Cited by 195Maternal Mental Health During Pregnancy and PostpartumCOVID-19 and Mental HealthCOVID-19 Impact on Reproduction

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COVID-19 and mental health during pregnancy: The importance of cognitive appraisal and social support

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Khoury, Jennifer E., Atkinson, Leslie, Bennett, Teresa, Jack, Susan M., Gonzalez, Andrea·2021·Journal of Affective Disorders

DOI 10.1016/j.jad.2021.01.027PMC PMC7837227

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Abstract

Background Pregnancy is a period of elevated risk for mental health difficulties, which are likely exacerbated by the COVID-19 pandemic. This study aims to understand the impact of COVID-19 on mental health and identify risk and protective factors during pregnancy.Methods Participants were 303 pregnant individuals from Ontario, Canada. Depression, anxiety and insomnia were measured using validated questionnaires. COVID-related experiences (i.e., financial difficulties, relationship conflict, social isolation) were assessed in relation to mental health. Social support and cognitive appraisal of the pandemic were examined as protective factors.Results 57% of the sample reported clinically elevated depression, >30% reported elevated worries, and 19% reported elevated insomnia. Depression (t = 25.14, p < .0001) and anxiety (t = 17.21, p < .0001) levels were higher than non-COVID pregnant samples. Social isolation, financial trouble, relationship difficulties and threat of COVID-19 were associated with mental health. Social support (r range -.24 to -.38, p <.01) was associated with lower mental health problems and negative cognitive appraisal (r range .20 to .33, p <.01) was linked to more mental health problems. Furthermore, social support and cognitive appraisal interacted (β = -.92, SE = .41, p < .05), such that higher social support acted as a protective factor, particularly for those who appraise the impact of COVID-19 to be more negative.Conclusions Findings underscore the need to address the high rates of mental health during pregnancy and outline potential targets (cognitive appraisal and social support) to protect pregnant people from experiencing mental health problems during the COVID-19 pandemic.

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Authors: Khoury, J. E., Atkinson, L., Bennett, T., Jack, S. M., & Gonzalez, A.
Affiliations: McMaster University (CA)
Toronto Metropolitan University (CA)
Corresponding author: Khoury, Jennifer E.
ORCID: Khoury, Jennifer E.
Atkinson, Leslie
Bennett, Teresa
Jack, Susan M.
Venue: Journal of Affective Disorders
Publisher: Elsevier BV
Published: 2021-03
Volume: 282
Pages: 1161-1169
ISSN: 0165-0327 (ISSN-L)
DOI: 10.1016/j.jad.2021.01.027
PMC: PMC7837227
OpenAlex: W3120171561
Cited by: 195
References: 76
Citations by year: 2026: 9 · 2025: 12 · 2024: 23 · 2023: 48 · 2022: 56 · 2021: 46
FWCI: 37.49
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
doi.org/10.15223/policy-017 (stm-asf)
doi.org/10.15223/policy-037 (stm-asf)
doi.org/10.15223/policy-012 (stm-asf)
doi.org/10.15223/policy-029 (stm-asf)
doi.org/10.15223/policy-004 (stm-asf)
Locations: Journal of Affective Disorders (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Canadian Institutes of Health Research (20011917)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Health Sciences › Medicine › Obstetrics and Gynecology › COVID-19 Impact on Reproduction
Keywords: COVID-19 pandemic, pregnancy, maternal mental health, depression, anxiety, insomnia, cognitive appraisal, social support, social isolation, financial hardship, relationship conflict, protective factors, risk factors
MeSH terms: COVID-19, SARS-CoV-2, Anxiety, Cognition, Depression, Female, Humans, Mental Health, Ontario, Pregnancy, Social Support, Pandemics

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COVID-19 and mental health during pregnancy: The importance of cognitive appraisal and social support

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