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Original article

Vol. 151 No. 3738 (2021)

Impact of the COVID-19 pandemic on Swiss pregnant and breastfeeding women – a cross-sectional study covering the first pandemic wave

  • Valentine Lambelet
  • Michael Ceulemans
  • Hedvig Nordeng
  • Guillaume Favre
  • Antje Horsch
  • Milos Stojanov
  • Ursula Winterfeld
  • David Baud
  • Alice Panchaud
  • Léo Pomar
DOI
https://doi.org/10.4414/SMW.2021.w30009
Cite this as:
Swiss Med Wkly. 2021;151:w30009
Published
17.09.2021

Summary

Information on the impact of the COVID-19 pandemic on pregnancy and breastfeeding experiences, as well as on perinatal mental health in Switzerland is limited. In Switzerland, there are few national studies and little information. Using an anonymous online survey accessible after the first wave of the outbreak in Switzerland, we have investigated how this pandemic affected pregnant and breastfeeding women. Among women who completed the survey, 69.0% (1050/1518) indicated the first wave of the pandemic affected their personal habits, 61.0% (689/1131) were affected in their work and 40.0% (632/1573) reported impaired relations with healthcare services (different denominators correspond to the number of participants who answered the question). 36.8% (110/299) of women reported an impact of the pandemic on their current pregnancy experience or breastfeeding experience (8.2%, 46/555). Overall, 11.6% (170/1467) of participants who completed the validated screening tests for mental health symptoms (Edinburgh Postnatal Depression Scale, Generalized Anxiety Disorder 7, Perceived Stress Scale) presented a score compatible with symptoms of major depression, severe anxiety or high perceived stress, which is higher than in the pre-pandemic period according to literature. Risk factors independently associated with impaired mental health were being hospitalized, having symptoms of COVID-19, living with a person with COVID-19 symptoms, having comorbidities, having experienced reduced healthcare services, having restricted usual activities and being a housewife. Protective factors independently associated were a high level of education and living with a partner. Our findings suggest that the COVID-19 pandemic might have significantly affected the well-being and mental health of pregnant and breastfeeding women, directly in the case of exposure, and indirectly as a result of the potential modifications in their life habits and in healthcare facilities.

