Pregnancy-Related COVID Worry, Depressive Symptom Severity, and Mediation Through Sleep Disturbance in a Low-Income, Primarily Latinx Population in California’s Central Valley

Authors

Jennifer N Felder
Patience A Afulani
Kimberly Coleman-Phox
Serwaa S Omowale
Charles E McCulloch
Lauren Lessard
Miriam Kuppermann

Publication Date

1-1-2023

Journal

Journal of Psychiatric Research

Abstract

Purpose: This study (1) assessed the psychometric properties of a pregnancy-related COVID worry scale, (2) explored variations in pregnancy-related COVID worry over the course of the pandemic, and (3) examined associations between pregnancy-related COVID worry and depressive symptom severity, and evaluated sleep disturbance as a mediator.

Methods: Data were drawn from an ongoing randomized trial comparing the effectiveness of two enhanced forms of prenatal care. The current analysis includes baseline pre-randomization data collected from participants who enrolled November 2020-November 2021 (n = 201). Participants were pregnant individuals with low income and primarily Latinx.

Results: Our 7-item scale was valid and reliable for assessing pregnancy-related COVID worry. Pregnancy-related COVID worry did not vary significantly by any participant characteristic or pandemic stage. Pregnancy-related COVID worry was significantly associated with depressive symptom severity in multivariate analysis (p = .002). For each unit increase on the 10-point pregnancy-related COVID worry scale, the odds of mild-to-severe depression increased by 16% (odds ratio = 1.16, 95% confidence interval 1.02-1.32, p = .02), holding all other variables constant. Sleep disturbance mediated the pregnancy-related COVID worry-depressive symptom relationship (48% of the total effect mediated).

Conclusions: Worry about how COVID may impact their baby, birth, and postpartum experiences was associated with higher depressive symptom severity, partly through its effect on sleep. These findings suggest that interventions related to improving sleep quality among perinatal populations may reduce depressive symptoms.

Trial registration: ClinicalTrials.gov NCT04154423, "Engaging Mothers & Babies; Reimagining Antenatal Care for Everyone (EMBRACE) Study".

Keywords

Female, Humans, Pregnancy, California, COVID-19, Depression, Hispanic or Latino, Mothers, Sleep Wake Disorders, Psychometrics, Randomized Controlled Trials as Topic

DOI

10.1016/j.jpsychires.2022.11.019

PMID

36459760

PMCID

PMC10019815

PubMedCentral® Posted Date

1-1-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes