OAR@UM Collection:

The mental health of women with gestational diabetes during the COVID-19 pandemic : an international cross-sectional survey

2025-05-22T13:11:26Z

Title: The mental health of women with gestational diabetes during the COVID-19 pandemic : an international cross-sectional survey Authors: Wilson, Claire A.; Gómez-Gómez, Irene; Parsons, Judith; Costa, Raquel; Mesquita, Ana; Vousoura, Eleni; Contreras-García, Yolanda; Levy, Drorit; Mateus, Vera; Christoforou, Andri; Felice, Ethel; Dikmen-Yildiz, Pelin; Domínguez-Salas, Sara; Motrico, Emma Abstract: Background: There is evidence that women with gestational diabetes are at increased risk of the common mental disorders of anxiety and depression. The COVID-19 pandemic may have exerted an additional burden on the mental health of this population. The aim of this analysis was to compare levels of symptoms of common mental disorders and experiences during the COVID-19 pandemic between pregnant and postnatal women exposed and unexposed to gestational diabetes.; Methods: Cross-sectional study utilizing quantitative data from an online survey administered across 10 countries to women who were pregnant or up to 6 months postpartum from 15 June to October 31, 2020. Women self-reported gestational diabetes and completed the Edinburgh Postnatal Depression Scale and GAD-7 (Generalized Anxiety Disorder 7 items) measures. The COPE-IS (Coronavirus Perinatal Experiences-Impact Survey) tool was also administered. Complete case analyses were conducted on a sample of 7,371 women.; Results: There was evidence of an association between gestational diabetes and increased levels of depression symptoms, which was robust to adjustment for age, education, and employment status. There was only evidence of an association with anxiety in postnatal women. There was also evidence that women with gestational diabetes, particularly those in the postnatal period, experienced higher levels of pandemic-related distress, although they did not experience higher levels of COVID-19 infection in this sample.; Conclusions: The increased risk of common mental disorders in women with gestational diabetes underscores the importance of integrated physical and mental health care for pregnant and postnatal women both during and beyond the pandemic. Clinical Trial Registration no. NCT04595123.

Unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety during the COVID-19 pandemic

2025-05-22T13:01:43Z

Title: Unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety during the COVID-19 pandemic Authors: Costa, Raquel; Mesquita, Ana; Motrico, Emma; Domínguez-Salas, Sara; Dikmen-Yildiz, Pelin; Saldivia, Sandra; Vousoura, Eleni; Osorio, Ana; Wilson, Claire A.; Bina, Rena; Levy, Drorit; Christoforou, Andri; González, Maria Fernanda; Hancheva, Camelia; Felice, Ethel; Pinto, Tiago Miguel Abstract: Objective/Background: Unmet needs in perinatal mental healthcare are an important public health issue particularly in the context of a stressful life event such as the COVID-19 pandemic but data on the extent of this problem are needed.; Aim: The aim of this study is to determine the (1) proportion of women with clinically significant symptoms of perinatal depression, anxiety or comorbid symptoms of depression and anxiety, receiving mental healthcare overall and by country and (2) factors associated with receiving mental healthcare.; Method: Women in the perinatal period (pregnancy or up to 6 months post-partum) participating in the Riseup-PPD-COVID-19 cross-sectional study, reported on sociodemographic, social support health-related factors, andCOVID-19 related factors, and on symptoms of depression (Edinburgh Postnatal Depression Scale [EPDS]) and anxiety (Generalised Anxiety Disorder[GAD-7]) using self-report questionnaires. Clinically significant symptoms were defined as EPDS ≥ 13 for depression and GAD-7 ≥ 10 for anxiety. Mental healthcare was defined as self-reported current mental health treatment.; Results: Of the 11 809 participants from 12 countries included in the analysis, 4 379 (37.1%) reported clinically significant symptoms of depression (n = 1 228; 10.4%; EPDS ≥ 13 and GAD-7 ⟨ 10), anxiety (n = 848; 7.2%; GAD-7 ≥ 10 and EPDS ⟨ 13) or comorbid symptoms of depression and anxiety (n = 2 303; 19.5%; EPDS ≥ 13 and GAD-7 ≥ 10). Most women with clinically significant symptoms of depression, anxiety, or comorbid symptoms of depression and anxiety were not receiving mental healthcare (89.0%). Variation in the proportion of women with clinically significant symptoms of depression and/or anxiety reporting mental healthcare was high (4.7% in Turkey to 21.6% in Brazil). Women in the postpartum (vs. pregnancy) were less likely (OR 0.72; 95% CI 0.59-0.88), whereas women with previous mental health problems (vs. no previous mental health problems) (OR 5.56; 95% CI 4.41-7.01), were more likely to receive mental healthcare.; Conclusion: There are high unmet needs in mental healthcare for women with clinically significant symptoms of perinatal depression and/or anxiety across countries during the COVID-19 pandemic. Studies beyond the COVID-19 pandemic and covering the whole range of mental health problems in the perinatal period are warranted to understand the gaps in perinatal mental healthcare.