References

  1. WHO Director-General’s opening remarks at the media briefing on COVID-19 - 11 March 2020 [Internet]. [cited 2020 Apr 9]. Available from: https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
  2. Coronavirus Disease (COVID-19) Situation Reports [Internet]. [cited 2020 Sep 23]. Available from: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
  3. Allotey J, Stallings E, Bonet M, Yap M, Chatterjee S, Kew T, et al.; for PregCOV-19 Living Systematic Review Consortium. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis. BMJ. 2020 Sep;370:m3320. https://doi.org/10.1136/bmj.m3320
  4. Martinez‐Portilla RJ, Sotiriadis A, Chatzakis C, Torres‐Torres J, Sosa SE, Sandoval‐Mandujano K, et al. Pregnant women with SARS-CoV-2 infection are at higher risk of death and severe pneumonia: propensity score-matched analysis of a nationwide prospective cohort study (COV19Mx). Ultrasound in Obstetrics & Gynecology [Internet]. [cited 2020 Dec 27];n/a(n/a). Available from: https://obgyn.onlinelibrary.wiley.com/doi/abs/10.1002/uog.23575
  5. Zambrano LD, Ellington S, Strid P, Galang RR, Oduyebo T, Tong VT, et al.; CDC COVID-19 Response Pregnancy and Infant Linked Outcomes Team. Update: Characteristics of Symptomatic Women of Reproductive Age with Laboratory-Confirmed SARS-CoV-2 Infection by Pregnancy Status - United States, January 22-October 3, 2020. MMWR Morb Mortal Wkly Rep. 2020 Nov;69(44):1641–7. https://doi.org/10.15585/mmwr.mm6944e3
  6. Jering KS, Claggett BL, Cunningham JW, Rosenthal N, Vardeny O, Greene MF, et al. Clinical Characteristics and Outcomes of Hospitalized Women Giving Birth With and Without COVID-19. JAMA Intern Med [Internet]. 2021 Jan 15 [cited 2021 Feb 16]; Available from: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2775396
  7. Flaxman S, Mishra S, Gandy A, Unwin HJ, Mellan TA, Coupland H, et al.; Imperial College COVID-19 Response Team. Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe. Nature. 2020 Aug;584(7820):257–61. https://doi.org/10.1038/s41586-020-2405-7
  8. fédéral LC. Page d’accueil [Internet]. [cited 2021 Feb 15]. Available from: https://www.admin.ch/gov/fr/start.html
  9. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020 Mar;395(10227):912–20. https://doi.org/10.1016/S0140-6736(20)30460-8
  10. Lebel C, MacKinnon A, Bagshawe M, Tomfohr-Madsen L, Giesbrecht G. Elevated depression and anxiety among pregnant individuals during the COVID-19 pandemic [Internet]. PsyArXiv; 2020 Apr [cited 2020 Sep 22]. Available from: https://osf.io/gdhkt https://doi.org/10.31234/osf.io/gdhkt
  11. Maternal mental health [Internet]. [cited 2020 Dec 27]. Available from: https://www.who.int/teams/maternal-newborn-child-adolescent-health-and-ageing/maternal-health/about/mental-health-and-substances-use
  12. Biaggi A, Conroy S, Pawlby S, Pariante CM. Identifying the women at risk of antenatal anxiety and depression: A systematic review. J Affect Disord. 2016 Feb;191:62–77. https://doi.org/10.1016/j.jad.2015.11.014
  13. Ceulemans M, Hompes T, Foulon V. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic: A call for action. Int J Gynaecol Obstet. 2020 Oct;151(1):146–7. https://doi.org/10.1002/ijgo.13295
  14. Liu X, Chen M, Wang Y, Sun L, Zhang J, Shi Y, et al. Prenatal anxiety and obstetric decisions among pregnant women in Wuhan and Chongqing during the COVID-19 outbreak: a cross-sectional study. BJOG. 2020 Sep;127(10):1229–40. https://doi.org/10.1111/1471-0528.16381
  15. Office FS. Federal Statistical Office [Internet]. [cited 2021 Feb 20]. Available from: https://www.bfs.admin.ch/bfs/en/home.html
  16. Ceulemans M, Foulon V, Ngo E, Panchaud A, Winterfeld U, Pomar L, et al. Mental health status of pregnant and breastfeeding women during the COVID-19 pandemic-A multinational cross-sectional study. Acta Obstet Gynecol Scand. 2021 Jul;100(7):1219–29. https://doi.org/10.1111/aogs.14092
  17. Cox JL, Holden JM, Sagovsky R. Detection of postnatal depression. Development of the 10-item Edinburgh Postnatal Depression Scale. Br J Psychiatry. 1987 Jun;150(6):782–6. https://doi.org/10.1192/bjp.150.6.782
  18. Bergink V, Kooistra L, Lambregtse-van den Berg MP, Wijnen H, Bunevicius R, van Baar A, et al. Validation of the Edinburgh Depression Scale during pregnancy. J Psychosom Res. 2011 Apr;70(4):385–9. https://doi.org/10.1016/j.jpsychores.2010.07.008
  19. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006 May;166(10):1092–7. https://doi.org/10.1001/archinte.166.10.1092
  20. Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385–96. https://doi.org/10.2307/2136404
