A cross-country study on the impact of governmental responses to the COVID-19 pandemic on perinatal mental health

Ana Mesquita; Raquel Costa; Rena Bina; Carmen Cadarso-Suárez; Francisco Gude; Carla Díaz-Louzao; Pelin Dikmen-Yildiz; Ana Osorio; Vera Mateus; Sara Domínguez-Salas; Eleni Vousoura; Drorit Levy; Samira Alfayumi-Zeadna; Claire A. Wilson; Yolanda Contreras-García; Mercedes Carrasco-Portiño; Sandra Saldivia; Andri Christoforou; Eleni Hadjigeorgiou; Ethel Felice; Rachel Buhagiar; Camellia Hancheva; Erilda Ajaz; Ana Uka; Emma Motrico

doi:10.1038/s41598-023-29300-w

A cross-country study on the impact of governmental responses to the COVID-19 pandemic on perinatal mental health

Ana Mesquita
, Raquel Costa
, Rena Bina
, Carmen Cadarso-Suárez
, Francisco Gude
, Carla Díaz-Louzao
, Pelin Dikmen-Yildiz
, Ana Osorio
, Vera Mateus
, Sara Domínguez-Salas
, Eleni Vousoura
, Drorit Levy
, Samira Alfayumi-Zeadna
, Claire A. Wilson
, Yolanda Contreras-García
, Mercedes Carrasco-Portiño
, Sandra Saldivia
, Andri Christoforou
, Eleni Hadjigeorgiou
, Ethel Felice

Rachel Buhagiar, Camellia Hancheva, Erilda Ajaz, Ana Uka, Emma Motrico

The Louis & Gabi Weisfeld School of Social Work

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

Abstract

This study aimed to analyse the role of governmental responses to the coronavirus disease 2019 (COVID-19) outbreak, measured by the Containment and Health Index (CHI), on symptoms of anxiety and depression during pregnancy and postpartum, while considering the countries’ Inequality-adjusted Human Development Index (IHDI) and individual factors such as age, gravidity, and exposure to COVID-19. A cross-sectional study using baseline data from the Riseup-PPD-COVID-19 observational prospective international study (ClinicalTrials.gov: NCT04595123) was carried out between June and October 2020 in 12 countries (Albania, Brazil, Bulgaria, Chile, Cyprus, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom). Participants were 7645 pregnant women or mothers in the postpartum period—with an infant aged up to 6 months—who completed the Edinburgh Postnatal Depression Scale (EPDS) or the Generalised Anxiety Disorder Assessment (GAD-7) during pregnancy or the postpartum period. The overall prevalence of clinically significant depression symptoms (EPDS ≥ 13) was 30%, ranging from 20,5% in Cyprus to 44,3% in Brazil. The prevalence of clinically significant anxiety symptoms (GAD-7 ≥ 10) was 23,6% (ranging from 14,2% in Israel and Turkey to 39,5% in Brazil). Higher symptoms of anxiety or depression were observed in multigravida exposed to COVID-19 or living in countries with a higher number of deaths due to COVID-19. Furthermore, multigravida from countries with lower IHDI or CHI had higher symptoms of anxiety and depression. Perinatal mental health is context-dependent, with women from more disadvantaged countries at higher risk for poor mental health. Implementing more restrictive measures seems to be a protective factor for mental health, at least in the initial phase of the COVID-19.

Original language	English
Article number	2805
Journal	Scientific Reports
Volume	13
Issue number	1
DOIs	https://doi.org/10.1038/s41598-023-29300-w
State	Published - Dec 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s).

