Association of Outdoor and Indoor Environment with Mental Wellbeing of Lebanese Mothers During COVID-19: Findings from the Environmental Exposures for Lebanese Infants (EELI) Study

Background and Aim: COVID-19 containment efforts in Lebanon included movement restrictions, social distancing, and quarantine measures that confined EELI study participants in their homes during their pregnancy and in the early months of their maternity. Household characteristics and proximity and access to green spaces can potentially support wellbeing and mental health. The aim of this study is to explore the associations between factors of the immediate natural and built environments and mental health outcomes in a population of new mothers in Lebanon during the ongoing COVID-19 pandemic. Methodology: Participants were recruited as part of the ongoing EELI birth cohort study from Hôtel-Dieu de France hospital in Beirut, Lebanon. Participants (n=100) provided informed consent and data on variables of interest included in this analysis. The current wellbeing of the participants was assessed using WHO Wellbeing Index [WHO-5], pregnancy-specic and COVID-19-specic stress scales. Chi-square tests are used to analyze household and natural environment characteristics against wellbeing and mental health outcomes. An exploratory qualitative component is also conducted to inquire about the environmental factors affecting maternal mental health and wellbeing in the context of the pandemic. Focus and Implications: With its longitudinal design and its launch during the COVID-19 pandemic, the EELI Study is uniquely poised to assess the links between the deteriorating natural and built environments and its impact on maternal mental wellbeing and potentially the development of infants in the long run. We hope to inform mitigation strategies and home-based and/or internet-based interventions to address the damage that the pandemic has had on the mental health of new mothers. Keywords: COVID-19, Wellbeing, Prenatal health, Indoor Environment, Natural environment, Mental health