Pregnant and Postpartum Women Report Elevated Distress During Pandemic, HSPH Study Finds

Pregnant and postpartum women around the world reported high levels of loneliness, post-traumatic stress, and anxiety or depression during the Covid-19 pandemic in a Harvard School of Public Health study published last month.

The study reported results from an anonymous online survey sent out to nearly 7,000 pregnant and postpartum women from 64 countries between May and June 2020. Of all respondents, 53 percent reported loneliness, 43 percent reported elevated post-traumatic stress, and 31 percent reported experiencing anxiety or depression.

The researchers also found that 86 percent of surveyed women reported being somewhat or very worried about Covid-19. The most common worries were related to pregnancy and delivery.

The study’s senior author, Karestan C. Koenen, who is a professor of psychiatric epidemiology at HSPH, said in an interview that pregnant women are particularly vulnerable to the changes in health care delivery caused by the pandemic.

“Pregnancy is a time when you’re going to the doctor a lot, even if you’re someone who never goes you’re going usually regularly, even if you have a totally normal pregnancy,” Koenen said. “We recognize that because of the distancing measures and the lockdowns that women were — that these sort of very normal aspects of pregnancy were — being radically affected.”

The researchers found that participants of the study reported distress at a higher rate than both women who were pregnant before the coronavirus pandemic and the general population during the health crisis.

The study also found an association with time spent checking the news and increased distress levels, explained Archana Basu, first author of the study and a research scientist in epidemiology at HSPH.

“We basically found that for people who checked the news from any source that was specific to the pandemic five or more times a day, that was associated with more than twice the odds of elevated post traumatic stress symptoms as well as anxiety and depression,” Basu said. “Excessive information seeking can in fact be associated with detrimental mental health symptoms.”

Elevated mental health concerns in pregnant and postpartum women were consistent across the countries surveyed.

“That was striking,” Koenen said. “I do a lot of global work and it’s very unusual you find the same thing at the same time.”

Harvard Medical School assistant professor of pediatrics Cindy H. Liu — who was not involved in the study — said she believes future studies should consider how the introduction of a vaccine against Covid-19 affects the mental health of pregnant women.

“There is still very little information about the mental health of women with the advent of vaccines,” Liu said. “I think the next step is to follow the mental health given the advancements of Covid and its recovery.”

Co-author of the study and HSPH professor of epidemiology Sonia Hernández-Díaz said she hopes to do follow-up research to the previous study — which was conducted in the summer of 2020 — that considers how new factors have affected maternal mental health during the current phase of the pandemic.

“I think the sources of potential anxiety and concern have changed,” Hernández-Díaz said. “I would love to have another similar survey maybe so they’re more targeted now, to see if anything has changed.”

Bizu Gelaye, a professor of psychiatric epidemiology at HSPH who was not involved in the study, said he hopes researchers continue to prioritize the study of women’s mental health once the pandemic ends.

“The fact that mental health has received greater attention during this pandemic and people start to talk about it is a good thing,” Gelaye said. “I hope that this attention that it is getting right now can continue beyond the pandemic so we can try to address perinatal mental health issues beyond the pandemic.”

—Staff writer Ariel H. Kim can be reached at ariel.kim@thecrimson.com.

—Staff writer Anjeli R. Macaranas can be reached at anjeli.macaranas@thecrimson.com.