Cumulative and compounding effects of pre-pandemic vulnerabilities and pandemic-related hardship on psychological distress among pregnant individuals

This is the authors' abstract. We don't add key points for this paper.

Objective: Our primary objective was to determine whether pre-existing vulnerabilities and pandemic-related hardship resulted in cumulative (i.e., additive) versus compounding (i.e., multiplicative) effects on psychological distress in pregnant individuals during the COVID-19 pandemic. A secondary objective was to determine whether perceived social support and/or receipt of government financial aid buffered the effects of pandemic-related hardship on psychological distress.Method: Data are from a prospective pregnancy cohort study, the Pregnancy During the COVID-19 Pandemic study (PdP). This cross-sectional report is based upon the initial survey collected at recruitment between April 5, 2020 and April 30, 2021. Logistic regression was used to evaluate our objectives.Results: The data provide substantial evidence supporting a cumulative (additive) relationship between pandemic-related hardship and pre-existing vulnerabilities in relation to psychological distress. There was no evidence to support compounding (multiplicative) effects. Likewise, the buffering effect of social support was additive but not multiplicative. Government financial aid did not buffer the effects of objective hardship on psychological distress. Conclusion: Pre-pandemic vulnerability and pandemic-related hardship had cumulative effects on psychological distress during the COVID-19 pandemic. Adequate and equitable responses to pandemics and disasters may require more intensive supports for those with multiple vulnerabilities.