| Literature DB >> 32979272 |
Sarah Dib1, Emeline Rougeaux1, Adriana Vázquez-Vázquez1, Jonathan C K Wells1, Mary Fewtrell1.
Abstract
OBJECTIVE: To assess how mothers are feeling and coping during lockdown, and to identify the potential pathways that can assist them.Entities:
Keywords: COVID-19; Coping; Coronavirus; Maternal health; Mental health; Postpartum
Mesh:
Year: 2020 PMID: 32979272 PMCID: PMC9087547 DOI: 10.1002/ijgo.13397
Source DB: PubMed Journal: Int J Gynaecol Obstet ISSN: 0020-7292 Impact factor: 4.447
Figure 1Directed acyclic graph of the relationship between maternal mental health or coping and activities, support and consequences of lockdown.
Background characteristics of women who completed the survey in week 1.
| Maternal age (years) | 31.7 ± 4.7 |
| Infant age (months) | 4.8 ± 3.1 |
| Infant gestation (weeks) | 39.3 ± 1.8 |
| Male infant | 675 (51) |
| Having other children in the household | 601 (45.2) |
| Maternal ethnicity | |
| White | 1251 (94.0) |
| Mixed/multiple ethnic groups | 35 (2.7) |
| Black/African/Caribbean/black British | 6 (0.5) |
| Asian/Asian British | 28 (2.1) |
| Arab | 1 (0.1) |
| Other ethnic group | 3 (0.2) |
| Maternal education | |
| ≤5 GCSE grade A–C | 58 (4.4) |
| ≥5 GCSE grade A–C | 100 (7.5) |
| A levels/equivalent | 280 (21.0) |
| Batchelor’s degree | 521 (39.1) |
| Master’s degree | 183 (13.7) |
| PhD/professional qualification | 180 (13.5) |
| Living conditions | |
| Flat/apartment | 173 (13.0) |
| House/bungalow | 1142 (85.8) |
| Mobile/temporary structure | 9 (0.7) |
| Access to green space within walking distance | 1306 (98.1) |
| Marital status | |
| Married/Civil partnership/Cohabitation | 1267 (95.2) |
| Single parent—living on own | 34 (2.6) |
| Single parent—living with family | 16 (1.2) |
| Household income | |
| <£20,000 | 87 (6.5) |
| <£30,000 | 139 (10.4) |
| <£45,000 | 238 (17.9) |
| <£75,000 | 428 (32.2) |
| <£100,000 | 200 (15.0) |
| >£100,000 | 179 (13.4) |
| Prefer not to say | 53 (4.0) |
Values are given as number (percentage) or mean ± standard deviation.
The extent to which the participants agreed with the following perceptions, since the lockdown began.
| Not at all | Very little | To some extent | To a high extent | |
|---|---|---|---|---|
| Maternal mental health | ||||
| I’ve been feeling down | 161 (12.1) | 414 (31.1) | 529 (39.7) | 222 (16.7) |
| I’ve been feeling lonely | 232 (17.4) | 310 (23.3) | 472 (35.5) | 316 (23.7) |
| I’ve had trouble relaxing | 220 (16.5) | 336 (25.2) | 465 (34.9) | 301 (22.6) |
| I’ve become easily annoyed or irritable | 143 (10.7) | 354 (26.6) | 502 (37.7) | 328 (24.6) |
| I’ve been feeling worried | 98 (7.4) | 291 (21.9) | 532 (40.0) | 407 (30.6) |
| Coping | ||||
| I’ve had the opportunity to chat with my family and friends | 4 (0.3) | 100 (7.5) | 602 (45.2) | 619 (46.5) |
| I’ve enjoyed the spring weather | 46 (3.5) | 150 (11.3) | 485 (36.4) | 645 (48.5) |
| I feel able to cope with the situation | 85 (6.4) | 320 (24.0) | 748 (56.2) | 178 (13.4) |
| Changes to appetite and sleep | ||||
| I’ve had trouble falling or staying asleep | 460 (34.6) | 339 (25.5) | 326 (24.5) | 205 (15.4) |
| I’ve been having a poor appetite | 848 (63.7) | 230 (17.3) | 196 (14.7) | 49 (3.7) |
| Time to focus on health and interests | ||||
| I’ve had time to enjoy personal interests | 635 (47.7) | 476 (35.8) | 169 (12.7) | 48 (3.6) |
| I’ve had time to focus on my health | 374 (28.1) | 549 (41.2) | 313 (23.5) | 93 (7.0) |
| I’ve had time to exercise | 284 (21.3) | 481 (36.1) | 391 (29.4) | 173 (13.0) |
Values are given as number (percentage).