Funding

This article is based upon work from COST Action CA18138 "Research Innovation and Sustainable Pan-European Network in Peripartum Depression Disorder" (Riseup-PPD), supported by COST (European Cooperation in Science and Technology; https://www.cost.eu/ ); also, by the Spanish Ministry of Health, the Institute of Health Carlos III, and the European Regional Development Fund «Una manera de hacer Europa» by the Prevention and Health Promotion Research Network ‘redIAPP’ (RD16/0007). Raquel Costa is supported by the Portuguese Foundation for Science and Technology (FCT) and from EU through the European Social Fund and FCT under an individual Post-Doctoral Grant SFRH/BPD/117597/2016. EPIUnit, ITR and HEI-Lab are finaced by national funds through the FCT within the scope of projects UIDB/ 04750/2020, LA/P/0064/2020, and UIDB/05380/2020. Rena Bina and Drorit Levy received funding from the Bar-Ilan Dangoor Centre for Personalized Medicine, Israel. Ana Mesquita is supported from the Portuguese Foundation for Science and Technology (FCT) and from EU through the European Social Fund and from the Human Potential Operational Program—IF/00750/2015. The work developed by ProChild CoLAB was supported by NORTE-06-3559-FSE-000044, integrated in the invitation NORTE-59-2018- 41, aiming to hire Highly Qualified Human Resources, co-financed by the Regional Operational Programme of the North 2020, thematic area of Competitiveness and Employment, through the European Social Fund (ESF). Ana Osório received financial support from CAPES/Proex no. 0426/2021 and CAPES/PrInt Grant No. 88887.310343/2018-00. Vera Mateus received financial support from CAPES/PrInt Grant No. 88887.583508/2020-00. Carmen Cadarso-Suárez and Carla Díaz-Louzao are supported by the Ministry of Economy and Competitiveness (Spain), and by the European Regional Development Fund (ERDF) under the project MTM2017-83513-R, and also under the project ED431C 2020/20, financed by the Competitive Research Unit Consolidation 2020 Programme of the Galician Regional Authority (Xunta de Galicia). CAW is funded by the UK’s National Institute for Health and Care Research (NIHR) as an Academic Clinical Lecturer. We thank the Management Committee of COST Action Riseup-PPD for their support. We would also like to thank the all other researchers who are collaborating on the project as the Riseup-PPD-COVID-19 Group “: Mercedes Carrasco-Portiño (Chile), Natalia Houliara (Greece), Yanis Zervas (Greece), Areti Spyropoulou (Greece), Aggeliki Leonardou (Greece), Alexia Karain (Greece), Iliana Liakea (Greece), Patricia Moreno-Peral (Spain), Sonia Conejo-Cerón (Spain), María del Pilar Garrido-Borrego (Spain), María José Gonzalez-Vereda (Spain), Carmen Martín-Gomez (Spain), Irene Gómez-Gómez (Spain), Javier Álvarez (Spain), Carmen Rodríguez-Domínguez (Spain), María Fe Rodriguez (Spain), Ana Ganho-Ávila (Portugal), Bárbara Figueiredo (Portugal), Isabel Soares (Portugal), Adriana Sampaio (Portugal), Cristina Nogueira-Silva (Portugal), Berta Maia (Portugal), Mariana Marques (Portugal), Joana Antunes (Portugal), Rita Pereira (Portugal), Marlene Sousa (Portugal), María Fernanda González (Argentina), Marina Mattioli (Argentina), Gisele Apter (France), Emmanuel Devauche (France), Lisa Vitte (France) and Cyriaque Hauguel (France).

Funders	Funder number
Dangoor Centre for Personalized Medicine
Galician Regional Authority
Human Potential Operational Program	NORTE-06-3559-FSE-000044, IF/00750/2015
PrInt	88887.310343/2018-00, 88887.583508/2020-00
Proex	0426/2021
National Institute for Health and Care Research
European Commission
European Cooperation in Science and Technology	CA18138
Fundação para a Ciência e a Tecnologia
Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
Ministerio de Economía y Competitividad	MTM2017-83513-R, ED431C 2020/20
Instituto de Salud Carlos III
European Social Fund	LA/P/0064/2020, UIDB/ 04750/2020, SFRH/BPD/117597/2016, UIDB/05380/2020
European Regional Development Fund	RD16/0007
Consejería de Salud y Familias, Junta de Andalucía
Xunta de Galicia

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/s41598-023-29300-w

Cite this

Mesquita, A., Costa, R., Bina, R., Cadarso-Suárez, C., Gude, F., Díaz-Louzao, C., Dikmen-Yildiz, P., Osorio, A., Mateus, V., Domínguez-Salas, S., Vousoura, E., Levy, D., Alfayumi-Zeadna, S., Wilson, C. A., Contreras-García, Y., Carrasco-Portiño, M., Saldivia, S., Christoforou, A., Hadjigeorgiou, E., ... Motrico, E. (2023). A cross-country study on the impact of governmental responses to the COVID-19 pandemic on perinatal mental health. Scientific Reports, 13(1), Article 2805. https://doi.org/10.1038/s41598-023-29300-w

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abstract = "This study aimed to analyse the role of governmental responses to the coronavirus disease 2019 (COVID-19) outbreak, measured by the Containment and Health Index (CHI), on symptoms of anxiety and depression during pregnancy and postpartum, while considering the countries{\textquoteright} Inequality-adjusted Human Development Index (IHDI) and individual factors such as age, gravidity, and exposure to COVID-19. A cross-sectional study using baseline data from the Riseup-PPD-COVID-19 observational prospective international study (ClinicalTrials.gov: NCT04595123) was carried out between June and October 2020 in 12 countries (Albania, Brazil, Bulgaria, Chile, Cyprus, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom). Participants were 7645 pregnant women or mothers in the postpartum period—with an infant aged up to 6 months—who completed the Edinburgh Postnatal Depression Scale (EPDS) or the Generalised Anxiety Disorder Assessment (GAD-7) during pregnancy or the postpartum period. The overall prevalence of clinically significant depression symptoms (EPDS ≥ 13) was 30\%, ranging from 20,5\% in Cyprus to 44,3\% in Brazil. The prevalence of clinically significant anxiety symptoms (GAD-7 ≥ 10) was 23,6\% (ranging from 14,2\% in Israel and Turkey to 39,5\% in Brazil). Higher symptoms of anxiety or depression were observed in multigravida exposed to COVID-19 or living in countries with a higher number of deaths due to COVID-19. Furthermore, multigravida from countries with lower IHDI or CHI had higher symptoms of anxiety and depression. Perinatal mental health is context-dependent, with women from more disadvantaged countries at higher risk for poor mental health. Implementing more restrictive measures seems to be a protective factor for mental health, at least in the initial phase of the COVID-19.",

