The Effect of Fear of Covid-19 on Anxiety and Postpartum Depression in Postpartum Women: Cross-sectional study

The Effect of Fear of Covid-19 on Anxiety and Postpartum Depression in Postpartum Women: Cross-sectional study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article The Effect of Fear of Covid-19 on Anxiety and Postpartum Depression in Postpartum Women: Cross-sectional study Cennet Nur KIZOGLU, HATİCE ACAR BEKTAS This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4693602/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Purpose This study aimed to determine the effect of fear of Covid-19 on anxiety and postpartum depression in postpartum women. Methods The research, which is cross-sectional, was conducted online between December 2021 and May 2022 on 110 postpartum women who were between 2 and 4 weeks postpartum. Data were collected using a personal data collection form, Fear of Covid-19 Scale (FCV-19S), General Anxiety Disorder 7 (GAD 7) and Edinburgh Postpartum Depression Scale (EPDS). In the analysis of the data, minimum-maximum values, percentages and numbers were given, and the relationship between the scale scores was examined with Pearson correlation analysis. Logistic regression analysis was performed to determine the factors affecting postpartum depression. Results The average age of women is 29.98 ± 5.62. 13.60% of the participating postpartum women were diagnosed with Covid-19 during their pregnancy, and 69.10% of them were diagnosed with Covid-19 by a relative of the pregnant woman. It was determined that 73.60% of the participants in the research had received the Covid-19 vaccine. The prevalence of postpartum depression was found to be 30.90%. It was determined that 18.20% of the participants suffered from general anxiety. The average score of the fear of Covid-19 scale was determined as 14.27 ± 6.55. Conclusion It was determined that an increase in the GAD 7 and FCV-19S scale scores increased the postpartum depression score. Health sciences/Health care Health sciences/Diseases/Psychiatric disorders/Anxiety Health sciences/Diseases/Psychiatric disorders/Depression Covid 19 Fear Pandemic Anxiety Postpartum Depression Midwifery Article Highlights The fear of COVID-19 exerts a notable influence on levels of anxiety and depression experienced during the postpartum period. This research indicates a substantial occurrence of postpartum depression (30.90%) and generalized anxiety disorder (18.20%). A heightened fear of COVID-19 is associated with elevated scores of anxiety and depression. The research highlights the necessity for providing mental health assistance to women in the postpartum phase during disaster like pandemics. Introduction The declaration by the World Health Organization (WHO) (2020) indicates that anxiety and somatic complaints are more prevalent among women amid the Covid-19 Pandemic (WHO, 2020). Women who are dedicated to fulfilling the caregiving responsibilities for their family members over an extended period at home are potentially exposed to higher susceptibility to both the Covid-19 pandemic and subsequent mental health disorders. This revelation underscores the urgent necessity for a more extensive evaluation and management of maternal mental well-being. The combination of the perilous postpartum phase and the presence of the Covid-19 pandemic may have elevated the likelihood of encountering substantial health issues in women. The second week following childbirth holds significant importance concerning postpartum depression (PPD). The apprehension felt during this period escalates anxiety and stress levels in individuals, thereby exacerbating pre-existing psychiatric symptoms (Shigemura et al., 2020). Various factors such as the risk of viral transmission postpartum, the limitations on receiving partner support during childbirth due to stringent isolation measures, the absence of family members at the hospital post-delivery, and the enforcement of a 14-day quarantine period at home following childbirth have all contributed to the predisposition to PPD (Liu et al., 2022). The Covid-19 pandemic has been linked to a notable augmentation in the probability of depression and anxiety among mothers (Pierce et al., 2021). Research conducted in different nations has presented evidence indicating a surge in the prevalence of PPD during the pandemic (Handelzalts et al., 2022; Layton et al., 2021; Mariño-Narvaez et al., 2021; Ostacoli et al., 2020; Zanardo et al., 2020). In a study focusing on pregnant women and those in the initial year postpartum, it was found that the occurrence of PPD increased from 15% in the pre-pandemic era to 40.7% during the pandemic. Moreover, 29% of women exhibited moderate to high anxiety levels before the pandemic, whereas the figure rose to 72% during the pandemic. Elevated PPD scores have been correlated with Covid-19-induced anxiety owing to PPD's susceptibility to environmental stressors (Davenport et al., 2020). During periods of global turmoil, the escalation of fear, anxiety, and stress levels correspond with heightened stressors like insomnia, health-related anxieties, frustration, fear of contracting the virus, and feelings of isolation (Alqahtani et al., 2022). This scenario contributes to the separation of mothers with confirmed or suspected Covid diagnosis from their newborns, resulting in the inability to breastfeed, lack of skin-to-skin contact, delayed mother-infant bonding, and disrupted breastfeeding continuity. Consequently, this leads to increased stress and anxiety for mothers during the postpartum period (Chua et al., 2020; Stepowicz et al., 2020). Anxiety emerges as a primary factor linked to perinatal depression (Galletta et al., 2022). In Brazil, the prevalence rates of anxiety during pregnancy range from 19.8% to 42.9% (Almeida et al., 2012; Silva et al., 2017), and hover around 20% in the postpartum phase (Lamus et al., 2021) In this investigation, the primary objective was to ascertain the impact of Covid-19 apprehension on anxiety and postpartum depression in maternity patients. Research questions 1. What is the prevalence rate of postpartum depression during the outbreak? 