. Racism was identified as either structural or interpersonal.

Negative COVID-19 pandemic experiences were associated with a greater likelihood of screening positive for depression at higher levels of systemic racism (OR, 2.52; 95% CI, 1.38-4.6) and interpersonal racism (OR, 1.9; 95% CI, 1.04-3.48), but not at lower levels of systemic or interpersonal racism.

Negative COVID-19 experiences were associated with anxiety only with higher levels of interpersonal racism (OR, 1.85; 95% CI, 0.86-4.01), but not at lower levels.

Overall, 29% (n = 44) of participants met screening criteria for postpartum depression and 13% (n = 20) for postpartum anxiety.

“These estimates highlight the possibility that the COVID-19 pandemic, when combined with structural endemic racism, has created syndemic forces that have worsened conditions for Black communities,” the researchers wrote.