Increased maternal inflammation after SARS-CoV-2 reduces responsiveness to a novel perinatal mental health program

To evaluate whether maternal inflammation after SARS-CoV-2 infection is associated with maternal mental health scores following a novel community-based intervention in a high-risk urban population. Overall, the program was associated with improvement in depression, anxiety, and perceived stress on validated survey instruments performed before and after program completion, but whether maternal COVID-19-associated inflammation modified the impact of the program was not known. We performed a prospective cohort study of peripartum persons referred to a novel community-based intervention, Helping Us Grow Stronger (HUGS/Abrazos), who also had serum drawn after SARS-CoV-2 infection in pregnancy. Through HUGS, participants received acute behavioral health support, resource navigation tools, and a grocery gift card. The Perceived Stress Scale (PSS) was administered pre- and post-program. Serum cytokines were quantified using the Human Inflammation 20-Plex ProcartaPlex assay. Relationships between maternal SARS-CoV-2-associated cytokines and pre/post-program PSS scores were evaluated with univariable logistic regression. 35 participants had serum cytokine levels drawn after SARS-CoV-2 infection and completed surveys. Higher maternal MCP1 was associated with greater odds of moderate or high stress prior to the program, and higher maternal IL13 and IL17A levels were associated with greater odds of persistent moderate or high stress after program completion (Table). Higher MCP1, IL17A and IL13 at COVID-19 infection were associated with lack of improvement in moderate or high stress (Kruskal-Wallis test, p=0.02, p=0.03, and p=0.07, respectively, Figure). Maternal inflammation after SARS-CoV-2 is associated with higher baseline stress levels and reduced improvement in stress after participation in a novel community-based intervention to improve perinatal mental health. Additional support may be needed to mitigate maternal stress in those with more severe COVID-19 in pregnancy.View Large Image Figure ViewerDownload Hi-res image Download (PPT)