Table_1_Trajectories of distress from pregnancy to 15-months post-partum during the COVID-19 pandemic.docx

BackgroundThe COVID-19 pandemic has particularly burdened pregnant and postpartum women. It remains unclear how distress levels of pregnant and postpartum people have changed (or persisted) as the pandemic continues on and which factors may contribute to these trajectories of distress.
MethodsThis longitudinal study included 304 pregnant people, who were followed during pregnancy, 6-weeks, 6-months and 15-months postpartum. At each time point, a latent “distress” factor was estimated using self-reported depressive symptoms, anxiety symptoms, and stress. Reported negative impact of COVID-19 and social support were assessed during pregnancy as risk and protective factors related to distress. Second-order latent growth curve modeling with a piecewise growth function was used to estimate initial levels and changes in distress over time.
ResultsMean distress was relatively stable from the pregnancy to 6-weeks postpartum and then declined from 6-weeks to 15-months postpartum. Higher education, greater social support, and lower negative impact of COVID-19 were associated with a lower distress during pregnancy. Unexpectedly, negative impact of COVID-19 was associated with a faster decrease in distress and more social support was associated with a greater increase in distress from pregnancy to 6-weeks postpartum. However, these effects became non-significant after controlling for distress during pregnancy.
ConclusionFindings indicate high but declining levels of distress from pregnancy to the postpartum period. Changes in distress are related to social support and the negative impact of the pandemic in pregnancy. Findings highlight the continued impact of COVID-19 on perinatal mental health and the need for support to limit the burden of this pandemic on pregnant people and families.

背景：新冠疫情（COVID-19 pandemic）对孕妇及产后人群造成了尤为沉重的负担。目前尚不明确，随着疫情持续蔓延，孕妇与产后人群的心理困扰水平发生了怎样的变化（或持续状态），又有哪些因素会影响这类困扰的发展轨迹。
方法：本纵向研究共纳入304名孕妇，在孕期、产后6周、产后6个月及产后15个月对其进行随访。在每个时间点，均通过自评抑郁症状、焦虑症状与压力水平估算潜在的“心理困扰”因子。研究在孕期评估了受试者报告的新冠疫情负面影响与社会支持，将其作为与心理困扰相关的风险与保护因素。本研究采用带有分段增长函数的二阶潜在增长曲线模型，估算心理困扰的初始水平及其随时间的变化情况。
结果：从孕期至产后6周，受试者的平均心理困扰水平相对稳定，随后从产后6周至产后15个月呈下降趋势。较高的受教育程度、更好的社会支持以及较低的新冠疫情负面影响，均与孕期较低的心理困扰水平相关。出乎意料的是，从孕期至产后6周阶段，新冠疫情负面影响与更快的心理困扰下降幅度相关，而更高的社会支持则与心理困扰更大幅度的上升相关。但在控制孕期心理困扰水平后，这些效应均不再具有统计学显著性。
结论：本研究结果显示，从孕期至产后阶段，受试者的心理困扰水平居高但呈下降趋势。心理困扰的变化与社会支持以及孕期所感知的疫情负面影响相关。研究结果凸显了新冠疫情对围产期心理健康（perinatal mental health）的持续影响，同时也提示亟需采取支持措施，以减轻此次疫情对孕妇及其家庭造成的负担。