Differences in psychological symptoms in pregnancy and postpartum before and during COVID-19a cross-sectional study
- Blanca Riquelme-Gallego 1
- Sergio Martínez-Vázquez
- Carmen Amezcua-Prieto 2
- Juan Miguel Martínez-Galiano 3
- Borja Romero-González
- María I Peralta-Ramírez
- Ester Leno-Durán
- Rafael A Caparrós-González 4
- 1 Facultad de Ciencias de la Salud de Ceuta
- 2 Universidad de Granada Departamento de Medicina Preventiva
- 3 Instituto de Salud Carlos III CIBER Epidemiología y Salud Pública
- 4 Universidad de Granada Facultad de Ciencias de la Salud Departamento de Enfermería
ISSN: 1130-5274
Año de publicación: 2023
Volumen: 34
Número: 2
Páginas: 85-90
Tipo: Artículo
Otras publicaciones en: Clínica y salud: Investigación Empírica en Psicología
Resumen
RESUMEN Justificación: Las mujeres embarazadas son especialmente vulnerables a los problemas de salud mental, como el estrés, la ansiedad y la depresión. Este riesgo se ha incrementado durante la pandemia de COVID-19, habiendo diferencias en los síntomas psicológicos en el embarazo y el puerperio antes y después de la pandemia. Los problemas de salud mental pueden tener efectos perjudiciales tanto en la mujer como en el recién nacido, como abortos espontáneos, partos prematuros, bajo peso al nacer y tasas más altas de cesáreas y partos asistidos. Objetivo: Evaluar la prevalencia de síntomas psicológicos de gestantes antes y durante la pandemia de COVID-19. Método: Se realizó un estudio transversal para evaluar el perfil psicológico en una muestra de mujeres embarazadas seleccionadas antes de la pandemia y una muestra de mujeres estudiadas durante la primera ola de la pandemia. Se seleccionó un total de 122 mujeres antes de la pandemia y 181 mujeres durante el brote de COVID-19. Se utilizó la Inventario de Verificación de Síntomas-90 Revisada (SCL-90-R) para evaluar la depresión y la ansiedad durante el embarazo y el puerperio. Resultados: La prevalencia de síntomas de depresión y ansiedad durante el embarazo fue mayor en la muestra de mujeres estudiadas durante la pandemia (SCL-90-R: M = 54.6 vs. 42.6 y M = 62.6 vs. 51.7 respectivamente). En el postparto la diferencia entre ambas muestras de mujeres fue aún mayor para depresión y ansiedad (SCL-90-R: M = 50.4 vs. 35.0 y M = 51.3 vs. 36.0 respectivamente). Ser mujer embarazada en el brote de COVID-19 se asoció directamente con una mayor puntuación de síntomas de depresión (aOR = 8.67, IC 95% [3.26, 23.02, p < .001). Las mujeres manifestaron ansiedad durante el parto con mayor frecuencia antes de la pandemia (aOR = 5.13, IC 95% 2.53, 10.44], p < .001). La variable estadio (antes/durante la pandemia) también se asoció con tener una puntuación clínica SCL-90-R superior a 70 (aOR = 7.61, IC 95% [2.7, 21.47], p < .001). Conclusión: Durante la pandemia, el embarazo y el postparto se asociaron con la presencia de ansiedad y depresión. El principal factor asociado a la depresión posparto fue la edad materna. Estos hallazgos resaltan la vulnerabilidad de las mujeres embarazadas ante la pandemia, en la que la salud psicológica y el bienestar mental se ven afectados, no solo durante el embarazo, sino también en el posparto.
Referencias bibliográficas
- Ahmad, M,Vismara, L.. (2021). The psychological impact of COVID-19 pandemic on women’s mental health during pregnancy: A rapid evidence review. International Journal of Environmental Research and Public Health. 18. 7112
- Allotey, J,Stallings, E,Bonet, M,Yap, M,Chatterjee, S,Kew, T,Debenham, L,Llavall, A. C,Dixit, A,Zhou, D,Balaji, R,Lee, S. I,Qiu, X,Yuan, M,Coomar, D,Sheikh, J,Lawson, H,Ansari, K,van Wely, M,Thangaratinam, S.. (2020). Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: Living systematic review and meta-analysis. BMJ (Clinical Research Ed.). 370.
- Astbury, J.. (2009). Mental health aspects of women’s reproductive health: A global review of the literature. World Health Organization. Switzerland.
