Introduction
In some Western countries, suicides are one of the main causes of maternal deaths.1,2 Long before the COVID-19 pandemic, a systematic review found that between 7 and 13% of women are depressed during pregnancy and 19% have postpartum depression; 7% of these cases were considered major.3 We also know that the mental disorders of mothers are strongly associated with their children’s physical and mental well-being.4
At the beginning of the COVID-19 pandemic period, the medical situation was considered much more anxiety-inducing for pregnant than for non-pregnant women. In March 2020, no data were available about the potential for a higher risk of severe effects due to this coronavirus during pregnancy, for both mother and child, by possible vertical transmission.5 Applying the precautionary principle, pregnant women were considered to be at high risk of medical complications.6 The separation of an infected mother from the child at birth was debated7 and many French hospitals prevented women (infected or uninfected) from receiving support from their partners during childbirth.8 The lockdown measures, imposed to limit the epidemic’s spread and applied to maternity wards in elsewhere in Europe and in the USA, have raised concerns among professionals about their psychological impact on pregnant women and mothers.9 The reorganisation of hospitals and the community care sector may have generated concern about access to care during pregnancy and childbirth.10
These factors indicate that the current pandemic period, with its repeated lockdowns, is likely to negatively affect the mental well-being of pregnant women.11,12 Most of the recently reviewed studies have reported that isolation has negative psychological effects on the population, including anxiety, depression, and post-traumatic and other stress symptoms.13,14 While some controlled comparative studies on the lockdown’s impact on depression during the postpartum period are available, to our knowledge, no such data exist for broader outcomes such as mental well-being among pregnant women in Western countries.15–17
We therefore sought to compare the mental well-being of French pregnant and non-pregnant women during the first COVID-19 lockdown. As a secondary objective, we examined the association between pregnant women’s characteristics and their level of well-being.