PhD Student Faculty of Pharmacy, University of Montreal, Montreal, Quebec, Canada, Canada
Background: The COVID-19 pandemic has had a significant impact on pregnant persons’ mental health. Indeed, their experience was disrupted by restrictions established to stop the spread of the virus. Pre-pandemic data reports an impact of depression, anxiety and stress on the emotional and behavioral development of the child.
Objectives: We aimed to evaluate the impact of gestational maternal depression, anxiety and stress during the COVID-19 pandemic on the child's cognitive development at 18 months.
Methods: The CONCEPTION study is a prospective mother-child cohort, established since June 23, 2020, during the COVID-19 pandemic. Depression and anxiety were assessed during pregnancy and in the postpartum period using validated tools in French and English (Edinburgh Postnatal Depression Scale (EPDS) and General Anxiety Disorder-7 (GAD-7)) as well as stress related to pandemic and antidepressant consumption. The child's cognitive development was reported by the mother using the third edition of Ages and stages questionnaires (ASQ-3) at 18 months of age. Data on other covariates were also collected electronically. Multivariate linear regression models were built to assess the association between prenatal maternal depression, anxiety, stress and the child development across five domains: communication, gross motor, fine motor, problem solving, and personal-social domains, while adjusting for covariates (child's cognitive development risks factors). In addition, sensitivity analyses have been added like COVID-19 diagnosis.
Results: Overall, 445 mother-child dyads were included in our analyses (mean gestational age at delivery 39.2 weeks ±1.8). Mean gestational scores were, for depression (EDPS, 7.8±5.4), anxiety (GAD-7, 4.4±4.0) and stress (4.3±2.1). Adjusting for potential confounders, as well as for maternal depression and anxiety during pregnancy, maternal prenatal stress was associated with communication skills (adjusted β = 1.5, CI 95 % (0.34, 2.7)) and fine motor skills (adjusted β = 1.06, CI 95 % (0.02, 2.6)) at 18 months age. Gestational depression, anxiety and antidepressants use were not associated with any of the ASQ-3’s domains. In addition, no significant association was found in stratified analysis for COVID-19 diagnosis.
Conclusions: During the COVID-19 pandemic, although antidepressant use and COVID-19 diagnosis were not associated with children’s cognitive development delay, gestational maternal stress was associated with some aspects of childhood cognitive problems, including communication and fine motor skills. Our results highlight the need to continue following-up children until kindergarten to better understand the impact of maternal mental health during pregnancy on the child’s cognitive development in the era of COVID-19.