- Ayaz, R,Hocaoğlu, M,Günay, T,Yardımcı, O. D,Turgut, A,Karateke, A.. (2020). Anxiety and depression symptoms in the same pregnant women before and during the COVID-19 pandemic. Journal of Perinatal Medicine. 48. 965
- Bennett, H. A,Einarson, A,Taddio, A,Koren, G,Einarson, T. R.. (2004). Prevalence of depression during pregnancy: Systematic review. Obstetrics and Gynecology. 103. 698-709
- Caparrós Caparrós, B,Villar, E,Juan i Ferrer, J,Viñas i Poch, F.. (2007). Symptom Check-List-90-R: fiabilidad, datos normativos y estructura factorial en estudiantes universitarios. Asociación Española de Psicologia Conductual. 7. 781
- Ceulemans, M,Foulon, V,Ngo, E,Panchaud, A,Winterfeld, U,Pomar, L,Lambelet, V,Cleary, B,O’Shaughnessy, F,Passier, A,Richardson, J. L,Hompes, T,Nordeng, H.. (2021). Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic – a multinational cross-sectional study. Acta Obstetricia et Gynecologica Scandinavica. 100. 1219
- Cohen, S,Kamarck, T,Mermelstein, R.. (1983). A global measure of perceived stress. Journal of Health and Social Behavior. 24. 385
- (2020). Covid-19 and Pregnancy BMJ (Clinical Research Ed.). Article 1672. 369.
- Derogatis, L. R.. (1983). SCL-90-R: Administration, scoring, and procedures: Manual II. Clinical Psychometric Research.
- El Founti Khsim, I,Martínez Rodríguez, M,Riquelme Gallego, B,Caparros-González, R. A,Amezcua-Prieto, C.. (2022). Risk factors for post-traumatic stress disorder after childbirth: A systematic review. Diagnostics. 12. 2598
- Farrell, T,Reagu, S,Mohan, S,Elmidany, R,Qaddoura, F,Ahmed, E. E,Corbett, G,Lindow, S,Abuyaqoub, S. M,Alabdulla, M. A.. (2020). The impact of the COVID-19 pandemic on the perinatal mental health of women. Journal of Perinatal Medicine. 48. 971
- Favre, G,Pomar, L,Baud, D.. (2020). Coronavirus disease 2019 during pregnancy: do not underestimate the risk of maternal adverse outcomes. American Journal of Obstetrics & Gynecology MFM. 2. 100160
- Flores-Ramos, M.. (2013). La salud mental en la mujer embarazada. Perinatología y Reproducción Humana. 27. 143
- Hartmann, J. M,Mendoza-Sassi, R. A,Cesar, J. A.. (2017). Depressão entre puérperas: prevalência e fatores associados [Postpartum depression: prevalence and associated factors]. Cadernos de Saude Publica. 33.
- Karlsson, A. T,Vederhus, J.-K,Clausen, T,Weimand, B,Solli, K. K,Tanum, L.. (2021). Levels of impulsivity, hyperactivity, and inattention and the association with mental health and substance use severity in opioid-dependent patients seeking treatment with extended-release naltrexone. Journal of Clinical Medicine. 10. 4558-4558
- Kotlar, B,Gerson, E,Petrillo, S,Langer, A,Tiemeier, H.. (2021). The impact of the COVID-19 pandemic on maternal and perinatal health: A scoping review. Reproductive Health. 18. 10
- Kovacheva, K,Rodríguez-Muñoz, M. F,Baya, D. G,Salas, S. D,Motrico, E.. (2022). The Relationship between healthcare experience and perinatal depression during COVID-19 Pandemic. Clínica y Salud. 33. 117
- Lebel, C,MacKinnon, A,Bagshawe, M,Tomfohr-Madsen, L,Giesbrecht, G.. (2020). Elevated depression and anxiety symptoms among pregnant individuals during the COVID-19 pandemic. Journal of Affective Disorders. 277. 5-13
- Lübke, K. T,Busch, A,Hoenen, M,Schaal, B,Pause, B. M.. (2017). Pregnancy reduces the perception of anxiety. Scientific Reports. 7. 9213
- Manchia, M,Gathier, A. W,Yapici-Eser, H,Schmidt, M. V,de Quervain, D,van Amelsvoort, T,Bisson, J. I,Cryan, J. F,Howes, O. D,Pinto, L,van der Wee, N. J,Domschke, K,Branchi, I,Vinkers, C. H.. (2022). The impact of the prolonged COVID-19 pandemic on stress resilience and mental health: A critical review across waves. European Neuropsychopharmacology : The Journal of the European College of Neuropsychopharmacology. 55. 22-83
- Mappa, I,Distefano, F. A,Rizzo, G.. (2020). Effects of coronavirus 19 pandemic on maternal anxiety during pregnancy: a prospectic observational study. Journal of Perinatal Medicine. 48. 545
- Mariño-Narvaez, C,Puertas-González, J. A,Romero-González, B,Peralta-Ramirez, M. I.. (2021). Giving birth during the COVID-19 pandemic: The impact on birth satisfaction and postpartum depression. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics. 153. 83
- Martínez-Vázquez, S,Hernández-Martínez, A,Rodríguez-Almagro, J,Delgado-Rodríguez, M,Martínez-Galiano, J. M.. (2022). Relationship between perceived obstetric violence and the risk of postpartum depression: An observational study. Midwifery. 108.
