The impact of COVID-19 infection on postpartum depression, anxiety, and comorbidity of conditions among pregnant women

Objective: To investigate the impact of COVID-19 infection on postpartum depression, anxiety, and the presence of comorbid conditions among pregnant women.Methods: Postpartum women were recruited into this study between November 2020 and February 2023 and the demographic characteristics were surveyed using a Demographic Questionnaire, while depression and anxiety symptoms were evaluated with the EPDS and GAD-7, respectively.Multivariate Logistic regression was used to analyze the independent and interactive effects of COVID-19 infections on postpartum depression, anxiety, and comorbid depression and anxiety.Results: 2,683 postpartum women were studied, with a mean age of 28.93 ± 3.80 years.Of these women, 14.8% developed depression, 21.4% anxiety, and 11% had both depression and anxiety.A total of 85.1% reported pre-pregnancy COVID-19 infection, while 37.0% reported infection during pregnancy.Compared to uninfected counterparts, women with pre-pregnancy COVID-19 infection showed elevated risks of depression (1.74-fold), anxiety (1.76-fold), and comorbid depression and anxiety (2.14-fold) (P<0.05).During pregnancy, COVID-19 infection was associated with increased depression risk (1.64-fold), anxiety risk (2.21-fold), and comorbid risks (1.89-fold) (P<0.05).Notably, those infected twice during pregnancy faced even higher risks, with depression risk increasing by 2.45-fold, anxiety risk by 2.61-fold, and an increased comorbid risk by 2.37-fold (P<0.05).Additionally, women with pre-pregnancy infections alone exhibited increased risks of depression (1.84-fold), anxiety (2.21-fold), and comorbid depression and anxiety (2.19-fold) (P<0.05).Similarly, women infected only during pregnancy faced elevated risks, with the highest risks observed in those with both pre-and during-pregnancy infections.Conclusion: The study provides clear evidence of the negative impact of COVID-19 infections on postpartum mental health, emphasizing the need for heightened attention and intervention strategies to safeguard women's mental wellbeing during this critical period.