2. What is the prevalence rate of generalized anxiety in the postnatal period during the outbreak? 3. What is the status of Covid-19 apprehension in women in the postnatal period during the outbreak? 4. What is the influence of Covid-19 apprehension on the prevalence of postpartum depression? 5. What is the influence of generalized anxiety disorder on the prevalence of postpartum depression? Methods This research is cross-sectional study. The data was gathered online from women who gave birth at state hospital. in the northern region of Türkiye during the pandemic period spanning from December 2021, to June 2022, within a timeframe of 2–4 weeks postpartum. Face to face meetings could not be held due to the measures taken during the pandemic period. Sample The determination of the sample size was conducted utilizing the G*Power 3.1.9.4 software. The effect size was identified as 0.3, with an alpha value of 0.05, power of 0.90, leading to the selection of 110 participants (Faul et al., 2007, 2009). The recruitment of participants for the study was done through convenience sampling. Participant Data Collection Contact details of the volunteering women were acquired by the midwives/nurses working in the relevant unit and forwarded to the researcher. Online questionnaires were administered by the researcher between 2–4 weeks postpartum, and responses were collected. Scales The collection of data involved the use of a introductory information, Edinburgh Postpartum Depression Scale (EPDS), General Anxiety Disorder-7 (GAD-7)Test, and The Fear of COVID-19 Scale (FCV-19S). The introductory information sheet comprised inquiries regarding socio-demographic characteristics, Covid-19 testing and vaccination status. The Edinburgh Postpartum Depression Scale (EPDS) is a self-report instrument presented in a quadruple Likert format with 10 items by Cox et al 1987 (Cox et al., 1987). The Turkish validation study was carried out by Engindeniz et al 1996 (Engindeniz et al., 1996). The responses, which consist of four choices, are scored from 0 to 3, resulting in a total score ranging from 0 to 30. A score of ≥ 13 is indicative of a risk for PPD, with higher scores reflecting increased severity (Karaçam et al., 2018). In the present study, the Cronbach's alpha coefficient for the scale was calculated as 0.85. The General Anxiety Disorder-7 Test (GAD-7) is a concise self-report evaluation tool designed to assess generalized anxiety disorder based on DSM-IV-TR criteria, developed by Spitzer et al 2006 (Spitzer et al., 2006). The Turkish validation study was conducted by Konkan et al. 2013 (Konkan et al., 2013). It consists of a 7-item quadruple Likert type scale that gauges experiences over the past 2 weeks. The scale defines cut-off points for mild, moderate, and severe anxiety at scores of 5, 10, and 15, respectively. In the current investigation, the Cronbach's alpha value for the scale was computed as 0.87. The Fear of COVID-19 Scale (FCV-19S) , developed by Ahorsu et al. (2020) (Ahorsu et al., 2022), aims to assess the level of fear induced by Covid-19. The Turkish validation study was conducted by Bakioğlu et al. (2021)(Bakioğlu et al., 2021). This scale, with a one-factor structure, consists of seven items in a five-factor Likert format. Higher scores on the scale denote elevated levels of Covid-19 fear, although there is no specific cut-off point. In the current study, the Cronbach's alpha coefficient for the scale was determined as 0.91. Ethical considerations Ethical issues were prioritized in this study with the approval received from the Ministry of Health of the Republic of Turkey, X University Social Sciences and Humanities Research Ethics Committee (Date:16.12.2021 No: 26.03) as well as the relevant institutions and scale authors. Since the questionnaires were administered online, all participants' informed consent was also obtained online. All methods were carried out in accordance with relevant rules and regulations. This study was performed in line with the principles of the Declaration of Helsinki. Data analysis Data analysis was performed using a statistical software package. The data was assessed to conform to normal distribution and possess evenly distributed variances. Continuous variables were evaluated using t-tests, while categorical variables were compared using chi-square tests. Pearson correlation analysis was conducted to determine the strength and direction of linear relationships between the scales. Descriptive statistics were presented in terms of means and standard deviations or numbers and percentages, and logistic regression prediction multiples were computed. Furthermore, Cronbach's Alpha coefficients were calculated for the scales utilized. Results 110 females aged between 19 and 44 years were enrolled in the research, with a mean age of 29.98 ± 5.62. The investigation revealed that 35.50% of the participants had attained an education level of 12 years or below, 80.00% were classified as having a medium to poor income status, and 94.50% resided within a nuclear family structure. Additionally, findings indicated that 20.90% of the female subjects lacked social security, and 55.50% were not engaged in any income-generating occupation. Moreover, it was established that 62.70% of the participants had not undergone Covid-19 testing during their gestation period. Out of the total, 13.60% of the participants tested positive for Covid-19 while pregnant, while 23.60% received negative test results. Furthermore, 73.60% of the participants reported being vaccinated against Covid-19 