Department of Psychiatry, Icahn School of Medicine at Mount Sinai, The Mount Sinai Hospital, New York, USA.
MICDS, St. Louis, USA.
Sci Rep. 2020 Dec 24;10(1):22380. doi: 10.1038/s41598-020-79564-9.
The mental health effects of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and the Coronavirus Disease 2019 (COVID-19) pandemic on postpartum women are of increasing concern among mental health practitioners. To date, only a handful of studies have explored the emotional impact of the pandemic surrounding pregnancy and none have investigated the consequence of pandemic-related social restrictions on the postpartum mood of those living among different socioeconomic status (SES). All postpartum patients appearing to the Mount Sinai Health System for their postpartum appointment between January 2, 2020 and June 30, 2020, corresponding to before and during pandemic imposed social restrictions, were screened for mood symptomatology using the Edinburgh Postnatal Depression Scale (EPDS). Each patient's socioeconomic status (high/low) was determined by their location of clinical service. A total of 516 postpartum patients were screened. While no differences in EPDS scores were observed by SES prior to social restrictions (U = 7956.0, z = - 1.05, p = .293), a significant change in mood symptomatology was observed following COVID-19 restrictions (U = 4895.0, z = - 3.48, p < .001), with patients living in lower SES reporting significantly less depression symptomatology (U = 9209.0, z = - 4.56, p < .001). There was no change in symptomatology among patients of higher SES (U = 4045.5, z = - 1.06, p = .288). Postpartum depression, the most common complication of childbearing, is a prevalent, cross-cultural disorder with significant morbidity. The observed differences in postpartum mood between patients of different SES in the context of temporarily imposed COVID-19-related social restrictions present a unique opportunity to better understand the specific health and social support needs of postpartum patients living in urban economic poverty. Given that maternal mental illness has negative long-term developmental implications for the offspring and that poor mental health reinforces the poverty cycle, future health policy specifically directed towards supporting postpartum women living in low SES by ameliorating some of the early maternal burdens associated with balancing employment-family-childcare demands may assist in interrupting this cycle while simultaneously improving the long-term outcomes of their offspring.
严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)和 2019 年冠状病毒病(COVID-19)大流行对产后妇女的心理健康影响引起了心理健康从业者的越来越多的关注。迄今为止,只有少数研究探讨了围绕怀孕的大流行对不同社会经济地位(SES)的产后妇女情绪的影响,并且没有研究调查与大流行相关的社会限制对生活在这些地区的妇女产后情绪的影响。2020 年 1 月 2 日至 2020 年 6 月 30 日期间,所有在西奈山健康系统进行产后预约的产后患者都接受了爱丁堡产后抑郁量表(EPDS)的情绪症状筛查。每位患者的社会经济地位(高/低)由其临床服务地点决定。共筛查了 516 名产后患者。在实施社会限制之前,按 SES 划分,EPDS 评分无差异(U=7956.0,z=-1.05,p=.293),但 COVID-19 限制后情绪症状明显变化(U=4895.0,z=-3.48,p<.001),SES 较低的患者报告抑郁症状明显减轻(U=9209.0,z=-4.56,p<.001)。SES 较高的患者症状无变化(U=4045.5,z=-1.06,p=.288)。产后抑郁症是生育最常见的并发症,是一种普遍存在的、跨文化的疾病,发病率很高。在暂时实施 COVID-19 相关社会限制的背景下,不同 SES 的患者之间产后情绪的差异为更好地了解生活在城市经济贫困中的产后患者的具体健康和社会支持需求提供了一个独特的机会。鉴于产妇精神疾病对后代有长期的发展影响,而不良的心理健康又会加剧贫困循环,因此,专门针对社会经济地位较低的产后妇女的未来卫生政策,通过改善与平衡就业-家庭-儿童保育需求相关的一些早期产妇负担,可能有助于打破这种循环,同时改善其后代的长期结果。