Recognizing Perinatal Depression During COVID-19 Pandemic: Lessons Learned and Interventions Taken to Prevent Suicide/Infanticide

Abstract

Objective: COVID-19 pandemics is a global mental health threat with increased rate of anxiety, panic disorders, depression and suicidal behavior in women who are in their perinatal period during COVID-19 pandemic. The aim of the study was to determine the presence of depression in women in perinatal period in Skopje during the COVID-19 pandemic period and possible interventions for early detection, prevention and adequate treatment with special emphasis on perinatal depression during events with highly stressful circumstances and conditions e.g. large catastrophes. Methods: This was a cross-sectional study, which included 494 pregnant women. The study was realized in a one-month period. Informed consent was obtained from participants of the study. The Edinburgh postnatal depression scale (EPDS) was used as well as socio-demographic questionnaire regarding age, number of pregnancies, course of the pregnancy, education, marital and employment status. EPDS is a self-reported scale consisting of ten questions/items. The cutoff score was 11 and over since it is considered that for this value the sensitivity and specificity of the test is maximized: sensitivity 0.81 (from 0.75 to 0.87) and specificity 0.88 (from 0.85 to 0.91). Results: No depression was registered in 82.4% of pregnant women and in 17.2% depression was present. The percentage difference regarding presence or absence of depression during pregnancy was statistically significant for p<0.05 (Difference test, p=0.0000). Of the total number of subjects, almost 3% (15 participants) said that it had crossed their mind to hurt themselves which are (potentially) suicidal thoughts and/or suicidal behavior. Conclusion: In pandemic conditions particularly vulnerable group of women are those in perinatal period, with a special accent to pregnant women who previously had depressive disorders. They should be continuously monitored and advised either face-to-face or via telemedicine means in attempt to avoid suicide.