Alexandra Doncarli

and 12 more

Objective To study the impact of the SARS-CoV-2 pandemic and the first lockdown in France on voluntary changes by pregnant women in the medical monitoring of their pregnancy. Study population Adult (>18 years old) pregnant women during the first lockdown (March-May 2020), living in France, and participating in an access panel of internet users. Design and Settings A cross-sectional study was conducted in July 2020 using a web-questionnaire completed by 500 pregnant women selected by quotas sampling (age group, socio-professional category, region of residence at the time of the lockdown, and parity). Methods A robust variance Poisson regression model was used to estimate adjusted prevalence ratios (aPRs). A manual stepwise descending approach was applied to obtain the final model. Main Outcome Measures Voluntary postponement or foregoing of pregnancy monitoring. Results Almost one women of five (23.4%) reported having voluntarily postponed or foregone at least one consultation or pregnancy check-up during the lockdown. Women who were professionally inactive (aPR=1.98, CI95%[1.24-3.16]), who had experienced serious disputes or violence during the lockdown (1.47, [1.00-2.16]), who felt they received little or no support (1.71, [1.07-2.71]), and those who changed health professionals during the lockdown (1.57, [1.04-2.36]) were all more likely to have voluntarily changed their pregnancy monitoring. Higher level of worry about the pandemic was associated with a lower probability of voluntarily changing pregnancy monitoring (0.66, [0.46 -0.96]). Conclusions Our results can guide prevention and support policies for pregnant women in the current and future pandemics. Financing Santé publique France

Sarah Tebeka

and 11 more

Objective To identify risk factors of early and late postpartum depression (PPD) among a wide range of variables including sociodemographic characteristics, childhood trauma, stressful life events during pregnancy, and history of personal and family psychiatric disorders; and to assess the contribution of each risk factor. Design Nested case-control in a prospective longitudinal cohort study. Setting Eight maternity departments in Paris metropolitan area, France. Sample 3310 women with deliveries between November 2011 and June 2016 Methods Cases were identified as women with early or late PPD. Controls were all cohort participants without either early or late PPD. Main Outcome Measures Early and late PPD are assessed respectively at 2 months and one year postpartum. Results: Stressful life events during pregnancy have a dose response relationship with both early and late PPD: each additional event increased the risk of PPD. In multivariable models, early PPD was independently associated with emotional neglect during childhood (aOR:1.6, 95%CI:1.0-2.6), stressful life event during pregnancy (aOR:1.8, 95%CI:1.4-2.4), physical concomitant chronic disease during pregnancy (aOR:1.5, 95%CI:1.0-2.1), and a history of depression (aOR:1.8, 95%CI:1.4-2.4); whereas late PPD was significantly associated with unemployment (aOR:1.8, 95%CI:1.1-2.8), emotional abuse during childhood (aOR:2.2, 95%CI:1.3-3.9), stressful life event during pregnancy (aOR:2.2, 95%CI:1.6-2.9), emergency consultation during pregnancy (aOR:1.4, 95%CI:1.0-1.8), serious postpartum complications (aOR:1.7; 95%CI:1.0-2.8) and personal and family history of mood disorder (aOR:1.5, 95%CI:1.1-2.0, and aOR:1.4, 95%CI:1.0-1.8). Conclusion: Early and late PPD presented distinct patterns of correlates, with sociodemographic, psychiatric and trauma factors. These results have important consequences in terms of prevention and specific care