before childbirth. No distinctions were observed in the characteristics of the participants concerning the average score on the FCV-19S (Table 1 ). The mean EPDS score among the subjects was calculated as 9.73 ± 6.00, the mean GAD-7 score as 5.70 ± 4.34, and the FCV-19S mean as 14.27 ± 6.55 (Table 1 ). A total of 30.90% of the participants scored ≥ 13 points in the EPDS, while 18.20% achieved a score of ≥ 10 on the GAD-7 scale. The study investigated the distribution of participants' characteristics in terms of EPDS scores. A statistically significant variance was identified among the groups regarding the encounters between the participants and individuals infected with Covid-19 (p 0.05). The distribution of participants' attributes based on GAD-7 scores was also examined. Statistically significant differences were observed in terms of GAD-7 scores based on the presence of chronic health conditions and encounters with Covid-19 patients (p 0.05) (Table 1 ). Table 1 Distribution of participants' characteristics according to FCV-19S, EPDS and GAD-7 scale scores Scales FCV-19S + EPDS ++ GAD-7 +++ t < 13 puan ≥ 13 puan X 2 30 years old 39 ( 35 , 50 ) 0,848 26 ( 34 , 20 ) 13 ( 38 , 20 ) 0,683 34 (37,80) 5 (25,00) 0,28 Education ≤ 12 years 39 ( 35 , 50 ) -1,177 27 ( 35 , 50 ) 12 ( 35 , 30 ) 0,001 a 33 (36,70) 6 (30,00) 0,318 a > 12 years 71 (65,50) 0,242 49 (64,50) 22 (64,70) 0,981 57 (63,30) 14 (70,00) 0,573 Income Good 22 (20,00) -0,726 16 ( 21 , 10 ) 6 (17,60) 0,170 a 20 ( 22 , 20 ) 2 (10,00) 1.528* Middle - Low 88 (80,00) 0.470 60 (78,90) 28 (82,40) 0,68 70 (77,80) 18 (90,00) 0.354 Family type Nuclear 104 (94,50) 0,984 73 (96,10) 31 (91,20) 1,083* 86 (95,60) 18 (90,00) 0,979* Extended 6 ( 5 , 50 ) 0,327 3 (3,90) 3 (8,80) 0,371 4 ( 4 , 40 ) 2 (10,00) 0,299 Social Security Yes 87 (79,10) 0,209 63 (82,90) 24 (70,60) 2,151 a 70 (77,80) 17 (85,00) 0,516 * No 23 (20,90) 0,836 13 ( 17 , 10 ) 10 ( 29 , 40 ) 0,142 20 ( 22 , 20 ) 3 (15,00) 0,56 Working Yes 49 ( 44 , 50 ) -0,722 37 (48,70) 12 ( 35 , 30 ) 1,705 a 41 (45,60) 8 (40,00) 0,204 a No 61 (55,50) 0,472 39 (51,30) 22 (64,70) 0,192 49 ( 43 , 40 ) 12 (60,00) 0,651 Chronic health problem Yes 10 (09,10) -0,316 5 (6,60) 5 (14,70) 1,877* 5 ( 5 , 50 ) 5 (25,00) 7,486* No 100 (90,90) 0,753 71 (93,40) 29 (85,30) 0,279 85 (94,40) 15 (75,00) 0,017 PCR No 69 (62,70) -1,663 51 (67,10) 18 (52,90) 2,016 a 57 (63,30) 12 (60,00) 0,078 a Yes 41 ( 37 , 30 ) 0,099 25 (32,90) 16 ( 47 , 10 ) 0,156 33 (36,70) 8 (40,00) 0,78 Encounter with a Covid-19 patient Yes 76 (69,10) 0,336 48 (63,20) 28 (82,40) 4,053 a 57 (63,30) 19 (95,00) 7,684 a No 34 (30,90) 0,737 28 (36,80) 6 (17,60) 0,044 33 (36,70) 1 (5,00) 0,006 Vaccination Covid-19 I got vaccinated 81 (73,60) 1,121 55 (72,40) 26 (76,50) 0,204 a 66 (73,30) 15 (75,00) 0,023 a I have not been vaccinated 29 ( 26 , 40 ) 0,265 21 (27,60) 8 ( 23 , 50 ) 0,652 24 (26,70) 5 (25,00) 0,878 Total 110 (100,00) 76(100,00) 34 (100,00) 90 (100,00) 20 (100,00) a : Chi square test, *: FisherExact Test. **:Age: X̅±ss = 29,98 ± 5,62 (19–44). +: The Fear of COVID-19 Scale: X̅±ss (Min-Max) = 14,27 ± 6,55 (7–35). EPDS: Edinburgh Postpartum Depression Scale. ++: EPDS X̅±ss (Min-Max) = 9,73 ± 6,00 (0–23). GAD-7: Genarel Anxiety Disorder − 7. +++: GAD-7 X̅±ss (Min-Max) = 5,70 ± 4,34 (0–21) The results of Pearson correlation analysis demonstrate the relationships between EPDS, GAD-7, and FCV-19S scores. The findings suggest a significant positive correlation between EPDS and GAD-7 (r = 0.535, p < 0.01), EPDS and FCV-19S (r = 0.371, p < 0.01), and GAD-7 and FCV-19S (r = 0.213, p < 0.05) (Table 2). Tablo 2 EDDÖ, YAB-7 ve Covid-19 korkusu ölçeklerinin puanlarının korelasyonu EPDS GAD 7 FCV-19S EPDS r 1 p GAD 7 r ,535 ** 1 p ,000 FCV-19S r ,371 ** ,213 * 1 p ,000 ,025 *.p < 0.05 level **.p < 0.01 level EPDS: Edinburgh Postpartum Depression Scale, GAD-7: Genarelized Anxiety Disorder − 7, FCV-19S: The Fear of COVID-19 Scale According to Table 3, a one point increase in GAD 7 scale score increases EPDS by 1.26 times. One point increase in the FCV-19S score increases PPD by 1.11 times. Tablo 3 Table of logistic regression estimation coefficients B S.E. Sig. OR 95% C.I.for EXP(B) Lower Upper Constant -3,869 ,765 ,000 ,021 GAD-7 ,231 ,065 ,000 1,259 1,110 1,429 FCV-19S ,107 ,035 ,003 1,113 1,038 1,193 OR: Odds Ratio Discussion In the scholarly literature, socio-demographic factors that could serve as predictors for PPD are discussed. Key predictors include low educational level, unemployment, and low socioeconomic status, which have been consistently associated with higher PPD rates (Howard et al., 2022; Vrcić Amar & Sejfović, 2023). Marital status is another critical factor, with unmarried women showing a higher risk of developing PPD (Smorti et al., 2019). Additionally, dissatisfaction with marriage and lack of social support from partners, family, and friends are significant predictors (Gök et al., 2023; Molgora et al., 2022). A history of depression or anxiety, both personal and familial, also strongly correlates with PPD, highlighting the importance of mental health history in assessing risk (English et al., 2018; Tsai et al., 2023). Other factors include the number of previous pregnancies and abortions, with increased parity and history of abortion linked to higher PPD rates (Martínez-Borba et al., 2020). Unplanned pregnancies and negative feelings about the pregnancy are also significant predictors (Fiala et al., 2017; Unnisa & Lavanya, 2018). Research in the state of New York, USA, delved into the emotional well-being of womens across various socioeconomic backgrounds. Particularly, amidst the challenges of the pandemic era, it was identified that individuals with lower socioeconomic status experienced elevated EPDS scores (Silverman et al., 2020). In Italy, advanced maternal age and poor physical health were associated with adverse mental health