The COVID-19 pandemic and the experience of postpartum depression

Abstract

Background: Early studies assessing peripartum mood disorders during the COVID-19 pandemic have conflicting results.

Objective: The primary aim was to examine if postpartum depression (PPD) was more common or more severe during the COVID-19 pandemic compared to earlier periods, and to assess what individual factors may worsen the impact of the pandemic.

Methods: Electronic health records at an academic pediatric practice in Michigan identified 242 biological mother-child dyads with delivery between 1/1/2017 and 12/31/2021. PPD was evaluated using the Edinburgh Postnatal Depression Scale (EPDS) during well-child visits. Participants were divided into three groups for analysis: Pre-Pandemic (n = 100), Early Pandemic (n = 93), and Later Pandemic (n = 49). Logistic regression analysis was used to predict PPD development, controlling for background factors.

Results: After controlling for confounders, the three groups did not differ significantly. Preexisting mental health conditions was a significant (p<.001) moderator; PPD rates peaked early in the pandemic (60%), compared to late pandemic (42%) and pre-pandemic (36%). Women without a mental health diagnosis pre-pregnancy experienced the lowest levels of PPD during the pandemic.

Conclusions: Rates of PPD were not significantly affected by the COVID-19 pandemic for most women. However, biological mothers with preexisting mental health conditions had significantly higher rates of PPD.

Keywords:

• Postpartum depression (PPD)
• COVID-19
• EPDS: Edinburgh Postnatal Depression Scale
• peripartum depression

Acknowledgments

We would also like to thank the CMU Pediatrics Department for their assistance with data collection and Victoria Zablocki for her work with data collection and data analysis.

Author contribution

N.B., H.K, and M.S. devised the project, the main conceptual ideas, and proof outline. All authors contributed to IRB submission/exemption, data collection sheet creation, review of patient charts, and data collection. B.B. and N.B. performed the data analysis, figure/table creation, and results interpretation. K.D. table creation and results interpretation/table creation and results interpretation. K.D., N.B., H.K., and C.D. wrote the manuscript. M.H. updated citations and reference formatting/style.

Disclosure statement

No conflicts of interest to report. Researchers never directly interacted with patients.

Disclosures

The authors have no business and/or financial interest to disclose.

Data availability statement

The datasets generated and analyzed for this study are the property of CMU Medical Education Partners and Covenant Health System, not the study authors. As such, data are not publicly available, and any request for access would need to be made to and approved by both CMU Medical Education Partners and Covenant Health System.

Ethics statement: human participants

The Covenant Medical Center Institutional Review Board has determined this project is exempt from IRB review according to federal regulations. This IRB is associated with Covenant Healthcare, and it was assigned the following reference number: C-22-04 PPD-COVID-19. This retrospective study had no direct contact with participants and was thus determined to be exempt from IRB review. Participant data was deidentified and stored securely.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.