Activities the participants engaged in during the previous week.
| 0 times | 1–3 times | 4–5 times | Daily or more | |
|---|---|---|---|---|
| Went shopping at the grocery store or pharmacy | 625 (47.2) | 670 (50.6) | 25 (1.9) | 4 (0.3) |
| Travelled for work | 1269 (95.3) | 44 (3.3) | 4 (0.3) | 7 (0.5) |
| Went outside for a walk or for exercise | 67 (5.1) | 438 (33.2) | 296 (22.4) | 520 (39.4) |
| Practiced a relaxation technique | 1021 (76.7) | 218 (16.4) | 57 (4.3) | 32 (2.4) |
Values are given as number (percentage).
Support measures for women who completed the survey in week 1.
| Got or getting enough support and help with own health | |
| Yes | 783 (58.8) |
| No | 545 (40.9) |
| Had contact with a mother and baby or breastfeeding support group | |
| 0 times | 976 (73.3) |
| 1–3 times | 238 (17.9) |
| 4–5 times | 53 (4.0) |
| Daily or more | 58 (4.4) |
| Had contact with a health professional (GP, health visitor, midwife) | |
| 0 times | 791 (59.4) |
| 1–3 times | 496 (37.3) |
| 4–5 times | 31 (2.3) |
| Daily or more | 5 (0.4) |
| Attended an appointment with a mental health professional | |
| 0 times | 1236 (92.9) |
| 1–3 times | 81 (6.1) |
| 4–5 times | 10 (0.8) |
| Daily or more | 1 (0.1) |
| I feel the household chores are more equally divided among household members | |
| Not at all | 494 (37.1) |
| Very little | 343 (25.8) |
| To some extent | 298 (22.4) |
| To a high extent | 186 (14.0) |
Abbreviation: GP, general practitioner.
Values are given as number (percentage).
In the previous week.
Predictors of maternal mental health (anxiety, low mood, and loneliness).
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| |
|---|---|---|---|---|
| Contact in person, by phone, or online | Healthcare professionals | −0.045 | −0.167 to 0.077 | 0.470 |
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| |
| Mental health professional | −0.197 | −0.418 to 0.025 | 0.082 | |
| Extent to which chores are more equally divided |
|
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| Not at all | 0.101 | −0.073 | 0.255 | |
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| |
| To some extent | 0.091 | −0.094 to 0.277 | 0.335 | |
| Shopped at grocery store/pharmacy | 0.063 | −0.051 to 0.176 | 0.278 | |
| Went outside for a walk or exercise | 0.138 | −0.109 to 0.385 | 0.274 | |
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| |
| Practiced a relaxation technique | 0.113 | −0.020 to 0.247 | 0.095 | |
| Gave birth during lockdown | 0.086 | −0.082 to 0.254 | 0.313 | |
|
Impact of lockdown on the ability to afford rent Impact of lockdown on the ability to afford food Impact of lockdown on the ability to afford other essentials | Advised to shield due to risk | −0.045 | −0.318 to 0.228 | 0.745 |
| Minor | 0.075 | −0.101 to 0.251 | 0.405 | |
| Moderate | 0.117 | −0.110 to 0.345 | 0.312 | |
| Major | 0.063 | −0.312 to 0.437 | 0.743 | |
| Minor | 0.170 | −0.035 to 0.375 | 0.105 | |
| Moderate | −0.204 | −0.518 to 0.109 | 0.202 | |
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| |
| Minor | −0.081 | −0.313 to 0.151 | 0.494 | |
| Moderate | 0.193 | −0.140 to 0.526 | 0.255 | |
| Major | 0.329 | −0.234 to 0.891 | 0.252 | |
| Age | Maternal age | 0.004 | −0.009 to 0.017 | 0.525 |
| Infant’s age | 0.017 | −0.007 to 0.041 | 0.154 | |
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| |
| Ethnicity | BAME | −0.166 | −0.398 to 0.066 | 0.160 |
| Marital status | Single—living alone | 0.047 | −0.311 to 0.405 | 0.798 |
| Single—living with family | −0.078 | −0.598 to 0.443 | 0.770 | |
| Income |
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| <£75,000 | −0.045 | −0.204 to 0.113 | 0.575 | |
| <£100,000 | −0.067 | −0.260 to 0.126 | 0.496 | |
| Number of children in the household | 1 | −0.005 | −0.120 to 0.111 | 0.939 |
Abbreviations: BAME, black, Asian and minority ethnic group; CI, confidence interval; PCA, principal component analysis.
