Molly Wardaguga Research Centre, Faculty of Health, Charles Darwin University, Brisbane, QLD, Australia; School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; BC Children's Hospital Research Institute, Vancouver, BC, Canada; School of Psychology & Neuroscience, Auckland University of Technology, Auckland, New Zealand.
Women Birth. 2024 Nov;37(6):101827. doi: 10.1016/j.wombi.2024.101827. Epub 2024 Sep 28.
Women pregnant during the COVID-19 pandemic may be at risk of elevated postpartum mental health problems.
Social support protects maternal mental health during a pandemic. It is possible that formal supports, such as continuity maternity models of care, may also support maternal wellbeing.
To investigate whether model of care moderates the association between prenatal maternal stress from the COVID-19 pandemic, and postpartum (a) depression and (b) anxiety.
Women in Australia, pregnant during the COVID-19 pandemic (n = 3048), completed a survey detailing their COVID-19-related objective hardship and subjective distress during pregnancy and completed depression and anxiety measures at birth to six weeks ("Early"), seven to 21 weeks ("Moderate"), and/or 22-30 weeks ("Late") postpartum.
Higher subjective distress was associated with elevated depression and anxiety at all timepoints. Model of care did not moderate the association of objective hardship or subjective distress and depression or anxiety at any timepoint. Compared with Standard Care, women receiving private midwifery care had a 74 % reduction in the odds of elevated anxiety in early postpartum.
Women receiving private midwifery may have experienced lower anxiety due to a greater duration of postpartum in-home care, fewer changes to service delivery, and the option of homebirth. Women pregnant during a pandemic should be screened for higher subjective distress about the event.
These results suggest that continuity of private midwifery care may be beneficial for supporting postpartum mental health during a pandemic, with implications for practice and policy for the current and future pandemics.
在 COVID-19 大流行期间怀孕的女性可能面临产后心理健康问题风险增加的问题。
社会支持可以保护产妇在大流行期间的心理健康。在大流行期间，正式支持（例如连续性产妇护理模式）也可能支持产妇的幸福感。
调查护理模式是否调节了 COVID-19 大流行期间产妇压力与产后（a）抑郁和（b）焦虑之间的关联。
在澳大利亚怀孕的女性（n = 3048）在怀孕期间完成了一项调查，详细说明了她们在怀孕期间与 COVID-19 相关的客观困难和主观困扰，并在分娩后至六周（“早期”）、七至二十一周（“中期”）和/或二十二至三十周（“晚期”）时完成了抑郁和焦虑测量。
较高的主观困扰与所有时间点的抑郁和焦虑升高有关。在任何时间点，护理模式都不能调节客观困难或主观困扰与抑郁或焦虑之间的关联。与标准护理相比，接受私人助产士护理的女性在早期产后出现焦虑症的几率降低了 74%。
接受私人助产士护理的女性可能由于产后在家中接受护理的时间更长、服务提供的变化更少以及可以选择在家分娩，而经历了较低的焦虑。在大流行期间怀孕的女性应接受更高的主观困扰的筛查。
这些结果表明，连续性私人助产士护理可能有助于在大流行期间支持产后心理健康，对当前和未来的大流行具有实践和政策意义。