- Martínez-Vázquez, S,Riquelme-Gallego, B,Lugo-Toro, L. J,Lucena-Prieto, L,Garrido-Torres, N,Lopez-Soto, T,Caparros-González, R. A,la Torre-Luque, A.. (2023). Maternal psychopathological profile during childbirth and neonatal development during the COVID-19 pandemic: A pre-posttest study. Behavioral Sciences. 13. 80
- Miller, C. J,Smith, S. N,Pugatch, M.. (2020). Experimental and quasi-experimental designs in implementation research. Psychiatry Research. 283.
- Motrico, E,Mateus, V,Bina, R,Felice, E,Bramante, A,Kalcev, G,Mauri, M,Martins, S,Mesquita, A.. (2020). Good practices in perinatal mental health during the COVID-19 pandemic: A report from task-gorce RISEUP-PPD COVID-19. Clinica y Salud. 31. 155
- Oyetunji, A,Chandra, P.. (2020). Postpartum stress and infant outcome: A review of current literature. Psychiatry Research. 284.
- Pfefferbaum, B,North, C. S.. (2020). Mental health and the Covid-19 pandemic. New England Journal of Medicine. 383. 510
- Preis, H,Mahaffey, B,Heiselman, C,Lobel, M.. (2020). Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic. Social Science & Medicine. 266.
- Puertas-González, J. A,Mariño-Narvaez, C,Peralta-Ramirez, M. I,Romero-González, B.. (2021). The psychological impact of the COVID-19 pandemic on pregnant women. Psychiatry Research. 301.
- Puertas-González, J. A,Mariño-Narvaez, C,Romero-González, B,Peralta-Ramirez, M. I.. (2021). Stress and psychopathology reduction in pregnant women through online cognitive behavioural therapy during COVID-19: A feasibility study. Behavioral Sciences. 11. 100
- Puertas-González, J. A,Mariño-Narvaez, C,Romero-González, B,Sanchez-Perez, G. M,Peralta-Ramirez, M. I.. (2022). Online cognitive behavioural therapy as a psychological vaccine against stress during the COVID-19 pandemic in pregnant women: A randomised controlled trial. Journal of Psychiatric Research. 152. 397-405
- Remor, E.. (2006). Psychometric properties of a European Spanish version of the Perceived Stress Scale (PSS). The Spanish Journal of Psychology. 9. 86-93
- Romero-González, B,Caparros-González, R. A,González-Perez, R,Delgado-Puertas, P,Peralta-Ramirez, M. I.. (2018). Newborn infants’ hair cortisol levels reflect chronic maternal stress during pregnancy. PLOS ONE. 13. 1-13
- Saccone, G,Florio, A,Aiello, F,Venturella, R,De Angelis, M. C,Locci, M,Bifulco, G,Zullo, F,Di Spiezio Sardo, A.. (2020). Psychological impact of coronavirus disease 2019 in pregnant women. American Journal of Obstetrics and Gynecology. 223. 293
- Stepowicz, A,Wencka, B,Biekiewicz, J,Horzelski, W,Grzesiak, M.. (2020). Stress and anxiety levels in pregnant and post-partum women during the COVID-19 pandemic. International Journal of Environmental Research and Public Health. 17. 9450
- Stranges, S,Samaraweera, P. C,Taggart, F,Kandala, N.-B,Stewart-Brown, S.. (2014). Major health-related behaviours and mental well-being in the general population: The Health Survey for England. BMJ Open. 4.
- Tariq, N,Naeem, H,Tariq, A,Naseem, S.. (2021). Maternal depression and its correlates: A longitudinal study. JPMA. The Journal of the Pakistan Medical Association. 71. 1618
- Tomfohr-Madsen, L. M,Racine, N,Giesbrecht, G. F,Lebel, C,Madigan, S.. (2021). Depression and anxiety in pregnancy during COVID-19: A rapid review and meta-analysis. Psychiatry Research. 300.
- Upadhyay, R. P,Chowdhury, R,Salehi, A,Sarkar, K,Singh, S. K,Sinha, B,Pawar, A,Rajalakshmi, A. K,Kumar, A. (2017). Postpartum depression in India: A systematic review and meta-analysis. Bulletin of the World Health Organization. 95. 706-717
- Wang, C,Pan, R,Wan, X,Tan, Y,Xu, L,Ho, C. S,Ho, R. C.. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. International Journal of Environmental Research and Public Health. 17. 1729
- Westgren, M,Pettersson, K,Hagberg, H,Acharya, G.. (2020). Severe maternal morbidity and mortality associated with COVID-19: The risk should not be downplayed. Acta Obstetricia et Gynecologica Scandinavica. 99. 815
- (2020). World Health Organization World Health Organization. Maternal mental health. WHO.
- Zhou, Y,Shi, H,Liu, Z,Peng, S,Wang, R,Qi, L,Li, Z,Yang, J,Ren, Y,Song, X,Zeng, L,Qian, W,Zhang, X.. (2020). The prevalence of psychiatric symptoms of pregnant and non-pregnant women during the COVID-19 epidemic. Translational Psychiatry. 10. 319