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

2025-05-22T12:38:11Z

Title: A cross-country study on the impact of governmental responses to the COVID-19 pandemic on perinatal mental health Authors: Mesquita, Ana; Costa, Raquel; Bina, Rena; Cadarso-Suárez, Carmen; Gude, Francisco; Díaz-Louzao, Carla; Dikmen-Yildiz, Pelin; Osorio, Ana; Mateus, Vera; Domínguez-Salas, Sara; Vousoura, Eleni; Levy, Drorit; Alfayumi-Zeadna, Samira; Wilson, Claire A.; Contreras-García, Yolanda; Carrasco-Portiño, Mercedes; Saldivia, Sandra; Christoforou, Andri; Hadjigeorgiou, Eleni; Felice, Ethel; Buhagiar, Rachel; Hancheva, Camellia; Ajaz, Erilda; Uka, Ana; Motrico, Emma 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.

Changes to women’s childbirth plans during the COVID-19 pandemic and posttraumatic stress symptoms : a cross-national study

2025-05-22T12:20:56Z

Title: Changes to women’s childbirth plans during the COVID-19 pandemic and posttraumatic stress symptoms : a cross-national study Authors: Mesquita, Ana; Costa, Raquel; Dikmen-Yildiz, Pelin; Faria, Susana; Silvestrini, Gabriela; Mateus, Vera; Vousoura, Eleni; Wilson, Claire A.; Felice, Ethel; Ajaz, Erilda; Hadjigeorgiou, Eleni; Hancheva, Camellia; Contreras-García, Yolanda; Domínguez-Salas, Sara; Motrico, Emma; Soares, Isabel; Ayers, Susan Abstract: A considerable number of women giving birth during COVID-19 pandemic reported being concerned about changes to their childbirth plans and experiences due to imposed restrictions. Research prior to the pandemic suggests that women may be more at risk of post-traumatic stress symptoms (PTSS) due to unmet expectations of their childbirth plans. Therefore, this study aimed to examine if the mismatch between women’s planned birth and actual birth experiences during COVID-19 was associated with women’s postpartum PTSS. Women in the postpartum period (up to 6 months after birth) across 11 countries reported on childbirth experiences, mental health, COVID-19-related factors, and PTSS (PTSD checklist DSM-5 version) using self-report questionnaires (ClinicalTrials.gov: NCT04595123). More than half (64%) of the 3532 postpartum women included in the analysis reported changes to their childbirth plans. All changes were significantly associated with PTSS scores. Participants with one and two changes to their childbirth plans had a 12% and 38% increase, respectively, in PTSS scores compared to those with no changes (Exp(β) = 1.12; 95% CI [1.06–1.19]; p < 0.001 and Exp(β) = 1.38; 95% CI [1.29–1.48]; p < 0.001). In addition, the effect of having one change in the childbirth plan on PTSS scores was stronger in primigravida than in multigravida (Exp(β) = 0.86; 95% CI [0.77–0.97]; p = 0.014). Changes to women’s childbirth plans during the COVID-19 pandemic were common and associated with women’s postpartum PTSS score. Developing health policies that protect women from the negative consequences of unexpected or unintended birth experiences is important for perinatal mental health.