Socioenvironmental Determinants of Maternal Mental Health During the COVID-19 Pandemic: the MOOD-COVID Project

Background and aim: We aimed to study the socioenvironmental determinants of maternal mental health during the COVID-19 pandemic in Barcelona, for which there is limited evidence. Methods: We assessed 394 pregnant women or women with a recent delivery who had participated in the Barcelona Life Study Cohort (BiSC) before March 14th, 2020. Participants filled five online questionnaires during the lockdown period (March-June 2020) and one year after. We characterized the presence of balcony/garden, plants, amount of green space and frequency looking through windows, and social conditions at home, among others. We used the Perceived Stress Scale (short version) in all surveys. Hair cortisol was analyzed at the end of the lockdown. Depression and anxiety were assessed with the Symptom Checklist-90-Revised at the end of the lockdown and one year after. Pre-pandemic data on the urban environment and mental health was also available. Results: The mean (SD) age was 25.6 (4.4) years. Perceived stress, depression and anxiety were higher after than before the pandemic, but anxiety levels went back to normal one year after. Cortisol levels were lower at the end than before the lockdown. The lack of balcony/garden was associated with greater perceived stress at the beginning of the lockdown β=1.40 (95%CI=0.05; 2.76). Presence of plants and frequent view of green spaces through windows were non-significantly associated with less cortisol and less depression and anxiety, respectively, at the end of the lockdown. Economical insecurities, inadequate conflict resolution styles with partners and childcare inequities were also associated with perceived stress during the lockdown. Conclusions: Preliminary results suggest that maternal mental health worsened during the pandemic, except for cortisol levels. Lack of green spaces, socioeconomical and family situations could influence maternal mental health during COVID-19. Keywords: Pregnant women, maternal stress, mental health, COVID-19. Funding: AXA Research Fund grant; ERC-AdG-2017 (785994); HEI (4959-RFA17-1/18-1).