When the Bough Breaks: A Systematic Review and Meta-analysis of Mental Health Symptoms in Mothers of Young Children During the COVID-19 Pandemic

Overview

Journal Infant Ment Health J

Specialties Pediatrics
Psychology
Social Sciences

Date 2021 Dec 28

PMID 34962649

Citations 41

Authors

Nicole Racine

Rachel Eirich

Jessica Cooke

Jenney Zhu

Paolo Pador

Nicole Dunnewold

Sheri Madigan

Affiliations

Soon will be listed here.

Abstract

Parents have experienced considerable challenges and stress during the COVID-19 pandemic, which may impact their well-being. This meta-analysis sought to identify: (1) the prevalence of depression and anxiety in parents of young children (<age 5) during the COVID-19 pandemic, and (2) sociodemographic (e.g., parent age, being racially minoritized) and methodological moderators (e.g., study quality) that explain heterogeneity among studies. A systematic search was conducted across four databases from January 1, 2020 to March 3, 2021. A total of 18 non-overlapping studies (8981 participants), all focused on maternal mental health, met inclusion criteria. Random-effect meta-analyses were conducted. Pooled prevalence estimates for clinically significant depression and anxiety symptoms for mothers of young children during the COVID-19 pandemic were 26.9% (95% CI: 21.3-33.4) and 41.9% (95% CI: 26.7-58.8), respectively. Prevalence of clinically elevated depression and anxiety symptoms were higher in Europe and North America and among older mothers. Clinically elevated depressive symptoms were lower in studies with a higher percentage of individuals who were racially minoritized. In comparison, clinically elevated anxiety symptoms were higher among studies of low study quality and in samples with highly educated mothers. Policies and resources targeting improvements in maternal mental health are essential.

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References

Vindegaard N, Benros M . COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav Immun. 2020; 89:531-542. PMC: 7260522. DOI: 10.1016/j.bbi.2020.05.048. View

Mangiavacchi L, Piccoli L, Pieroni L . Fathers matter: Intrahousehold responsibilities and children's wellbeing during the COVID-19 lockdown in Italy. Econ Hum Biol. 2021; 42:101016. PMC: 9760207. DOI: 10.1016/j.ehb.2021.101016. View

Horwitz S, Briggs-Gowan M, Storfer-Isser A, Carter A . Prevalence, correlates, and persistence of maternal depression. J Womens Health (Larchmt). 2007; 16(5):678-91. DOI: 10.1089/jwh.2006.0185. View

Zimmerman M . Resiliency theory: a strengths-based approach to research and practice for adolescent health. Health Educ Behav. 2013; 40(4):381-3. PMC: 3966565. DOI: 10.1177/1090198113493782. View

Cheng Z, Mendolia S, Paloyo A, Savage D, Tani M . Working parents, financial insecurity, and childcare: mental health in the time of COVID-19 in the UK. Rev Econ Househ. 2021; 19(1):123-144. PMC: 7802611. DOI: 10.1007/s11150-020-09538-3. View

McKnight-Eily L, Okoro C, Strine T, Verlenden J, Hollis N, Njai R . Racial and Ethnic Disparities in the Prevalence of Stress and Worry, Mental Health Conditions, and Increased Substance Use Among Adults During the COVID-19 Pandemic - United States, April and May 2020. MMWR Morb Mortal Wkly Rep. 2021; 70(5):162-166. PMC: 7861483. DOI: 10.15585/mmwr.mm7005a3. View

Agrati D, Browne D, Jonas W, Meaney M, Atkinson L, Steiner M . Maternal anxiety from pregnancy to 2 years postpartum: transactional patterns of maternal early adversity and child temperament. Arch Womens Ment Health. 2015; 18(5):693-705. DOI: 10.1007/s00737-014-0491-y. View

Razurel C, Kaiser B . The role of satisfaction with social support on the psychological health of primiparous mothers in the perinatal period. Women Health. 2015; 55(2):167-86. DOI: 10.1080/03630242.2014.979969. View

Dennis C, Falah-Hassani K, Shiri R . Prevalence of antenatal and postnatal anxiety: systematic review and meta-analysis. Br J Psychiatry. 2017; 210(5):315-323. DOI: 10.1192/bjp.bp.116.187179. View

10.

Racine N, McArthur B, Cooke J, Eirich R, Zhu J, Madigan S . Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis. JAMA Pediatr. 2021; 175(11):1142-1150. PMC: 8353576. DOI: 10.1001/jamapediatrics.2021.2482. View

11.

Moher D, Liberati A, Tetzlaff J, Altman D . Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7):e1000097. PMC: 2707599. DOI: 10.1371/journal.pmed.1000097. View

12.

Lovejoy M, Graczyk P, OHare E, Neuman G . Maternal depression and parenting behavior: a meta-analytic review. Clin Psychol Rev. 2000; 20(5):561-92. DOI: 10.1016/s0272-7358(98)00100-7. View

13.

Bornstein M, Putnick D, Suwalsky J, Gini M . Maternal chronological age, prenatal and perinatal history, social support, and parenting of infants. Child Dev. 2006; 77(4):875-92. PMC: 5827934. DOI: 10.1111/j.1467-8624.2006.00908.x. View

14.

Barker E, Jaffee S, Uher R, Maughan B . The contribution of prenatal and postnatal maternal anxiety and depression to child maladjustment. Depress Anxiety. 2011; 28(8):696-702. DOI: 10.1002/da.20856. View

15.

Patrick S, Henkhaus L, Zickafoose J, Lovell K, Halvorson A, Loch S . Well-being of Parents and Children During the COVID-19 Pandemic: A National Survey. Pediatrics. 2020; 146(4). DOI: 10.1542/peds.2020-016824. View

16.

Van Lieshout R, Savoy C, Boyle M, Georgiades K, Jack S, Niccols A . The Mental Health of Young Canadian Mothers. J Adolesc Health. 2020; 66(4):464-469. DOI: 10.1016/j.jadohealth.2019.10.024. View

17.

Anderson N, Graham S, Prime H, Jenkins J, Madigan S . Linking Quality and Quantity of Parental Linguistic Input to Child Language Skills: A Meta-Analysis. Child Dev. 2021; 92(2):484-501. DOI: 10.1111/cdev.13508. View

18.

Hjalmsdottir A, Bjarnadottir V . "I have turned into a foreman here at home": Families and work-life balance in times of COVID-19 in a gender equality paradise. Gend Work Organ. 2020; 28(1):268-283. PMC: 7537149. DOI: 10.1111/gwao.12552. View

19.

Tomfohr-Madsen L, Racine N, Giesbrecht G, Lebel C, Madigan S . Depression and anxiety in pregnancy during COVID-19: A rapid review and meta-analysis. Psychiatry Res. 2021; 300:113912. PMC: 9755112. DOI: 10.1016/j.psychres.2021.113912. View

20.

Cameron E, Joyce K, Delaquis C, Reynolds K, Protudjer J, Roos L . Maternal psychological distress & mental health service use during the COVID-19 pandemic. J Affect Disord. 2020; 276:765-774. PMC: 7370903. DOI: 10.1016/j.jad.2020.07.081. View