Postpartum Mental Health Problems in the Mothers of Very, Moderately and Late Preterm Infants During and After COVID-19 Pandemic: A Cross-Sectional Comparison Study and Possible Risk Factors.

Background: Preterm birth (PTB) affects ~11% of women worldwide. The COVID-19 pandemic put an additional burden on this already challenging situation. Aims: We aimed to analyse (1) the impact of the COVID-19 pandemic on the severity of specific depressive, anhedonia, anxiety and self-harm thoughts (SHTs) symptoms in mothers of preterm babies, (2) differences in the severity of these symptoms among mothers who gave birth very preterm, moderately and late preterm and (3) potential socio-demographic, psychological, birth-related and COVID-19-related factors associated with an increase in the mothers' scores. Methods: A total of 948 mothers of preterm children took part in a midwife-led postpartum depression (PPD) screening; 543 of them gave birth during the pandemic, and 405-after. A sociodemographic survey and the Edinburgh postnatal depression scale (EPDS) were administered. To investigate possible differences between comparison groups, we conducted Results: We found that mothers who gave birth to very preterm children scored higher in depressive symptoms than mothers of moderately and late preterm children. In general, women who gave birth during COVID-19 scored higher in anxiety (a statistical trend), but not in depression. The significant predictors of increased mental health problems were a worse financial situation, a higher education level, previous maternal mental health problems and a child's physical health (lower birth weight and the presence of medical complications during delivery). Conclusions: The severity of depressive symptoms was not explained by COVID-19, but gestational age. It shows that mothers of very preterm infants need additional attention and support in the postpartum period.