Perinatal depression before and during the COVID-19 pandemic in New York City
Notice bibliographique
Résumé
Quarantining and isolation during previous pandemics have been associated with higher levels of depression symptomatology. Studies in other countries found elevated rates of anxiety and/or depression among pregnant people during the Coronavirus pandemic compared to pre-pandemic rates. New York City was the initial epicenter of the pandemic in the United States and the effects of the pandemic on perinatal depression in this population are not well known. To evaluate the rates of perinatal depression before and during the Coronavirus pandemic. This is a single-center retrospective cohort study of patients screened for perinatal depression with the Edinburgh Postnatal Depression Scale at two private academic practices in New York City. This screen is done in these practices at the time of glucose challenge test and at the postpartum visit. Patients ≥ 18 years old who completed a screen at a postpartum visit and/or glucose challenge test during February 1, 2019 to July 31, 2019 and February 1, 2020 to July 31, 2020 were identified and the 2019 and 2020 groups were compared. The primary outcome was a positive screen, defined as ≥ 13 and ≥ 15 for postnatal and prenatal screens, respectively. Secondary outcomes included monthly changes in rates of positive screens and factors associated with perinatal depression. Data were analyzed using Mann-Whitney U test, Chi-square or Fisher's exact test, and univariate and multivariate analyses with p< 0.05 defined as significance. 1366 records met inclusion criteria. 75% of the pre-pandemic (2019) records were included compared to 65% of pandemic (2020) records due to a lower screen completion rate in the pandemic cohort. The 2020 cohort had a higher proportion of Hispanic patients (p=0.003), higher rates of diabetes (p=0.007), preterm labor (p=0.03), and current or former drug use (p<0.001). The 2019 cohort had higher rates of hypertension (p=0.002) and breastfeeding (p=0.03). 4.6% of the 2020 cohort had a suspected or confirmed Covid-19 infection. There was no difference in perinatal depression between the 2019 and 2020 cohorts (2.8% vs 2.6%, p>0.99). This finding persisted after adjusting for baseline differences (aOR 0.89, 95% CI 0.38-1.86, p=0.76). There were no differences in rates of positive EPDS by month. Several risk factors were associated with a positive screen, including being unmarried (p<0.001), pulmonary disease (p=0.02), depression (p<0.001), anxiety (p=0.01), bipolar disorder (p=0.009), and use of anxiolytics (p=0.04). There were no differences in the rates of perinatal depression before and during the Coronavirus pandemic. The rate of perinatal depression in this cohort was below the reported averages in the literature. Fewer women were screened for perinatal depression in 2020, which likely underestimated the prevalence of depression in our cohort. These findings highlight potential gaps in care in a pandemic setting.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».