The Impact of COVID-19 on Maternal Mental Health during Pregnancy: A Comparison between Canada and China within the CONCEPTION Cohort

Nicolas Pagès (), Jessica Gorgui (), Chongjian Wang, Xian Wang, Jin-Ping Zhao, Vanina Tchuente, Anaïs Lacasse, Sylvana Côté, Suzanne King, Flory Muanda, Yves Mufike, Isabelle Boucoiran, Anne Monique Nuyt, Caroline Quach, Ema Ferreira, Padma Kaul, Brandace Winquist, Kieran J. O’Donnell, Sherif Eltonsy, Dan Chateau, Gillian Hanley, Tim Oberlander, Behrouz Kassai, Sabine Mainbourg, Sasha Bernatsky, Évelyne Vinet, Annie Brodeur-Doucet, Jackie Demers, Philippe Richebé, Valerie Zaphiratos and Anick Bérard ()
Additional contact information
Nicolas Pagès: Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
Jessica Gorgui: Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
Chongjian Wang: College of Public Health, Zhengzhou University, Zhengzhou 450001, China
Xian Wang: College of Public Health, Zhengzhou University, Zhengzhou 450001, China
Jin-Ping Zhao: Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
Vanina Tchuente: Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
Anaïs Lacasse: Health Sciences Department, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, QC J9X 5E4, Canada
Sylvana Côté: Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
Suzanne King: Faculty of Medicine, McGill University, Montreal, QC H3G 2M1, Canada
Flory Muanda: Department of Epidemiology & Biostatistics, Western University, London, ON N6A 5W9, Canada
Yves Mufike: Department of Family Medicine, Protestant University in Congo, Kinshasa II, Kinshasa P.O. Box 4745, Democratic Republic of the Congo
Isabelle Boucoiran: Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
Anne Monique Nuyt: Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
Caroline Quach: Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
Ema Ferreira: Faculty of Pharmacy, University of Montreal, Montreal, QC H3T 1J4, Canada
Padma Kaul: Department of Medicine, 4-120 Katz Group Centre for Pharmacy and Health Research, University of Alberta, Edmonton, AL T6G 2R7, Canada
Brandace Winquist: Department of Community Health and Epidemiology, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
Kieran J. O’Donnell: Yale Child Study Center, Department of OB/GYN and Reproductive Sciences, Yale School of Medicine, New Haven, CT 06510, USA
Sherif Eltonsy: Rady Faculty of Health Sciences, College of Pharmacy, University of Manitoba, Winnipeg, MB R3E 0W2, Canada
Dan Chateau: Manitoba Center for Health Policy, Winnipeg, MB R3E 3P5, Canada
Gillian Hanley: Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
Tim Oberlander: Department of Pediatrics, School of Population and Public Health, University of BC, Vancouver, BC V6T 1Z4, Canada
Behrouz Kassai: Faculty of Medicine, Université Claude Bernard Lyon 1, 69003 Lyon, France
Sabine Mainbourg: Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada
Sasha Bernatsky: Divisions of Clinical Epidemiology and Rheumatology, McGill University Health Centre, Montreal, QC H3A 0G4, Canada
Évelyne Vinet: Divisions of Clinical Epidemiology and Rheumatology, McGill University Health Centre, Montreal, QC H3A 0G4, Canada
Annie Brodeur-Doucet: Dispensaire Diététique de Montréal/Montreal Diet Dispensary, Montreal, QC H3H 1J3, Canada
Jackie Demers: Dispensaire Diététique de Montréal/Montreal Diet Dispensary, Montreal, QC H3H 1J3, Canada
Philippe Richebé: Department of Anesthesiology and Pain Medicine, CIUSSS de l’Est de l’Ile de Montreal, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, QC H1T 2M4, Canada
Valerie Zaphiratos: Department of Anesthesiology and Pain Medicine, CIUSSS de l’Est de l’Ile de Montreal, Maisonneuve-Rosemont Hospital, University of Montreal, Montreal, QC H1T 2M4, Canada
Anick Bérard: Research Center CHU Ste-Justine, Montreal, QC H3T 1C5, Canada

IJERPH, 2022, vol. 19, issue 19, 1-22

Abstract: The effect of the COVID-19 pandemic on maternal mental health has been described in Canada and China but no study has compared the two countries using the same standardized and validated instruments. In this study, we aimed to evaluate and compare the impact of COVID-19 public health policies on maternal mental health between Canada and China, as we hypothesize that geographical factors and different COVID-19 policies are likely to influence maternal mental health. Pregnant persons >18 years old were recruited in Canada and China using a web-based strategy. All participants recruited between 26 June 2020 and 16 February 2021 were analyzed. Self-reported data included sociodemographic variables, COVID-19 experience and maternal mental health assessments (Edinburgh Perinatal Depression Scale (EPDS), Generalized Anxiety Disorders (GAD-7) scale, stress and satisfaction with life). Analyses were stratified by recruitment cohort, namely: Canada 1 (26 June 2020–10 October 2020), Canada 2 and China (11 October 2020–16 February 2021). Overall, 2423 participants were recruited, with 1804 participants within Canada 1, 135 within Canada 2 and 484 in China. The mean EDPS scores were 8.1 (SD, 5.1) in Canada 1, 8.1 (SD, 5.2) in Canada 2 and 7.7 (SD, 4.9) in China ( p -value Canada 2/China: p = 0.005). The mean GAD-7 scores were 2.6 (SD, 2.9) in China, 4.3 (SD, 3.8) in Canada 1 ( p < 0.001) and 5.8 (SD, 5.2) in Canada 2 ( p < 0.001). When adjusting for stress and anxiety, being part of the Chinese cohort significantly increased the chances of having maternal depression by over threefold (adjusted OR 3.20, 95%CI 1.77–5.78). Canadian and Chinese participants reported depressive scores nearly double those of other crises and non-pandemic periods. Lockdowns and reopening periods have an important impact on levels of depression and anxiety among pregnant persons.

Keywords: COVID-19 pandemic; maternal mental health; pregnancy; Edinburgh Perinatal Depression Scale (EPDS); Generalized Anxiety Disorders (GAD-7); stress (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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