Perinatal Depression of Women Along with 2019 Novel Coronavirus Breakout in China

Abstract

Background
On 20th Jan 2020, a new coronavirus epidemic with “human-to-human” transmission was officially announced, which inevitably caused public panic in China. Perinatal depression (PND) is one of the most common mental health problems. The purpose of this study is to explore the mental impact of COVID-19 outbreak on pregnant women.

Methods
A total of 4124 pregnant women during third trimester from 25 hospitals in 10 provinces were recruited in this cross-sectional study, from Jan/01 to Feb/09, 2020. Among them, 1285 pregnant women were assessed after Jan/20, and 2839 were assessed before that time point. The Edinburgh Postnatal Depression Scale (EPDS) was used to evaluate the maternal psychological situation. Prevalence of PND and anxiety were compared between two groups.

Findings
Pregnant women had higher scores in EPDS (7.7 vs 7.4, P=0.03) and anxiety subscale (3.4 vs 3.2, P=0.04), especially the highest score for thoughts of self-harm (P=0.005) after the declaration of COVID-19 epidemic. Awareness of COVID-19 significantly increased the prevalence of PND (26.0% vs 29.6%, P=0.02). The COVID-19 number of newly- confirmed, suspected infections, and death cases per day was positively associated with the prevalence of PND (P=0.003, 0.004, and 0.001, respectively). Pregnant women those who were underweight, full-time employed, middle income, age < 35 yrs, primiparous, less exercise, appropriate living area appeared to be more susceptible to the outbreak.

Interpretation
COVID-19 outbreak can increase the depressive risk of pregnant women, especially in the self-harm inclination, suggesting that psychological intervention is an urgent need for maternal population.

Funding: The study was supported by the National Natural Science Foundation of China (81661128010, 81671412), the National Key Research and Development Program of China (2017YFC1001300, 2018YFC1002804, 2016YFC1000203), Foundation of Shanghai Municipal Commission of Health and Family Planning (20144Y0110), Chinese Academy of Medical Sciences Research Unit, Shanghai Jiao Tong University(2019RU056), CAMS Innovation Fund for Medical Sciences (2019-I2M-5-064) and Shanghai Municipal Key Clinical Specialty, Shanghai, China.

Conflict of interest: The authors have declared that no conflict of interest exists.

Ethical Approval: This study was registered in Chinese Clinical Trial Registry (ChiCTR1900027020) and the ethical approval was obtained from the Institutional Review Board of International Peace Maternity and Child Health Hospital (GKLW2019-11). Informed consent was obtained from all participants before inclusion.

Keywords: COVID-19, perinatal depression, outbreak

JEL Classification: I1