Prenatal maternal mental health and resilience in the United Kingdom during the SARS-CoV-2 Pandemic: A cross- national comparison.

Abstract

1. Introduction: High levels of prenatal mental health problems are associated with morbidity for the pregnant person, and their infants are at long-term risk for poor health outcomes. We aim to explore how the SARS-CoV-2 pandemic affected the mental health of pregnant people in the United Kingdom (UK) in comparison with other countries, and to further identify UK specific influences which may have contributed to varying mental health outcomes. We also aim to examine the quality of antenatal care provided during the pandemic and to identify potential inadequacies to enhance preparedness for future events. Methods: During June-November 2020, we recruited 3666 individuals in the UK for the EPPOCH pregnancy cohort (Maternal mental health during the COVID-19 pandemic: Effect of the Pandemic on Pregnancy Outcomes and Childhood Health). Participants were assessed for depression, anxiety, anger and pregnancy-related anxiety using validated scales. Additionally, physical activity, social support, individualized support and personal resilience of the respondents were assessed as potential protective factors. Results: Participants reported high levels of depression (57.05%), anxiety (58.04%) and anger (58.05%). Higher levels of support and personal resilience were associated with lower mental health challenges. In the UK, depression was significantly increased during the pandemic compared to pre-pandemic data. Additionally, pregnant individuals in the UK experienced higher depression than that reported in five other nations. Finally, qualitative analysis revealed that restrictions for partners and support persons during medical appointments as well as poor public health communication led to increased mental health adversities and hindered ability to make medical decisions. Discussion: This study revealed alarmingly increased mental health challenges among pregnant individuals in the UK during the SARS-CoV-2 pandemic in comparison with other developed countries. These results highlight the need for reassessing the mental health support measures available to pregnant people in the UK, both during times of crisis and in general.