COVID-19 and the repercussions on pregnant women’s mental health: integrative review

Lima, Josefa Nayara de; Cruz Neto, João; Nicolau, Ana Izabel Oliveira; Oliveira, Célida Juliana de; Damasceno, Simone Soares; Cruz, Rachel de Sá Barreto Luna Callou; Quirino, Glauberto da Silva; Calou, Cinthia Gondim Pereira

doi:10.37689/acta-ape/2022AR0140666

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Acta Paulista de Enfermagem

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Review Article • Acta Paul Enferm 35 • 2022 • https://doi.org/10.37689/acta-ape/2022AR0140666 copy

COVID-19 and the repercussions on pregnant women’s mental health: integrative review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To identify the impacts of COVID-19 on pregnant women’s mental health from evidence in the literature.

Methods

This is an integrative literature review performed in MEDLINE, CINAHL, PUBCOVID19 and MEDRXIV databases/electronic libraries. The search took place in pairs in December 2020, with articles available in full addressing pregnant women’s mental health in the pandemic.

Results

The studies that made up the sample were published between April and December 2020 and in the ten studies included, depression and anxiety were identified as factors exerting impact on pregnant women’s health, and the fear of COVID-19, stress and worries associated with the pandemic as contributing elements.

Conclusion

There was an impact on pregnant women’s mental health in the pandemic with psychosocial, socioeconomic and health care repercussions. In this context, the approach to the psychological component in the nursing consultation can make a difference in pregnancy care.

Pregancy; COVID-19; Coronavirus infections; Mental health; Health attencion

Strategy items	Components	Descriptors
Population	Pregnancy during the COVID-19 pandemic	Pregnancy/Coronavirus infections/COVID-19
Intervention	-	-
Comparison	-	-
Outcomes	Impacts on mental health	Mental Health

Main author/year	Study objective	Design/level of evidence	Instrument used to assess mental health	Results
Wu Y⁽⁹⁾ 2020	Examine the impact of the COVID-19 outbreak on the prevalence of depression and anxiety.	Non-randomized clinical trial Level 3	Edinburgh Postnatal Depression Scale (EPDS)	4,124 participants/average age 30 years/0.2% had a history of anxiety and depression/68.8% were primiparas. Increased thoughts of self-harm and depressive and anxiety symptoms.
Moyer CA⁽¹⁰⁾ 2020	Explore the impact of the COVID-19 pandemic on pregnant women’s anxiety	Descriptive Study Level 6	Pregnancy-related Anxiety Scale (PRAS)	2,740 participants/mean age 32.7 years/35.9% had a prior history of depression and anxiety/mean 1.7 children. Increased anxiety related to interrupting face-to-face antenatal appointments and changing the birth plan, greater stress about family conflicts and depression.
Ayaz R⁽¹⁴⁾ 2020	Compare anxiety and depression scores before and during the pandemic	Descriptive study Level 6	Inventory of Depression and Anxiety Symptoms II (IDAS II) and Beck Anxiety Inventory (BAI)	63 participants/average age of 30.4 years/average of 1.38 children. Increased anxiety and depression.
López-Morales H⁽¹⁵⁾ 2020	Analyze psychopathological indicators in pregnant women throughout the confinement period	Descriptive study Level 6	Beck Depression Inventory-II (BDI-II) and State-Trait Anxiety Inventory (STAI)	204 participants/average age 32 years/57.4% did not have children. Significant increase in anxiety and depression during the pandemic.
Liu X⁽¹⁶⁾ 2020	Investigate the state of anxiety and its influencing factors.	Descriptive study Level 6	Self-Rating Anxiety Scale (SAS)	1947 participants/over 14 and under 60 years were included/most were nulliparous. Pregnant women developed pandemic anxiety.
Nwafor JI⁽¹⁷⁾ 2020	To determine the prevalence and associated factors of depression, anxiety and stress among pregnant women at a tertiary health facility in Abakaliki during COVID-19-related lockdown in Nigeria.	Descriptive study Level 6	Depression Anxiety and Stress Scale-21 (DASS-21)	456 participants/average age 27 years. Presence of mild, moderate, severe and extremely severe depression resulting from COVID-19. Mild to moderate stress related to COVID-19-related lockdown.
Schaal NK⁽¹⁸⁾ 2020	To investigate the association of maternal obstetric and sociodemographic factors with PREPS scores.	Cohort study Level 4	The Pandemic-Related Pregnancy Scale (PREPS)	1,364 participants/mean age 31.8 years/11 pregnant women were diagnosed with COVID-19. Preparation stress as well as infection stress correlated positively with fear of childbirth, pregnancy-specific stress, and perceived risk of infection of loved ones. Having a below-average income was associated with higher levels of perceived stress during the COVID-19 pandemic.
Farrell T⁽¹⁹⁾ 2020	Explore rates of anxiety and depression symptomatology during the COVID-19 pandemic, comparing them with pre-pandemic data.	Descriptive study Level 6	Patient Health Questionnaire Anxiety Depression Scale (PHQ-ADS)	288 participants/mean age 30.5 years/3.1% had previous mental health problems/Mean 1.7 children. Worsening of stress and depression in symptomatic women with moderate to severe scores.
Chivers BR⁽²⁰⁾ 2020	Understand the feeling and impacts on emotional wellbeing arising from changes in social and support dynamics in a perinatal cohort during the COVID-19 pandemic	Qualitative study Level 6	Not used	831 participants. Anxiety related to childbirth conditions and lack of knowledge about the disease. Signs of despair, anticipatory grief. Increase in family conflicts.
Salehi L⁽²¹⁾ 2020	Determine the fit of the conceptual model path analysis that measures the relationship between COVID-19 fear and anxiety, pregnancy experience, and the mental disorder of pregnant women.	Descriptive study Level 6	Corona Disease Anxiety Scale (CDAS) and Fear of COVID-19 Scale	194 participants/Mean 29.1 years/38.7% had a child. Mental health during pregnancy was significantly correlated with Fear of COVID-19.

Escola Paulista de Enfermagem, Universidade Federal de São Paulo R. Napoleão de Barros, 754, 04024-002 São Paulo - SP/Brasil, Tel./Fax: (55 11) 5576 4430 - São Paulo - SP - Brazil
E-mail: actapaulista@unifesp.br

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[1] Corresponding author Josefa Nayara de Lima E-mail: enfjosefanayara@gmail.com