IJERPH, Vol. 19, Pages 12386: The Impact of COVID-19 on Maternal Mental Health during Pregnancy: A Comparison between Canada and China within the CONCEPTION Cohort

International Journal of Environmental Research and Public Health doi: 10.3390/ijerph191912386

Nicolas Pagès
Jessica Gorgui
Chongjian Wang
Xian Wang
Jin-Ping Zhao
Vanina Tchuente
Anaïs Lacasse
Sylvana Côté
Suzanne King
Flory Muanda
Yves Mufike
Isabelle Boucoiran
Anne Monique Nuyt
Caroline Quach
Ema Ferreira
Padma Kaul
Brandace Winquist
Kieran J. O’Donnell
Sherif Eltonsy
Dan Chateau
Gillian Hanley
Tim Oberlander
Behrouz Kassai
Sabine Mainbourg
Sasha Bernatsky
Évelyne Vinet
Annie Brodeur-Doucet
Jackie Demers
Philippe Richebé
Valerie Zaphiratos
Anick Bérard

The effect of the COVID-19 pandemic on maternal mental health has been described in Canada and China but no study has compared the two countries using the same standardized and validated instruments. In this study, we aimed to evaluate and compare the impact of COVID-19 public health policies on maternal mental health between Canada and China, as we hypothesize that geographical factors and different COVID-19 policies are likely to influence maternal mental health. Pregnant persons >18 years old were recruited in Canada and China using a web-based strategy. All participants recruited between 26 June 2020 and 16 February 2021 were analyzed. Self-reported data included sociodemographic variables, COVID-19 experience and maternal mental health assessments (Edinburgh Perinatal Depression Scale (EPDS), Generalized Anxiety Disorders (GAD-7) scale, stress and satisfaction with life). Analyses were stratified by recruitment cohort, namely: Canada 1 (26 June 2020–10 October 2020), Canada 2 and China (11 October 2020–16 February 2021). Overall, 2423 participants were recruited, with 1804 participants within Canada 1, 135 within Canada 2 and 484 in China. The mean EDPS scores were 8.1 (SD, 5.1) in Canada 1, 8.1 (SD, 5.2) in Canada 2 and 7.7 (SD, 4.9) in China (p-value Canada 2/China: p = 0.005). The mean GAD-7 scores were 2.6 (SD, 2.9) in China, 4.3 (SD, 3.8) in Canada 1 (p < 0.001) and 5.8 (SD, 5.2) in Canada 2 (p < 0.001). When adjusting for stress and anxiety, being part of the Chinese cohort significantly increased the chances of having maternal depression by over threefold (adjusted OR 3.20, 95%CI 1.77–5.78). Canadian and Chinese participants reported depressive scores nearly double those of other crises and non-pandemic periods. Lockdowns and reopening periods have an important impact on levels of depression and anxiety among pregnant persons.

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