Santé Publique France, Saint-Maurice, France.
Department of Gynecology and Obstetrics, Louis Mourier University Hospital, AP-HP, Colombes, France.
PLoS One. 2023 Apr 20;18(4):e0272108. doi: 10.1371/journal.pone.0272108. eCollection 2023.
Previous pandemics and related lockdowns have had a deleterious impact on pregnant women's mental health. We studied the impact of the SARS-CoV-2/Covid-19 pandemic and France's first lockdown on pregnant women's mental health. A cross-sectional study was conducted in July 2020 using a web-questionnaire completed by 500 adult women who were pregnant during the first lockdown in France (March-May 2020). Questions focused on their self-perceived psychological state and affects they felt before and during the lockdown and anxiety symptomatology (HAD) two months after it ended. A robust variance Poisson regression model was used to estimate adjusted prevalence ratios (aPR) for anxiety and self-perceived psychological state evolution. One in five respondents (21.1%) reported psychological deterioration during lockdown. Associated determinants were: i) little or no social support (self-perceived) (aRP = 1.77, 95%CI[1.18-2.66]), ii) increased workload (1.65, [1.02-2.66]), and iii) poor/moderate knowledge about SARS-CoV-2 transmission (1.60, [1.09-2.35]). Seven percent of women reporting psychological deterioration had access to professional psychological support during lockdown, while 19% did not despite wanting it. Women reported heightened powerlessness (60.3%), frustration (64%) and fear (59.2%) during lockdown. One in seven respondents (14.2%, 95%CI[10.9-18.2]) had anxiety symptoms. Determinants associated: i) at least one pregnancy-related pathology (aPR = 1.82, 95%CI[1.15-2.88]), ii) overweightness or obesity (1.61, [1.07-2.43]), iii) one child under the age of six years in the household during the lockdown (3.26, [1.24-8.53]), iv) little or no social support (self-perceived) during the lockdown (1.66, [1.07-2.58]), v) friend or relatives diagnosed with Covid-19 or with symptoms of the disease (1.66; [1.06-2.60]), vi) no access to medication for psychological distress (2.86, [1.74-4.71]), and vii) unsuccessfully seeking exchanges with healthcare professionals about their pregnancy during the pandemic (1.66, [1.08-2.55]). Our results can guide prevention and support policies for pregnant women during pandemics, current or future, with or without lockdowns. Preventing perinatal mental health problems is essential to ensure a supportive environment for the child's development.
先前的大流行病和相关的封锁措施对孕妇的心理健康产生了有害影响。我们研究了 SARS-CoV-2/COVID-19 大流行和法国首次封锁对孕妇心理健康的影响。2020 年 7 月，我们使用网络问卷进行了一项横断面研究，该问卷由 500 名在法国首次封锁期间怀孕的成年女性（2020 年 3 月至 5 月）完成。问卷重点关注她们在封锁前和封锁期间的自我感知心理状态和感受，以及封锁结束两个月后的焦虑症状（HAD）。我们使用稳健方差泊松回归模型来估计焦虑和自我感知心理状态变化的调整后患病率比（aPR）。五分之一的受访者（21.1%）报告在封锁期间心理恶化。相关的决定因素包括：i）社交支持很少或没有（自我感知）（aPR=1.77，95%CI[1.18-2.66]），ii）工作量增加（1.65，[1.02-2.66]），iii）对 SARS-CoV-2 传播的了解较差/中等（1.60，[1.09-2.35]）。在封锁期间报告心理恶化的 7%的女性获得了专业的心理支持，而 19%的女性尽管需要但并未获得支持。女性在封锁期间报告了更高的无力感（60.3%）、沮丧感（64%）和恐惧感（59.2%）。七分之一的受访者（14.2%，95%CI[10.9-18.2]）有焦虑症状。相关的决定因素包括：i）至少有一种与妊娠相关的疾病（aPR=1.82，95%CI[1.15-2.88]），ii）超重或肥胖（1.61，[1.07-2.43]），iii）在封锁期间家中有一名 6 岁以下的儿童（3.26，[1.24-8.53]），iv）在封锁期间社交支持很少或没有（自我感知）（aPR=1.66，[1.07-2.58]），v）朋友或亲戚被诊断出患有 COVID-19 或有疾病症状（1.66；[1.06-2.60]），vi）无法获得治疗心理困扰的药物（2.86，[1.74-4.71]），vii）在大流行期间无法成功与医疗保健专业人员交流有关怀孕的问题（1.66，[1.08-2.55]）。我们的研究结果可以为当前或未来的大流行期间的孕妇提供预防和支持政策，无论是否有封锁措施。预防围产期心理健康问题对于确保为儿童发展提供支持环境至关重要。