outcomes, while in the Netherlands, this was not observed among mothers with higher educational attainment (Guo et al., 2022). These socio-demographic factors, when identified early, can help in the timely intervention and support for at-risk mothers, potentially mitigating the onset and severity of postpartum depression. In our own investigation, no statistically significant disparities in participants' characteristics were found in relation to EPDS scores (p > 0.05) (Table 1 ). During the Covid-19 pandemic, reported a 42.2% prevalence of postpartum depressive symptoms (Ostacoli et al., 2020). A study in Spain examining PPD during the pandemic categorized participants into two groups: pre-pandemic and pandemic. The incidence of PPD was notably higher among women who delivered during the epidemic (Mariño-Narvaez et al., 2021). A study in northeastern Italy compared the risk of PPD in mothers who gave birth during the Covid-19 pandemic (study group) with those from 2019 (control group), revealing significantly higher EPDS scores in the Covid-19 study group (Zanardo et al., 2020). In a study in Türkiye, it was noted that mothers who contracted Covid-19 and gave birth faced elevated risks of PPD, depression, and anxiety during the Pandemic (Işıkalan et al., 2021). The prevalence of PPD in Türkiye during the pandemic was determined to be 14.7% (Oskovi-Kaplan et al., 2021) and 34% (Guvenc et al., 2021). In our study found that 30.90% of participant scored 13 points or higher on the EPDS scale (Table 1 ), indicating a higher rate compared to pre-pandemic levels in Türkiye. The heightened prevalence of PPD in our study is believed to be linked to the pandemic circumstances, wherein maternity patients lacked social support due to restrictions, experienced quarantine measures, separation from their infants, and fears of contracting or transmitting Covid-19. If postpartum depression is indeed a complex condition influenced by biological, psychological, and social factors, it is likely that the current Covid-19 Pandemic has exacerbated all of these risk elements (Zanardo et al., 2020). Anxiety can be delineated as a broadened anticipation of an impending threat (APA, 2013). In contrast to fear, which exhibits a specific target and is promptly resolved upon the threat's disappearance, anxiety is indistinct and lingers much longer than fear (Leach et al., 2014). The prevalence of anxiety was documented to range between 20–31% and depression 17–33% based on extensive sample studies and meta-analyses conducted with the general populace during the pandemic era (Cooke et al., 2020; Jahrami et al., 2021; Rossi et al., 2020; Salari et al., 2020). Researchers identified in their research that the fear of Covid-19 significantly foretells postpartum anxiety in a favorable manner (Özşahin et al., 2022). Kurt et al. (2022) observed in their study that the fear of Covid-19 escalates perinatal anxiety (Kurt & Çelikay Söyler, 2022). The investigation by Aktaş et al. (2022) revealed that the anxiety levels of postpartum women amid the Covid-19 pandemic were of moderate intensity (Aktaş & İskender, 2022). According to our study outcomes, individuals scoring 10 points or above on the GAD-7 scale signify that roughly one out of five women undergo generalized anxiety. Additionally, a rise of one point in the GAD-7 scale score leads to a 1.26-fold increase in PPD (Table 3). Our research results establish that the fear of Covid-19 and the circumstances of the pandemic, akin to findings in the literature, impact anxiety. Our discoveries hold significant value in comprehending the repercussions of anxiety on PPD. Limitations The study acknowledges several constraints. Primarily, the dynamic nature of the pandemic necessitated the use of online surveys over in-person interviews. This circumstance arose from restricted contact protocols due to the Pandemic. It is imperative to highlight that the respondents who completed the questionnaire constituted a cohort actively engaged with technology, potentially leading to sampling bias. Furthermore, the study should acknowledge the potential impact of factors such as the swift rollout of Covid-19 vaccines in the country, fostering trust, and alleviating anxiety and fears. Nevertheless, the study was not intended to directly assess the efficacy of vaccines or establish causal relationships. Despite these constraints, it is believed that the study could yield valuable insights into postpartum depression. It is anticipated that future research endeavors utilizing diverse methodologies will advance our understanding of this subject matter. Declarations Author Contribution C.N.K.: conceptualization, methodology, simulations, analysis, writing—original draft, writing—review, editing, and validation. H.A.B.: writing— review, and editing- proofreading, editing, and validation. All authors have read and agreed to the published version of the manuscript. Data Availability The datasets used and/or analysed during the current study available from the corresponding author on reasonable request. References Ahorsu, D. K., Lin, C.