A multi-center survey on the postpartum mental health of mothers and attachment to their neonates during COVID-19 in Hubei Province of China
Sicong Peng, Yi Zhang, Hongyan Liu, Xiaona Huang, Douglas Noble, Lixia Yang, Wei Lü, Yahui Luo, Huaping Zhu, Li Cao, Chunhua Liu, Yang Chen, Pei Zhang, Shiwen Xia, Anuradha Narayan
Abstract
BACKGROUND: There is an emerging literature on the mental health of both pre- and post-partum mothers during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: As of April 1, 2020, 23 mothers confirmed with COVID-19, 15 mothers suspected with COVID-19 but with negative polymerase chain reaction tests, and 33 mothers without COVID-19 (Control Group) were recruited for a study from Hubei Province in China. The Maternal Postnatal Attachment Scale (MPAS), the Zung Self-rating Anxiety Scale, and the Zung Self-rating Depression Scale were applied to investigate the attachment of mothers to their neonates and the postpartum mental health of mothers within the first 3 months after delivery (between 20 to 89 days). RESULTS: The period of mother-child separation among the confirmed group (33.9±20.9 days) was significantly longer than that of suspected group (16.7±12.2 days) and control group (10.7±8.4 days). The total score of the MPAS in mothers confirmed with COVID-19 (45.5±4.2) was significantly lower (indicating less mother-child attachment) than that in the suspected (50.5±4.7) and control (48.8±4.6) groups. A negative correlation was noted between the mother-child separation time and the MPAS scores, including the subscale scores of attachment (MPAS acore: Spearman's ρ =-0.33, 95% CI: -0.095 to -0.538, P=0.005; Subscale score of attachment: Spearman's ρ =-0.40, 95% CI: -0.163 to -0.592, P=0.001). The incidence of postpartum anxiety in the confirmed, suspected and control groups was 4.3%, 6.7% and 12.1%, respectively; and the incidence of postpartum depression was 39.1%, 33.3% and 30.3%, respectively. No significant difference was found with regards to maternal postpartum anxiety and depression among the three groups. CONCLUSIONS: Decreased mother-child attachment found among mothers confirmed with COVID-19, indicates that further intervention is needed to ensure mother-child interaction to appropriately develop attachment. Mother-child attachment experienced disruption due to prolonged mother-child separation necessitated by the COVID-19 management protocol, which needs to be revised to reduce prolonged mother-child separation. Additionally, mothers with and without COVID-19 suffered a high incidence of depression, which warrants further mental health investment for pregnant mothers during the COVID-19 pandemic.