COVID-19 Pandemic and the Incidence of Postpartum Depression: a Retrospective Cohort Study

Introduction: To estimate the association between COVID-19 and postpartum depression (PPD) in a retrospective cohort study. Material and methods: Pregnant women who delivered between September 2019-June 2021 at a Mouth Sinai Health System practice in New York City were identified. Baseline information about maternal health, pregnancy outcomes, and postpartum visits were obtained from electronic health records. Edinburgh Postnatal Depression Scores (EPDS) were used as a postpartum depressive symptom marker. Three analyses were performed to compare scores between: (1) women who delivered before and after COVID-19, (2) pregnant women who delivered after the pandemic who did and did not contract COVID-19, and 3) pregnant women eligible for the COVID-19 vaccine who were and were not vaccinated. Results: A total of 1.797 pregnant women were identified. Pregnant women during the pandemic had statistically significant higher rates of pre-existing mental health diagnoses and psychiatric medicine use compared to those who were pregnant before. No difference was observed in EPDS scores of pregnant women who delivered before vs. after the start of COVID-19 nor between COVID-vaccinated and unvaccinated pregnant women. Women who contracted COVID-19 in pregnancy had lower EPDS scores than women who did not. Results remain unchanged after controlling for baseline mental health diagnoses. Conclusions: In our cohort, EPDS scores were not associated with pregnancy during the pandemic, COVID infection while pregnant, or COVID vaccination during pregnancy. However, we did identify a higher incidence of baseline mental health diagnoses during the COVID pandemic, but that did not lead to a higher rate of positive screens for postpartum depression.