-Y. Y., Imani, V., Saffari, M., Griffiths, M. D., & Pakpour, A. H. (2022). The Fear of COVID-19 Scale: Development and Initial Validation. International Journal of Mental Health and Addiction , 20 (3), 1537–1545. https://doi.org/10.1007/s11469-020-00270-8 Aktaş, D., & İskender, Ö. (2022). Investigation of Postpartum Anxiety Levels of Women in the COVID-19 Pandemic Process. Journal of Samsun Health Sciences , 7 (2), 339–350. https://doi.org/10.47115/jshs.1022310 Almeida, M. S. de, Nunes, M. A., Camey, S., Pinheiro, A. P., & Schmidt, M. I. (2012). Transtornos mentais em uma amostra de gestantes da rede de atenção básica de saúde no Sul do Brasil. Cadernos de Saúde Pública , 28 (2), 385–394. https://doi.org/10.1590/S0102-311X2012000200017 Alqahtani, J. S., Almamary, A. S., Alghamdi, S. M., Komies, S., Althobiani, M., Aldhahir, A. M., & Naser, A. Y. (2022). Effect of the COVID-19 pandemic on psychological aspects. In COVID-19 and the Sustainable Development Goals (pp. 235–258). Elsevier. https://doi.org/10.1016/B978-0-323-91307-2.00007-9 APA. (2013). Diagnostic and statistical manual of mental disorder (5th ed.). DC. Bakioğlu, F., Korkmaz, O., & Ercan, H. (2021). Fear of COVID-19 and Positivity: Mediating Role of Intolerance of Uncertainty, Depression, Anxiety, and Stress. International Journal of Mental Health and Addiction , 19 (6), 2369–2382. https://doi.org/10.1007/s11469-020-00331-y Chua, M., Lee, J., Sulaiman, S., & Tan, H. K. (2020). From the frontline of COVID-19 - how prepared are we as obstetricians? A commentary. BJOG : An International Journal of Obstetrics and Gynaecology , 127 (7), 786–788. https://doi.org/10.1111/1471-0528.16192 Cooke, J. E., Eirich, R., Racine, N., & Madigan, S. (2020). Prevalence of posttraumatic and general psychological stress during COVID-19: A rapid review and meta-analysis. Psychiatry Research , 292 , 113347. https://doi.org/10.1016/j.psychres.2020.113347 Cox, J. L., Holden, J. M., & Sagovsky, R. (1987). Detection of Postnatal Depression. British Journal of Psychiatry , 150 (6), 782–786. https://doi.org/10.1192/bjp.150.6.782 Davenport, M. H., Meyer, S., Meah, V. L., Strynadka, M. C., & Khurana, R. (2020). Moms Are Not OK: COVID-19 and Maternal Mental Health. Frontiers in Global Women’s Health , 1 . https://doi.org/10.3389/fgwh.2020.00001 Engindeniz, A. N., Küey, L., & Kültür, S. (1996). Edinburgh Doğum Sonrası Depresyon Ölçeği Türkçe formu geçerlilik ve güvenilirlik çalışması. Bahar Sempozyumları-1 , 51–52. https://toad.halileksi.net/olcek/edinburgh-dogum-sonrasi-depresyon-olcegi-2/ English, S., Steele, A., Williams, A., Blacklay, J., Sorinola, O., Wernisch, L., & Grammatopoulos, D. K. (2018). Modelling of psychosocial and lifestyle predictors of peripartum depressive symptoms associated with distinct risk trajectories: a prospective cohort study. Scientific Reports , 8 (1), 12799. https://doi.org/10.1038/s41598-018-30874-z Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods , 41 (4), 1149–1160. https://doi.org/10.3758/BRM.41.4.1149 Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods , 39 (2), 175–191. Fiala, A., Švancara, J., Klánová, J., & Kašpárek, T. (2017). Sociodemographic and delivery risk factors for developing postpartum depression in a sample of 3233 mothers from the Czech ELSPAC study. BMC Psychiatry , 17 (1), 104. https://doi.org/10.1186/s12888-017-1261-y Galletta, M. A. K., Oliveira, A. M. da S. S., Albertini, J. G. L., Benute, G. G., Peres, S. V., Brizot, M. de L., & Francisco, R. P. V. (2022). Postpartum depressive symptoms of Brazilian women during the COVID-19 pandemic measured by the Edinburgh Postnatal Depression Scale. Journal of Affective Disorders , 296 , 577–586. https://doi.org/10.1016/j.jad.2021.09.091 Gök, S., Atıgan, A., & Gök, B. (2023). Frequency of Postpartum Depression and Investigation of Related Factors. Dokuz Eylül Üniversitesi Tıp Fakültesi Dergisi , 36 (3), 287–295. https://doi.org/10.18614/deutip.1194640 Guo, J., De Carli, P., Lodder, P., Bakermans-Kranenburg, M. J., & Riem, M. M. E. (2022). Maternal mental health during the COVID-19 lockdown in China, Italy, and the Netherlands: a cross-validation study. Psychological Medicine , 52 (15), 3349–3359. https://doi.org/10.1017/S0033291720005504 Guvenc, G., Yesilcinar, İ., Ozkececi, F., Öksüz, E., Ozkececi, C. F., Konukbay, D., Kok, G., & Karasahin, K. E. (2021). Anxiety, depression, and knowledge level in postpartum women during the COVID‐19 pandemic. Perspectives in Psychiatric Care , 57 (3), 1449–1458. https://doi.org/10.1111/ppc.12711 Handelzalts, J. E., Hairston, I. S., Levy, S., Orkaby, N., Krissi, H., & Peled, Y. (2022). COVID-19 related worry moderates the association between postpartum depression and mother-infant bonding. Journal of Psychiatric Research , 149 , 83–86. https://doi.org/10.1016/j.jpsychires.2022.02.039 Howard, K., Maples, J. M., & Tinius, R. A. (2022). Modifiable Maternal Factors and Their Relationship to Postpartum Depression. International Journal of Environmental Research and Public Health , 19 (19), 12393. https://doi.org/10.3390/ijerph191912393 Işıkalan, M. M., Gündoğan, K. M., Khiavi, P. E., Alp, E. C., & Acar, A. (2021). Does the Risk of Postpartum Depression Increase in Women Who Gave Birth While Infected With SARS-CoV-2? A Preliminary Study in Turkey. Kocaeli Medical Journal , 10 (50), 29–34. https://doi.org/10.5505/ktd.2021.11129 Jahrami, H., BaHammam, A. S., Bragazzi, N. L., Saif, Z., Faris, M., & Vitiello, M. V. (2021). Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis. Journal of Clinical Sleep Medicine , 17 (2), 299–313. https://doi.org/10.5664/jcsm.8930 Karaçam, Z., Çoban, A., Akbaş, B., & Karabulut, E. (2018). Status of postpartum depression in Turkey: A meta-analysis. Health Care for Women International , 39 (7), 821–841. https://doi.org/10.1080/07399332.2018.1466144 Konkan, R., Şenormancı, Ö., Güçlü, O., Aydın, E., & Sungur, M. Z. (2013). Yaygın Anksiyete Bozukluğu-7 (YAB-7) Testi Türkçe Uyarlaması, Geçerlik ve Güvenirliği. Nöro Psikiyatri Arşivi , 50 (1), 53–58. https://doi.org/10.4274/npa.y6308 Kurt, A., & Çelikay Söyler, H. (2022). The Relationship Between Maternal Attachment, Obsessive Compulsive Disorder and Perinatal Anxiety in Women Who Give Birth During the Covi 19 Period. Journal of Social, Humanities and Administrative Sciences , 5 (3), 225–235. https://doi.org/10.26677/TR1010.2022.930 Lamus, M. N., Pabon, S., MPoca, C., Guida, J. P., Parpinelli, M. A., Cecatti, J. G., Vidarte, M. F., & Costa, M. L. (2021). Giving women WOICE postpartum: prevalence of maternal morbidity in high-risk pregnancies using the WHO-WOICE instrument. BMC Pregnancy and Childbirth , 21 (1), 357. https://doi.org/10.1186/s12884-021-03727-3 Layton, H., Owais, S., Savoy, C. D., & Van Lieshout, R. J. (2021). Depression, Anxiety, and Mother-Infant Bonding in Women Seeking Treatment for Postpartum Depression Before and During the COVID-19 Pandemic. The Journal of Clinical Psychiatry , 82 (4). https://doi.org/10.4088/JCP.21m13874 Leach, L. S., Christensen, H., & Mackinnon, A. (2014). Pregnancy and levels of depression and anxiety: A prospective cohort study of Australian women. Australian & New Zealand Journal of Psychiatry , 48 (10), 944–951. https://doi.org/10.1177/0004867414533013 Liu, T.