COVID-19 Posttraumatic Effects on Perinatal Psychological Distress: A Cross-Sectional Study at the End of the Pandemic Health Emergency

Introduction: Psychological distress in pregnant and postpartum women increased during the COVID-19 pandemic. However, the impact of the pandemic in perinatal women at the end of the health emergency has been rarely studied. This study is aimed at investigating the psychological health of pregnant and postpartum women at the end of the COVID-19 public health emergency, hypothesizing that the COVID-19-related fears influence perinatal psychological distress via the mediation of the COVID-19-related posttraumatic impact and loneliness. Methods: A total of 200 women in the perinatal period, of which 125 were pregnant and 75 were postpartum, participated in an online survey at the end of the COVID-19 public health emergency in Italy. Depression, anxiety, stress, loneliness, posttraumatic impact of COVID-19 pandemic and COVID-19-related fears were assessed. To test the hypotheses, robust serial mediation analyses were performed. Results: Increased levels of COVID-19- related fears were associated with an increase in perinatal depression, anxiety and stress indirectly through the serial mediation of COVID-19 posttraumatic impact and loneliness. Loneliness played a stronger role in mediating the relationship between COVID-19-related fears and depression than anxiety and stress outcomes. Conclusions: This study should be considered exploratory for its methodological characteristics and onreplicability of the pandemic condition. However, this study suggests the importance of assessing posttraumatic reactions to ‘collective’ crises in pregnant and postpartum women for research and clinical practice. In addition, it sustains the role of loneliness as a transversal construct that should be greatly considered in targeting psychological interventions for women in the perinatal period.