Perinatal depression before and during the COVID-19 pandemic in New York City
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".