Introduction
In some Western countries, suicides are one of the main causes of
maternal deaths.1,2 Long before the COVID-19 pandemic,
a systematic review found that between 7 and 13% of women are depressed
during pregnancy and 19% have postpartum depression; 7% of these cases
were considered major.3 We also know that the mental
disorders of mothers are strongly associated with their children’s
physical and mental well-being.4
At the beginning of the COVID-19 pandemic period, the medical situation
was considered much more anxiety-inducing for pregnant than for
non-pregnant women. In March 2020, no data were available about the
potential for a higher risk of severe effects due to this coronavirus
during pregnancy, for both mother and child, by possible vertical
transmission.5 Applying the precautionary principle,
pregnant women were considered to be at high risk of medical
complications.6 The separation of an infected mother
from the child at birth was debated7 and many French
hospitals prevented women (infected or uninfected) from receiving
support from their partners during childbirth.8 The
lockdown measures, imposed to limit the epidemic’s spread and applied to
maternity wards in elsewhere in Europe and in the USA, have raised
concerns among professionals about their psychological impact on
pregnant women and mothers.9 The reorganisation of
hospitals and the community care sector may have generated concern about
access to care during pregnancy and childbirth.10
These factors indicate that the current pandemic period, with its
repeated lockdowns, is likely to negatively affect the mental well-being
of pregnant women.11,12 Most of the recently reviewed
studies have reported that isolation has negative psychological effects
on the population, including anxiety, depression, and post-traumatic and
other stress symptoms.13,14 While some controlled
comparative studies on the lockdown’s impact on depression during the
postpartum period are available, to our knowledge, no such data exist
for broader outcomes such as mental well-being among pregnant women in
Western countries.15–17
We therefore sought to compare the mental well-being of French pregnant
and non-pregnant women during the first COVID-19 lockdown. As a
secondary objective, we examined the association between pregnant
women’s characteristics and their level of well-being.