COVID-19 increased anxiety rates during the perinatal period and pregnancy

1. In this systematic review and meta-analysis, women reported worsening anxiety during the COVID-19 pandemic compared to pre-pandemic times.

2. Furthermore, rates of depression were higher during the COVID-19 pandemic but did not reach statistical significance, compared to pre-pandemic times.

Evidence Rating Level: 1 (Excellent)

Depression and anxiety affect a significant proportion of women during both the perinatal period and pregnancy, making them a vulnerable high-risk group. Unfortunately, there is a lack of understanding of the impact that the COVID-19 pandemic has on this population. As a result, the objective of the present systematic review and meta-analysis was to assess the influence of the COVID-19 pandemic on measures on women’s health outcomes during pregnancy and the perinatal period.

Of 108 identified records, 8 studies (n=7750) were included in the final analysis from database inception up to July 2020. Studies were included if they measured depression and anxiety using the Edinburgh Postnatal Depression Scale (EDPS) and State-Trait Anxiety Inventory (STAI) scores, respectively. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Statistical analysis was performed using random-effects models.

Results demonstrated that compared to the pre-pandemic period, the EDPS score was higher amongst subjects during the COVID-19 pandemic, although this was not statistically significant. On the other hand, the STAI anxiety score was significantly higher during the pandemic when compared with pre-pandemic time. Despite these results, the study was limited by the inclusion of only studies using the EDPS and STAI which may not be widely used by the general population. Nonetheless, these findings suggest that clinicians should be aware of the increased vulnerability of this population with respect to mental health outcomes, particularly during the pandemic.

Click to read the study in The Journal of Maternal-Fetal & Neonatal Medicine

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