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      Prenatal and postpartum maternal mental health and neonatal motor outcomes during the COVID-19 pandemic

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          Abstract

          Background

          : Rates of prenatal and postpartum stress and depression in pregnant individuals have increased during the COVID-19 pandemic. Perinatal maternal mental health has been linked to worse motor development in offspring, with motor deficits appearing in infancy and early childhood. We aimed to evaluate the relationship between prenatal and postpartum stress and depression and motor outcome in infants born during the COVID-19 pandemic.

          Methods

          : One hundred and seventeen participants completed an online prospective survey study at two timepoints: during pregnancy and within 2 months postpartum. Depression was self-reported using the Edinburgh Perinatal/Postpartum Depression Scale (EPDS), and stress via the Perceived Stress Scale (PSS). Mothers reported total infant motor ability (fine and gross) using the interRAI 0-3 Developmental Domains questionnaire.

          Results

          : Prenatal (EPDS median=10.0, interquartile range[IQR]=6.0 – 14.0, B=-0.035, 95%CI=-0.062 to -0.007, p=.014) and postpartum maternal depression outcomes (median=7, IQR=4-12, B=-0.037, 95%CI= -0.066 to -0.008, p=0.012) were significantly negative associated with total infant motor ability. Neither pregnancy nor postpartum perceived stress was associated with infant motor function. A cluster analysis revealed that preterm and low-birth weight infants whose mothers reported elevated depressive symptoms during pregnancy and in the postpartum period had the poorest motor outcomes.

          Conclusions

          : Prenatal and postpartum depression, but not stress, was associated with early infant motor abilities. Preterm and low-birth weight infants whose mothers reported elevated depressive symptoms maybe at-risk of experiencing poor motor outcome. Results highlight the importance of identifying pre- and postnatal maternal mental health issues, especially during the ongoing COVID-19 pandemic.

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          Most cited references35

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          Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale.

          The development of a 10-item self-report scale (EPDS) to screen for Postnatal Depression in the community is described. After extensive pilot interviews a validation study was carried out on 84 mothers using the Research Diagnostic Criteria for depressive illness obtained from Goldberg's Standardised Psychiatric Interview. The EPDS was found to have satisfactory sensitivity and specificity, and was also sensitive to change in the severity of depression over time. The scale can be completed in about 5 minutes and has a simple method of scoring. The use of the EPDS in the secondary prevention of Postnatal Depression is discussed.
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            A global measure of perceived stress.

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              Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic

              Background Anxiety and depression symptoms in pregnancy typically affect between 10-25% of pregnant individuals. Elevated symptoms of depression and anxiety are associated with increased risk of preterm birth, postpartum depression, and behavioural difficulties in children. The current COVID-19 pandemic is a unique stressor with potentially wide-ranging consequences for pregnancy and beyond. Methods We assessed symptoms of anxiety and depression among pregnant individuals during the current COVID-19 pandemic and determined factors that were associated with psychological distress. 1987 pregnant participants in Canada were surveyed in April 2020. The assessment included questions about COVID-19-related stress and standardized measures of depression, anxiety, pregnancy-related anxiety, and social support. Results We found substantially elevated anxiety and depression symptoms compared to similar pre-pandemic pregnancy cohorts, with 37% reporting clinically relevant symptoms of depression and 57% reporting clinically relevant symptoms of anxiety. Higher symptoms of depression and anxiety were associated with more concern about threats of COVID-19 to the life of the mother and baby, as well as concerns about not getting the necessary prenatal care, relationship strain, and social isolation due to the COVID-19 pandemic. Higher levels of perceived social support and support effectiveness, as well as more physical activity, were associated with lower psychological symptoms. Conclusion This study shows concerningly elevated symptoms of anxiety and depression among pregnant individuals during the COVID-19 pandemic, that may have long-term impacts on their children. Potential protective factors include increased social support and exercise, as these were associated with lower symptoms and thus may help mitigate long-term negative outcomes.
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                Author and article information

                Journal
                J Affect Disord Rep
                J Affect Disord Rep
                Journal of Affective Disorders Reports
                The Author(s). Published by Elsevier B.V.
                2666-9153
                20 July 2022
                20 July 2022
                : 100387
                Affiliations
                [1 ]Applied Psychology, Faculty of Education, Western University, London, Ontario, Canada
                [2 ]The Brain and Mind Institute, Western University, London, Ontario, Canada
                [3 ]Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
                [4 ]Department of Computer Science, Western University, London, ON, Canada
                [5 ]School of Nutrition Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
                [6 ]Insititut du Savoir Monfort, Ottawa, Ontario, Canada
                [7 ]R. Samuel McLaughlin Foundation - Exercise and Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, Department of Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Children's Health Research Institute, Western University, London, Ontario, Canada
                [8 ]Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
                Author notes
                [* ]Correspondence to: Faculty of Education, 1137 Western Rd, London, Ontario N6G 1G7, Tel: 519-661-2111 ext. 88694
                Article
                S2666-9153(22)00079-8 100387
                10.1016/j.jadr.2022.100387
                9297659
                7ef0926a-24dd-4503-bb69-5b5508d2c98a
                © 2022 The Author(s). Published by Elsevier B.V.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 15 February 2022
                : 30 May 2022
                : 7 July 2022
                Categories
                Research Paper

                covid-19 depression infant postpartum pregnancy infant stress

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