-C., Peng, H.-C., Chen, C., & Chen, C.-S. (2022). Mode of Delivery Is Associated with Postpartum Depression: Do Women with and without Depression History Exhibit a Difference? Healthcare , 10 (7), 1308. https://doi.org/10.3390/healthcare10071308 Mariño-Narvaez, C., Puertas-Gonzalez, J. A., Romero-Gonzalez, B., & Peralta-Ramirez, M. I. (2021). Giving birth during the COVID-19 pandemic: The impact on birth satisfaction and postpartum depression. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics , 153 (1), 83–88. https://doi.org/10.1002/ijgo.13565 Martínez-Borba, V., Suso-Ribera, C., Osma, J., & Andreu-Pejó, L. (2020). Predicting Postpartum Depressive Symptoms from Pregnancy Biopsychosocial Factors: A Longitudinal Investigation Using Structural Equation Modeling. International Journal of Environmental Research and Public Health , 17 (22), 8445. https://doi.org/10.3390/ijerph17228445 Molgora, S., Saita, E., Barbieri Carones, M., Ferrazzi, E., & Facchin, F. (2022). Predictors of Postpartum Depression among Italian Women: A Longitudinal Study. International Journal of Environmental Research and Public Health , 19 (3), 1553. https://doi.org/10.3390/ijerph19031553 Oskovi-Kaplan, Z. A., Buyuk, G. N., Ozgu-Erdinc, A. S., Keskin, H. L., Ozbas, A., & Moraloglu Tekin, O. (2021). The Effect of COVID-19 Pandemic and Social Restrictions on Depression Rates and Maternal Attachment in Immediate Postpartum Women: a Preliminary Study. Psychiatric Quarterly , 92 (2), 675–682. https://doi.org/10.1007/s11126-020-09843-1 Ostacoli, L., Cosma, S., Bevilacqua, F., Berchialla, P., Bovetti, M., Carosso, A. R., Malandrone, F., Carletto, S., & Benedetto, C. (2020). Psychosocial factors associated with postpartum psychological distress during the Covid-19 pandemic: a cross-sectional study. BMC Pregnancy and Childbirth , 20 (1), 703. https://doi.org/10.1186/s12884-020-03399-5 Özşahin, Z., Erdem, N., Aksakal, Z. G., & Filoğlu, N. (2022). COVİD-19 Korkusunun Annenin Doğumu Algılaması ve Doğum Sonu Anksiyeteye Etkisi. Turkish Journal of Family Medicine and Primary Care , 16 (1), 40–47. https://doi.org/10.21763/tjfmpc.995666 Pierce, M., McManus, S., Hope, H., Hotopf, M., Ford, T., Hatch, S. L., John, A., Kontopantelis, E., Webb, R. T., Wessely, S., & Abel, K. M. (2021). Mental health responses to the COVID-19 pandemic: a latent class trajectory analysis using longitudinal UK data. The Lancet Psychiatry , 8 (7), 610–619. https://doi.org/10.1016/S2215-0366(21)00151-6 Rossi, R., Socci, V., Talevi, D., Mensi, S., Niolu, C., Pacitti, F., Di Marco, A., Rossi, A., Siracusano, A., & Di Lorenzo, G. (2020). COVID-19 Pandemic and Lockdown Measures Impact on Mental Health Among the General Population in Italy. Frontiers in Psychiatry , 11 . https://doi.org/10.3389/fpsyt.2020.00790 Salari, N., Hosseinian-Far, A., Jalali, R., Vaisi-Raygani, A., Rasoulpoor, S., Mohammadi, M., Rasoulpoor, S., & Khaledi-Paveh, B. (2020). Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. Globalization and Health , 16 (1), 57. https://doi.org/10.1186/s12992-020-00589-w Shigemura, J., Ursano, R. J., Morganstein, J. C., Kurosawa, M., & Benedek, D. M. (2020). Public responses to the novel 2019 coronavirus (2019‐nCoV) in Japan: Mental health consequences and target populations. Psychiatry and Clinical Neurosciences , 74 (4), 281–282. https://doi.org/10.1111/pcn.12988 Silva, M. M. de J., Nogueira, D. A., Clapis, M. J., & Leite, E. P. R. C. (2017). Anxiety in pregnancy: prevalence and associated factors. Revista Da Escola de Enfermagem Da USP , 51 . https://doi.org/10.1590/s1980-220x2016048003253 Silverman, M. E., Burgos, L., Rodriguez, Z. I., Afzal, O., Kalishman, A., Callipari, F., Pena, Y., Gabay, R., & Loudon, H. (2020). Postpartum mood among universally screened high and low socioeconomic status patients during COVID-19 social restrictions in New York City. Scientific Reports , 10 (1), 22380. https://doi.org/10.1038/s41598-020-79564-9 Smorti, M., Ponti, L., & Pancetti, F. (2019). A Comprehensive Analysis of Post-partum Depression Risk Factors: The Role of Socio-Demographic, Individual, Relational, and Delivery Characteristics. Frontiers in Public Health , 7 . https://doi.org/10.3389/fpubh.2019.00295 Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A Brief Measure for Assessing Generalized Anxiety Disorder. Archives of Internal Medicine , 166 (10), 1092. https://doi.org/10.1001/archinte.166.10.1092 Stepowicz, A., Wencka, B., Bieńkiewicz, J., Horzelski, W., & Grzesiak, M. (2020). Stress and Anxiety Levels in Pregnant and Post-Partum Women during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health , 17 (24). https://doi.org/10.3390/ijerph17249450 Tsai, J.-M., Tsai, L.-Y., Tsay, S.-L., & Chen, Y.