  21. Taylor JM. Psychometric analysis of the Ten-Item Perceived Stress Scale. - PsycNET [Internet]. [cited 2020 Dec 28]. Available from: https://content.apa.org/record/2014-44666-001
  22. Department of Health, Government of Western Australia. District of Columbia’s HealthCheck Provider Education System - EPDS Translations (Govt Western Australia).pdf [Internet]. 2006 [cited 2021 Feb 22]. Available from: https://www.dchealthcheck.net/
  23. Kozinszky Z, Dudas RB. Validation studies of the Edinburgh Postnatal Depression Scale for the antenatal period. J Affect Disord. 2015 May;176:95–105. https://doi.org/10.1016/j.jad.2015.01.044
  24. Teissèdre F, Chabrol H. Detecting women at risk for postnatal depression using the Edinburgh Postnatal Depression Scale at 2 to 3 days postpartum. Can J Psychiatry. 2004 Jan;49(1):51–4. https://doi.org/10.1177/070674370404900108
  25. de Quervain D, Aerni A, Amini E, Bentz D, Coynel D, Gerhards C, et al. The Swiss Corona Stress Study [Internet]. OSF Preprints; 2020 [cited 2021 May 15]. Available from: https://osf.io/jqw6a/
  26. Fisher J, Cabral de Mello M, Patel V, Rahman A, Tran T, Holton S, et al. Prevalence and determinants of common perinatal mental disorders in women in low- and lower-middle-income countries: a systematic review. Bull World Health Organ. 2012 Feb;90(2):139G–49G. https://doi.org/10.2471/BLT.11.091850
  27. Sawyer A, Ayers S, Smith H. Pre- and postnatal psychological wellbeing in Africa: a systematic review. J Affect Disord. 2010 Jun;123(1-3):17–29. https://doi.org/10.1016/j.jad.2009.06.027
  28. statistique O fédéral de la. Office fédéral de la statistique [Internet]. [cited 2021 Jan 24]. Available from: https://www.bfs.admin.ch/bfs/fr/home.html
  29. Wu Y, Zhang C, Liu H, Duan C, Li C, Fan J, et al. Perinatal depressive and anxiety symptoms of pregnant women during the coronavirus disease 2019 outbreak in China. Am J Obstet Gynecol. 2020 Aug;223(2):240.e1–9. https://doi.org/10.1016/j.ajog.2020.05.009
  30. Saccone G, Florio A, Aiello F, Venturella R, De Angelis MC, Locci M, et al. Psychological impact of coronavirus disease 2019 in pregnant women. Am J Obstet Gynecol. 2020 Aug;223(2):293–5. https://doi.org/10.1016/j.ajog.2020.05.003
  31. Taubman-Ben-Ari O, Chasson M, Abu Sharkia S, Weiss E. Distress and anxiety associated with COVID-19 among Jewish and Arab pregnant women in Israel. J Reprod Infant Psychol. 2020 Jul;38(3):340–8. https://doi.org/10.1080/02646838.2020.1786037
  32. Corbett GA, Milne SJ, Hehir MP, Lindow SW, O’connell MP. Health anxiety and behavioural changes of pregnant women during the COVID-19 pandemic. Eur J Obstet Gynecol Reprod Biol. 2020 Jun;249:96–7. https://doi.org/10.1016/j.ejogrb.2020.04.022
  33. Nanjundaswamy MH, Shiva L, Desai G, Ganjekar S, Kishore T, Ram U, et al. COVID-19-related anxiety and concerns expressed by pregnant and postpartum women-a survey among obstetricians. Arch Womens Ment Health. 2020 Aug 25;
  34. Stepowicz A, Wencka B, Bieńkiewicz J, Horzelski W, Grzesiak M. Stress and Anxiety Levels in Pregnant and Post-Partum Women during the COVID-19 Pandemic. Int J Environ Res Public Health. 2020 Dec;17(24):9450. https://doi.org/10.3390/ijerph17249450
  35. Reid KM, Taylor MG. Social support, stress, and maternal postpartum depression: A comparison of supportive relationships. Soc Sci Res. 2015 Nov;54:246–62. https://doi.org/10.1016/j.ssresearch.2015.08.009
  36. Preis H, Mahaffey B, Heiselman C, Lobel M. Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic. Soc Sci Med. 2020 Dec;266:113348. https://doi.org/10.1016/j.socscimed.2020.113348
  37. Shi L, Lu ZA, Que JY, Huang XL, Liu L, Ran MS, et al. Prevalence of and Risk Factors Associated With Mental Health Symptoms Among the General Population in China During the Coronavirus Disease 2019 Pandemic. JAMA Netw Open. 2020 Jul;3(7):e2014053. https://doi.org/10.1001/jamanetworkopen.2020.14053
  38. Slomian J, Honvo G, Emonts P, Reginster JY, Bruyère O. Consequences of maternal postpartum depression: A systematic review of maternal and infant outcomes. Womens Health (Lond) [Internet]. 2019 Apr 29 [cited 2021 Feb 20];15. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6492376/
  39. Brummelte S, Galea LA. Postpartum depression: Etiology, treatment and consequences for maternal care. Horm Behav. 2016 Jan;77:153–66. https://doi.org/10.1016/j.yhbeh.2015.08.008
  40. Antenatal and postnatal mental health: clinical management and service guidance. NICE 2021. Available from: https://www.nice.org.uk/guidance/cg192. Last updated 11 February 2020.
  41. COVID-19 Suisse | Coronavirus [Internet]. [cited 2021 Jan 24]. Available from: https://www.covid19.admin.ch/fr/overview

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