# Impact of closed-off management due to COVID-19 rebound on maternal depression during pregnancy

## TL;DR

Pregnant women in lockdown areas during a COVID-19 rebound had higher depression risk compared to those in non-lockdown areas, with proximity to infected patients also playing a role.

## Contribution

The study identifies specific impacts of lockdown strictness and geographic proximity to COVID-19 patients on prenatal depression during an epidemic rebound.

## Key findings

- Women in lockdown areas had higher depression scores and greater risk of depressive symptoms compared to non-lockdown areas.
- A progressive increase in depressive symptoms was observed with decreasing distance to COVID-19 patients under 8 kilometers.
- Pregnant women in closer proximity to infected patients had at least 6 times higher risk of depressive symptoms.

## Abstract

This study aimed to assess the impacts of closed-off measures with different strictness levels (lockdown, partial lockdown and non-lockdown) and geographic proximity to patients with coronavirus disease 2019 (COVID-19) on prenatal depression during an epidemic rebound of COVID-19.

This was a cross-sectional web-based survey including 880 pregnant women. Depressive symptoms were measured by Self-Rating Depression Scale (SDS) and geographic proximity was calculated using Geographic Information Systems. Linear and logistic regression were used to assess the associations of closed-off measures and geographic proximity with SDS scores and depressive symptoms. Restricted cubic splines were used to model non-linear associations between geographic proximity and depression symptoms.

Compared with those living in non-lockdown areas, women in lockdown areas had higher SDS scores (adjusted β: 3.51, 95% CI: 1.80, 5.21) and greater risk of depressive symptoms (adjusted OR: 4.00, 95% CI: 2.18, 7.35), but evidence for partial lockdown was not obvious. A progressive increase in the risk of depressive symptoms was found with decreasing distance to COVID-19 patients when geographic proximity was <8 kilometers. Compared to those in the 5th quintile of geographic proximity, women in the first, second and third quintiles had at least 6 times higher risk of depressive symptoms.

Pregnant women under strict closed-off management during COVID-19 epidemic have high risk of depression. A specific range around the residences of reported COVID-19 patients should be underlined as potential clustering of high prenatal depression levels. Our findings highlight the importance of enhancing mental health management during the COVID-19 epidemic for pregnant women.

The online version contains supplementary material available at 10.1186/s12884-024-06285-6.