-H. (2023). The prevalence and risk factors of postpartum depression among women during the early postpartum period: a retrospective secondary data analysis. Taiwanese Journal of Obstetrics and Gynecology , 62 (3), 406–411. https://doi.org/10.1016/j.tjog.2023.03.003 Unnisa, S., & Lavanya, P. S. (2018). The predictors of post-partum depression in a tertiary centre. International Journal of Reproduction, Contraception, Obstetrics and Gynecology , 7 (6), 2218. https://doi.org/10.18203/2320-1770.ijrcog20182323 Vrcić Amar, A., & Sejfović, H. (2023). Perceived social support, newborn temperament and socioeconomic status in postpartum depression: report from southwest Serbia. Archives of Psychiatry and Psychotherapy , 25 (1), 33–41. https://doi.org/10.12740/APP/152779 WHO. (2020). COVID-19: operational guidance for maintaining essential health services during an outbreak: interim guidance, 25 March 2020 . World Health Organization. https://iris.who.int/handle/10665/331561 Zanardo, V., Manghina, V., Giliberti, L., Vettore, M., Severino, L., & Straface, G. (2020). Psychological impact of COVID-19 quarantine measures in northeastern Italy on mothers in the immediate postpartum period. International Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics , 150 (2), 184–188. https://doi.org/10.1002/ijgo.13249 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4693602","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":333944444,"identity":"6646cfe4-6ff4-4dbc-bad0-e133b886a742","order_by":0,"name":"Cennet Nur KIZOGLU","email":"","orcid":"","institution":"Güneyce Salih Köse Health House, İkizdere, Rize, Turkey","correspondingAuthor":false,"prefix":"","firstName":"Cennet","middleName":"Nur","lastName":"KIZOGLU","suffix":""},{"id":333944445,"identity":"a447fc82-a26f-412e-acaa-7e49738a7863","order_by":1,"name":"HATİCE ACAR BEKTAS","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA6UlEQVRIiWNgGAWjYJACZgaGBBB1DMxjYydSiwRQbRpYKxsz8Vp4zKC2EVDO33742eeCirQ6/v4z3x58/LFNno+ZgfHDxxzcWiTOpBnPnnEmR0LiRu52wxkJtw3bmBmYJWduw2PNDQZjZt62CgmGG7zbpHkSbjMCtbAx8+LRIn+D/TMz778KCfnzZ56BtNgT1GJwgwdoS0OOhMGBHDaQlkSCWgzP5BQzzziWJrnxRpqZ5Iy028ltzIzNeP0id/z4ZuaCmmR+ufOHn0l8sLltO7+9+eCHj/i8jwUwNpCmfhSMglEwCkYBBgAAxUhKn5L9ovEAAAAASUVORK5CYII=","orcid":"","institution":"Tokat Gaziosmanpaşa University","correspondingAuthor":true,"prefix":"","firstName":"HATİCE","middleName":"ACAR","lastName":"BEKTAS","suffix":""}],"badges":[],"createdAt":"2024-07-05 17:02:37","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4693602/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4693602/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":73434519,"identity":"fcce5da8-a4d2-4807-800e-7fc81fd4d4e1","added_by":"auto","created_at":"2025-01-10 01:46:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":906780,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4693602/v1/41ba4c51-6974-4985-8aac-8ab17b7673e3.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Effect of Fear of Covid-19 on Anxiety and Postpartum Depression in Postpartum Women: Cross-sectional study","fulltext":[{"header":"Article Highlights","content":"\u003cul class=\"decimal_type\"\u003e\n \u003cli\u003eThe fear of COVID-19 exerts a notable influence on levels of anxiety and depression experienced during the postpartum period.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eThis research indicates a substantial occurrence of postpartum depression (30.90%) and generalized anxiety disorder (18.20%).\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eA heightened fear of COVID-19 is associated with elevated scores of anxiety and depression.\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eThe research highlights the necessity for providing mental health assistance to women in the postpartum phase during disaster like pandemics.\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"Introduction","content":"\u003cp\u003eThe declaration by the World Health Organization (WHO) (2020) indicates that anxiety and somatic complaints are more prevalent among women amid the Covid-19 Pandemic\u0026nbsp;(WHO, 2020). Women who are dedicated to fulfilling the caregiving responsibilities for their family members over an extended period at home are potentially exposed to higher susceptibility to both the Covid-19 pandemic and subsequent mental health disorders. This revelation underscores the urgent necessity for a more extensive evaluation and management of maternal mental well-being.\u003c/p\u003e\n\u003cp\u003eThe combination of the perilous postpartum phase and the presence of the Covid-19 pandemic may have elevated the likelihood of encountering substantial health issues in women. The second week following childbirth holds significant importance concerning postpartum depression (PPD). The apprehension felt during this period escalates anxiety and stress levels in individuals, thereby exacerbating pre-existing psychiatric symptoms\u0026nbsp;(Shigemura et al., 2020). Various factors such as the risk of viral transmission postpartum, the limitations on receiving partner support during childbirth due to stringent isolation measures, the absence of family members at the hospital post-delivery, and the enforcement of a 14-day quarantine period at home following childbirth have all contributed to the predisposition to PPD\u0026nbsp;(Liu et al., 2022). The Covid-19 pandemic has been linked to a notable augmentation in the probability of depression and anxiety among mothers\u0026nbsp;(Pierce et al., 2021).\u003c/p\u003e\n\u003cp\u003eResearch conducted in different nations has presented evidence indicating a surge in the prevalence of PPD during the pandemic\u0026nbsp;(Handelzalts et al., 2022; Layton et al., 2021; Mariño-Narvaez et al., 2021; Ostacoli et al., 2020; Zanardo et al., 2020). In a study focusing on pregnant women and those in the initial year postpartum, it was found that the occurrence of PPD increased from 15% in the pre-pandemic era to 40.7% during the pandemic. Moreover, 29% of women exhibited moderate to high anxiety levels before the pandemic, whereas the figure rose to 72% during the pandemic. Elevated PPD scores have been correlated with Covid-19-induced anxiety owing to PPD's susceptibility to environmental stressors\u0026nbsp;(Davenport et al., 2020).