Factors associated with depression in pregnant women during the COVID-19 pandemic

Abstract

Pregnancy is a challenging period for women, especially during the pandemic, which saw a large increase in occurrences of depression among pregnant mothers. In light of this, the purpose of this study is to discover the features that contributed to depression in pregnant women at this time. The following risk factors were taken into account: the mother’s age, annual family income, maternal education, anxiety level, gestational age, concern about virus exposure, concerns about hurting the baby’s health, and the baby’s life. In this dataset of 6,162 observations, the response variable depression was measured using the Edinburgh Postnatal Depression Scale (EDPS), a self assessment questionnaire developed in the United Kingdom for postpartum depression research, and transformed into a scale of zero to one, where a value of zero indicates the absence of any signs or manifestations associated with depression and a value of one indicates the maximum presence of depressive signs. Thus, generalised additive models for location, scale, and shape (GAMLSS) based on the zero-inflated beta distribution were considered. Covariates were selected for each of the distribution parameters using a stepwise-based method, allowing us to detect the primary features that lead to a woman scoring zero on the EDPS, as well as the main risk factors for developing depression. The residual analysis indicated that the fitted model was adequate for describing the analysed data. This study contributes to a better knowledge of the factors that influence pregnant women’s mental health throughout the pandemic, generating recommendations for public health strategies.