A cross-country study on the impact of governmental responses to the COVID-19 pandemic on perinatal mental health

This study aimed to analyse the role of governmental responses to the coronavirus disease 2019 (COVID-19) outbreak, measured by the Containment and Health Index (CHI), on symptoms of anxiety and depression during pregnancy and postpartum, while considering the countries' Inequality-adjusted Human Development Index (IHDI) and individual factors such as age, gravidity, and exposure to COVID-19. A cross-sectional study using baseline data from the Riseup-PPD-COVID-19 observational prospective international study (ClinicalTrials.gov: NCT04595123) was carried out between June and October 2020 in 12 countries (Albania, Brazil, Bulgaria, Chile, Cyprus, Greece, Israel, Malta, Portugal, Spain, Turkey, and the United Kingdom). Participants were 7645 pregnant women or mothers in the postpartum period-with an infant aged up to 6 months-who completed the Edinburgh Postnatal Depression Scale (EPDS) or the Generalised Anxiety Disorder Assessment (GAD-7) during pregnancy or the postpartum period. The overall prevalence of clinically significant depression symptoms (EPDS >= 13) was 30%, ranging from 20,5% in Cyprus to 44,3% in Brazil. The prevalence of clinically significant anxiety symptoms (GAD-7 >= 10) was 23,6% (ranging from 14,2% in Israel and Turkey to 39,5% in Brazil). Higher symptoms of anxiety or depression were observed in multigravida exposed to COVID-19 or living in countries with a higher number of deaths due to COVID-19. Furthermore, multigravida from countries with lower IHDI or CHI had higher symptoms of anxiety and depression. Perinatal mental health is context-dependent, with women from more disadvantaged countries at higher risk for poor mental health. Implementing more restrictive measures seems to be a protective factor for mental health, at least in the initial phase of the COVID-19.Correction to: Scientific Reports https://doi.org/10.1038/s41598-023-29300-w, published online 16 February 2023 In the original version of this Article Emma Motrico was incorrectly affiliated with ‘Department of Psychology, School of Philosophy, National and Kapodestrian University of Athens, Athens, Greece’. The correct affiliation is listed below. Psychology Department, Universidad Loyola Andalucia, Sevilla, Spain The original Article has been corrected.This article is based upon work from COST Action CA18138 Research Innovation and Sustainable Pan-European Network in Peripartum Depression Disorder (Riseup-PPD), supported by COST (European Cooperation in Science and Technology; https://www.cost.eu/); also, by the Spanish Ministry of Health, the Institute of Health Carlos III, and the European Regional Development Fund Una manera de hacer Europa by the Prevention and Health Promotion Research Network 'redIAPP' (RD16/0007). Raquel Costa is supported by the Portuguese Foundation for Science and Technology (FCT) and from EU through the European Social Fund and FCT under an individual Post-Doctoral Grant SFRH/BPD/117597/2016. EPIUnit, ITR and HEI-Lab are finaced by national funds through the FCT within the scope of projects UIDB/ 04750/2020, LA/P/0064/2020, and UIDB/05380/2020. Rena Bina and Drorit Levy received funding from the Bar-Ilan Dangoor Centre for Personalized Medicine, Israel. Ana Mesquita is supported from the Portuguese Foundation for Science and Technology (FCT) and from EU through the European Social Fund and from the Human Potential Operational Program-IF/00750/2015. The work developed by ProChild CoLAB was supported by NORTE-06-3559-FSE-000044, integrated in the invitation NORTE-59-2018- 41, aiming to hire Highly Qualified Human Resources, co-financed by the Regional Operational Programme of the North 2020, thematic area of Competitiveness and Employment, through the European Social Fund (ESF). Ana Osorio received financial support from CAPES/Proex no. 0426/2021 and CAPES/PrInt Grant No. 88887.310343/2018-00. Vera Mateus received financial support from CAPES/PrInt Grant No. 88887.583508/2020-00. Carmen Cadarso-Suarez and Carla Diaz-Louzao are supported by the Ministry of Economy and Competitiveness (Spain), and by the European Regional Development Fund (ERDF) under the project MTM2017-83513-R, and also under the project ED431C 2020/20, financed by the Competitive Research Unit Consolidation 2020 Programme of the Galician Regional Authority (Xunta de Galicia). CAW is funded by the UK's National Institute for Health and Care Research (NIHR) as an Academic Clinical Lecturer. We thank the Management Committee of COST Action Riseup-PPD for their support. We would also like to thank the all other researchers who are collaborating on the project as the Riseup-PPD-COVID-19 Group : Mercedes Carrasco-Portino (Chile), Natalia Houliara (Greece), Yanis Zervas (Greece), Areti Spyropoulou (Greece), Aggeliki Leonardou (Greece), Alexia Karain (Greece), Iliana Liakea (Greece), Patricia Moreno-Peral (Spain), Sonia Conejo-Ceron (Spain), Maria del Pilar Garrido-Borrego (Spain), Maria Jose Gonzalez-Vereda (Spain), Carmen Martin-Gomez (Spain), Irene Gomez-Gomez (Spain), Javier Alvarez (Spain), Carmen Rodriguez-Dominguez (Spain), Maria Fe Rodriguez (Spain), Ana Ganho-Avila (Portugal), Barbara Figueiredo (Portugal), Isabel Soares (Portugal), Adriana Sampaio (Portugal), Cristina Nogueira-Silva (Portugal), Berta Maia (Portugal), Mariana Marques (Portugal), Joana Antunes (Portugal), Rita Pereira (Portugal), Marlene Sousa (Portugal), Maria Fernanda Gonzalez (Argentina), Marina Mattioli (Argentina), Gisele Apter (France), Emmanuel Devauche (France), Lisa Vitte (France) and Cyriaque Hauguel (France)