Department of Anthropology, Washington University in St. Louis, St. Louis, MO, USA.
Department of Anthropology, Dartmouth College, Hanover, NH, USA.
BMC Pregnancy Childbirth. 2021 Dec 13;21(1):828. doi: 10.1186/s12884-021-04300-8.
The early postpartum period is recognized cross-culturally as being important for recovery, with new parents receiving increased levels of community support. However, COVID-19-related lockdown measures may have disrupted these support systems, with possible implications for mental health. Here, we use a cross-sectional analysis among individuals who gave birth at different stages of the pandemic to test (i) if instrumental support access in the form of help with household tasks, newborn care, and care for older children has varied temporally across the pandemic, and (ii) whether access to these forms of instrumental support is associated with lower postpartum depression scores.
This study used data from the COVID-19 And Reproductive Effects (CARE) study, an online survey of pregnant persons in the United States. Participants completed postnatal surveys between April 30 - November 18, 2020 (n = 971). Logistic regression analysis tested whether birth timing during the pandemic was associated with odds of reported sustained instrumental support. Linear regression analyses assessed whether instrumental support was associated with lower depression scores as measured via the Edinburgh Postnatal Depression survey.
Participants who gave birth later in the pandemic were more likely to report that the pandemic had not affected the help they received with household work and newborn care (p < 0.001), while access to childcare for older children appeared to vary non-linearly throughout the pandemic. Additionally, respondents who reported that the pandemic had not impacted their childcare access or help received around the house displayed significantly lower depression scores compared to participants who reported pandemic-related disruptions to these support types (p < 0.05).
The maintenance of postpartum instrumental support during the pandemic appears to be associated with better maternal mental health. Healthcare providers should therefore consider disrupted support systems as a risk factor for postpartum depression and ask patients how the pandemic has affected support access. Policymakers seeking to improve parental wellbeing should design strategies that reduce disease transmission, while facilitating safe interactions within immediate social networks (e.g., through investment in COVID-19 testing and contact tracing). Cumulatively, postpartum instrumental support represents a potential tool to protect against depression, both during and after the COVID-19 pandemic.
跨文化研究均认为，产后早期对于产妇恢复非常重要，新父母会得到更多来自社区的支持。然而，新冠疫情相关的封锁措施可能扰乱了这些支持系统，对心理健康产生了潜在影响。在这里，我们使用在疫情不同阶段分娩的个体的横断面分析来检验：（i）在疫情期间，是否以帮助做家务、照顾新生儿和照顾大孩子的形式获得了不同的工具性支持；（ii）获得这些形式的工具性支持是否与产后抑郁评分降低有关。
本研究使用了美国 COVID-19 和生殖影响（CARE）研究的在线调查数据，该研究是一项针对孕妇的在线调查。参与者于 2020 年 4 月 30 日至 11 月 18 日完成了产后调查（n=971）。逻辑回归分析检验了疫情期间分娩的时间是否与报告的持续工具性支持的几率有关。线性回归分析评估了工具性支持是否与爱丁堡产后抑郁量表（Edinburgh Postnatal Depression Scale）测量的较低抑郁评分有关。
在疫情期间较晚分娩的参与者更有可能报告疫情没有影响他们获得的家务和新生儿照顾方面的帮助（p<0.001），而儿童保育的获得似乎在整个疫情期间呈非线性变化。此外，与报告疫情对这些支持类型造成干扰的参与者相比，报告疫情没有影响他们获得儿童保育或家务帮助的参与者显示出显著更低的抑郁评分（p<0.05）。
疫情期间维持产后工具性支持与更好的产妇心理健康有关。因此，医疗保健提供者应将支持系统中断视为产后抑郁的一个风险因素，并询问患者疫情如何影响支持的获得。寻求改善父母幸福感的政策制定者应该设计减少疾病传播的策略，同时促进即时社交网络内的安全互动（例如，通过投资 COVID-19 检测和接触者追踪）。总体而言，产后工具性支持代表了一种在新冠疫情期间和之后预防抑郁的潜在工具。