author = "Ana Mesquita and Raquel Costa and Rena Bina and Carmen Cadarso-Su{\'a}rez and Francisco Gude and Carla D{\'i}az-Louzao and Pelin Dikmen-Yildiz and Ana Osorio and Vera Mateus and Sara Dom{\'i}nguez-Salas and Eleni Vousoura and Drorit Levy and Samira Alfayumi-Zeadna and Wilson, \{Claire A.\} and Yolanda Contreras-Garc{\'i}a and Mercedes Carrasco-Porti{\~n}o and Sandra Saldivia and Andri Christoforou and Eleni Hadjigeorgiou and Ethel Felice and Rachel Buhagiar and Camellia Hancheva and Erilda Ajaz and Ana Uka and Emma Motrico",

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year = "2023",

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doi = "10.1038/s41598-023-29300-w",

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Mesquita, A, Costa, R, Bina, R, Cadarso-Suárez, C, Gude, F, Díaz-Louzao, C, Dikmen-Yildiz, P, Osorio, A, Mateus, V, Domínguez-Salas, S, Vousoura, E, Levy, D, Alfayumi-Zeadna, S, Wilson, CA, Contreras-García, Y, Carrasco-Portiño, M, Saldivia, S, Christoforou, A, Hadjigeorgiou, E, Felice, E, Buhagiar, R, Hancheva, C, Ajaz, E, Uka, A & Motrico, E 2023, 'A cross-country study on the impact of governmental responses to the COVID-19 pandemic on perinatal mental health', Scientific Reports, vol. 13, no. 1, 2805. https://doi.org/10.1038/s41598-023-29300-w

TY - JOUR

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AU - Mesquita, Ana

AU - Costa, Raquel

AU - Bina, Rena

AU - Cadarso-Suárez, Carmen

AU - Gude, Francisco

AU - Díaz-Louzao, Carla

AU - Dikmen-Yildiz, Pelin

AU - Osorio, Ana

AU - Mateus, Vera

AU - Domínguez-Salas, Sara

AU - Vousoura, Eleni

AU - Levy, Drorit

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AU - Carrasco-Portiño, Mercedes

AU - Saldivia, Sandra

AU - Christoforou, Andri

AU - Hadjigeorgiou, Eleni

AU - Felice, Ethel

AU - Buhagiar, Rachel

AU - Hancheva, Camellia

AU - Ajaz, Erilda

AU - Uka, Ana

AU - Motrico, Emma

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N2 - This study aimed to analyse the role of governmental responses to the coronavirus disease 2019 (COVID-19) outbreak, measured by the Containment and Health Index (CHI), on symptoms of anxiety and depression during pregnancy and postpartum, while considering the countries’ Inequality-adjusted Human Development Index (IHDI) and individual factors such as age, gravidity, and exposure to COVID-19. A cross-sectional study using baseline data from the Riseup-PPD-COVID-19 observational prospective international study (ClinicalTrials.gov: NCT04595123) was carried out between June and October 2020 in 12 countries (Albania, Brazil, Bulgaria, Chile, Cyprus, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom). Participants were 7645 pregnant women or mothers in the postpartum period—with an infant aged up to 6 months—who completed the Edinburgh Postnatal Depression Scale (EPDS) or the Generalised Anxiety Disorder Assessment (GAD-7) during pregnancy or the postpartum period. The overall prevalence of clinically significant depression symptoms (EPDS ≥ 13) was 30%, ranging from 20,5% in Cyprus to 44,3% in Brazil. The prevalence of clinically significant anxiety symptoms (GAD-7 ≥ 10) was 23,6% (ranging from 14,2% in Israel and Turkey to 39,5% in Brazil). Higher symptoms of anxiety or depression were observed in multigravida exposed to COVID-19 or living in countries with a higher number of deaths due to COVID-19. Furthermore, multigravida from countries with lower IHDI or CHI had higher symptoms of anxiety and depression. Perinatal mental health is context-dependent, with women from more disadvantaged countries at higher risk for poor mental health. Implementing more restrictive measures seems to be a protective factor for mental health, at least in the initial phase of the COVID-19.

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A cross-country study on the impact of governmental responses to the COVID-19 pandemic on perinatal mental health

Abstract

Bibliographical note

Funding

UN SDGs

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