P values <0.05 were considered statistically significant and are given in bold.
PCA result of mental health. Higher scores reflect better mental health.
Participated in activities at least once in the previous week.
High extent as reference.
No impact as reference.
White ethnicity as reference.
Married/civil partnership/cohabitation as reference.
Income >£100,000 as reference.
More than one child as reference.
Predictors of coping.
| Variable | B | 95% CI |
| |
|---|---|---|---|---|
| Contact in person, by phone. or online | Healthcare professionals | −0.101 | −0.222 to 0.019 | 0.100 |
| Mother and baby support groups | −0.092 | −0.218 to 0.035 | 0.155 | |
| Mental health professional | −0.121 | −0.340 to 0.099 | 0.281 | |
| Extent to which chores are more equally divided |
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| Shopped at grocery store/pharmacy | 0.044 | −0.068 to 0.156 | 0.444 | |
| Went outside for a walk or exercise | −0.086 | −0.330 to 0.159 | 0.493 | |
| Travelled for work | −0.199 | −0.476 to 0.078 | 0.159 | |
| Practiced a relaxation technique | 0.001 | −0.131 to 0.133 | 0.990 | |
| Gave birth during lockdown | 0.031 | −0.135 to 0.198 | 0.711 | |
|
Impact of lockdown on the ability to afford rent Impact of lockdown on the ability to afford food Impact of lockdown on the ability to afford other essentials | Advised to shield due to risk | −0.091 | −0.362 to 0.179 | 0.508 |
| Minor | −0.033 | −0.207 to 0.142 | 0.714 | |
| Moderate | −0.061 | −0.286 to 0.164 | 0.596 | |
| Major | −0.002 | −0.373 to 0.369 | 0.991 | |
| Minor | −0.145 | −0.348 to 0.058 | 0.162 | |
| Moderate | −0.088 | −0.399 to 0.223 | 0.578 | |
| Major | −0.429 | −0.936 to 0.079 | 0.098 | |
| Minor | 0.003 | −0.227 to 0.233 | 0.980 | |
| Moderate | 0.215 | −0.114 to 0.545 | 0.200 | |
| Major | 0.543 | −0.014 to 1.099 | 0.056 | |
| Age | Maternal age | −0.003 | −0.016 to 0.010 | 0.605 |
| Infant’s age | 0.021 | −0.003 to 0.044 | 0.089 | |
| Infant’s gestational age | 0.023 | −0.008 to 0.054 | 0.142 | |
| Ethnicity | BAME | −0.144 | −0.374 to 0.085 | 0.218 |
| Marital status | Single—living alone | 0.039 | −0.315 to 0.394 | 0.827 |
| Single—living with family | 0.220 | −0.296 to 0.735 | 0.404 | |
| Income | <£30,000 | −0.185 | −0.400 to 0.029 | 0.090 |
| <£75,000 | −0.059 | −0.216 to 0.098 | 0.459 | |
| <£100,000 | −0.007 | −0.199 to 0.184 | 0.941 | |
| Number of children in the household | 1 | 0.039 | −0.076 to 0.154 | 0.503 |
Abbreviations: BAME, black, Asian and minority ethnic group; CI, confidence.
interval; PCA, principal component analysis.
P values <0.05 were considered statistically significant and are given in bold.
PCA result of coping. Higher scores reflect better coping.
Participated in activities at least once in the previous week.
High extent as reference.
No impact as reference.
White ethnicity as reference.
Married/civil partnership/cohabitation as reference.
Income above 100K as reference.
More than one child as reference.