Mental health of pregnant and postpartum women in response to the COVID-19 pandemic

Sarah E D Perzow, Ella-Marie P Hennessey, M Camille Hoffman, Nancy K Grote, Elysia Poggi Davis, Benjamin L Hankin

Research output: Contribution to journalArticlepeer-review


Background: The COVID-19 pandemic has been uniquely challenging for pregnant and postpartum women. Uncontrollable stress amplifies risk for maternal depression and anxiety, which are linked to adverse mother and child outcomes. This study examined change in internalizing symptoms from before to during the COVID-19 pandemic among pregnant and postpartum women longitudinally, and investigated moderation by loneliness and other contextual risk factors.

Methods: 135 women (Mage = 31.81; 26% Latina, 55% non-Hispanic White, 11% Black; 39% low-income) enrolled in an existing prospective study completed self-report questionnaires including the EPDS and STAI-short form during early pregnancy, prior to COVID-19, and during COVID-19.

Results: Depressive symptoms were higher during COVID-19 compared to pre-COVID-19 and just as high as during early pregnancy. Anxiety symptoms were higher during COVID-19 compared to both pre-COVID-19 and early pregnancy. Higher loneliness was associated with increased depressive symptoms during COVID-19. Greater COVID-19 specific adversity was linked to greater increases in internalizing symptoms during COVID-19. Lower income-to-needs-ratio most strongly predicted symptoms during early pregnancy.

Limitations: The present study is longitudinal, but the correlational nature of the data precludes causal conclusions regarding the effect of the pandemic on mental health.

Conclusion: Longitudinal analyses suggest the COVID-19 pandemic resulted in increased internalizing symptoms among diverse pregnant and postpartum women. Interpersonal and contextual factors exacerbate risk and the impact of the pandemic on women's mental health. Identifying mothers at-risk for depression and anxiety may increase treatment utilization, mitigate fetal and infant exposure to maternal depression and anxiety, and help prevent adverse child outcomes.

Original languageEnglish (US)
Article number100123
Pages (from-to)100123
JournalJournal of affective disorders reports
StatePublished - Apr 2021


  • COVID-19
  • anxiety
  • depression
  • pregnancy
  • longitudinal
  • stress
  • pandemic
  • Pregnancy
  • Covid-19 pandemic
  • Longitudinal
  • Depression
  • Stress

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology


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