\u003c/p\u003e\n\u003cp\u003eDuring periods of global turmoil, the escalation of fear, anxiety, and stress levels correspond with heightened stressors like insomnia, health-related anxieties, frustration, fear of contracting the virus, and feelings of isolation\u0026nbsp;(Alqahtani et al., 2022). This scenario contributes to the separation of mothers with confirmed or suspected Covid diagnosis from their newborns, resulting in the inability to breastfeed, lack of skin-to-skin contact, delayed mother-infant bonding, and disrupted breastfeeding continuity. Consequently, this leads to increased stress and anxiety for mothers during the postpartum period\u0026nbsp;(Chua et al., 2020; Stepowicz et al., 2020).\u003c/p\u003e\n\u003cp\u003eAnxiety emerges as a primary factor linked to perinatal depression\u0026nbsp;(Galletta et al., 2022). In Brazil, the prevalence rates of anxiety during pregnancy range from 19.8% to 42.9%\u0026nbsp;(Almeida et al., 2012; Silva et al., 2017), and hover around 20% in the postpartum phase\u0026nbsp;(Lamus et al., 2021)\u003c/p\u003e\n\u003cp\u003eIn this investigation, the primary objective was to ascertain the impact of Covid-19 apprehension on anxiety and\u0026nbsp;postpartum depression\u0026nbsp;in maternity patients.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Research questions\u003c/p\u003e\n\u003cp\u003e1. What is the prevalence rate of\u0026nbsp;postpartum depression\u0026nbsp;during the outbreak?\u003c/p\u003e\n\u003cp\u003e2. What is the prevalence rate of generalized anxiety in the postnatal period during the outbreak?\u003c/p\u003e\n\u003cp\u003e3. What is the status of Covid-19 apprehension in women in the postnatal period during the outbreak?\u003c/p\u003e\n\u003cp\u003e4. What is the influence of Covid-19 apprehension on the prevalence of\u0026nbsp;postpartum depression?\u003c/p\u003e\n\u003cp\u003e5. What is the influence of generalized anxiety disorder on the prevalence of\u0026nbsp;postpartum depression?\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis research is cross-sectional study. The data was gathered online from women who gave birth at state hospital. in the northern region of T\u0026uuml;rkiye during the pandemic period spanning from December 2021, to June 2022, within a timeframe of 2\u0026ndash;4 weeks postpartum. Face to face meetings could not be held due to the measures taken during the pandemic period.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eSample\u003c/h2\u003e \u003cp\u003eThe determination of the sample size was conducted utilizing the G*Power 3.1.9.4 software. The effect size was identified as 0.3, with an alpha value of 0.05, power of 0.90, leading to the selection of 110 participants (Faul et al., 2007, 2009). The recruitment of participants for the study was done through convenience sampling.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eParticipant\u003c/h2\u003e \u003cdiv id=\"Sec5\" class=\"Section3\"\u003e \u003ch2\u003eData Collection\u003c/h2\u003e \u003cp\u003eContact details of the volunteering women were acquired by the midwives/nurses working in the relevant unit and forwarded to the researcher. Online questionnaires were administered by the researcher between 2\u0026ndash;4 weeks postpartum, and responses were collected.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section3\"\u003e \u003ch2\u003eScales\u003c/h2\u003e \u003cp\u003eThe collection of data involved the use of a introductory information, Edinburgh Postpartum Depression Scale (EPDS), General Anxiety Disorder-7 (GAD-7)Test, and The Fear of COVID-19 Scale (FCV-19S).\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe introductory information\u003c/b\u003e sheet comprised inquiries regarding socio-demographic characteristics, Covid-19 testing and vaccination status.\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe Edinburgh Postpartum Depression Scale (EPDS)\u003c/b\u003e is a self-report instrument presented in a quadruple Likert format with 10 items by Cox et al 1987 (Cox et al., 1987). The Turkish validation study was carried out by Engindeniz et al 1996 (Engindeniz et al., 1996). The responses, which consist of four choices, are scored from 0 to 3, resulting in a total score ranging from 0 to 30. A score of \u0026ge;\u0026thinsp;13 is indicative of a risk for PPD, with higher scores reflecting increased severity (Kara\u0026ccedil;am et al., 2018). In the present study, the Cronbach's alpha coefficient for the scale was calculated as 0.85.\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe General Anxiety Disorder-7 Test (GAD-7)\u003c/b\u003e is a concise self-report evaluation tool designed to assess generalized anxiety disorder based on DSM-IV-TR criteria, developed by Spitzer et al 2006 (Spitzer et al., 2006). The Turkish validation study was conducted by Konkan et al. 2013 (Konkan et al., 2013). It consists of a 7-item quadruple Likert type scale that gauges experiences over the past 2 weeks. The scale defines cut-off points for mild, moderate, and severe anxiety at scores of 5, 10, and 15, respectively. In the current investigation, the Cronbach's alpha value for the scale was computed as 0.87.\u003c/p\u003e \u003cp\u003e \u003cb\u003eThe Fear of COVID-19 Scale (FCV-19S)\u003c/b\u003e, developed by Ahorsu et al. (2020) (Ahorsu et al., 2022), aims to assess the level of fear induced by Covid-19. The Turkish validation study was conducted by Bakioğlu et al. (2021)(Bakioğlu et al., 2021). This scale, with a one-factor structure, consists of seven items in a five-factor Likert format. Higher scores on the scale denote elevated levels of Covid-19 fear, although there is no specific cut-off point. In the current study, the Cronbach's alpha coefficient for the scale was determined as 0.91.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section3\"\u003e \u003ch2\u003eEthical considerations\u003c/h2\u003e \u003cp\u003e Ethical issues were prioritized in this study with the approval received from the Ministry of Health of the Republic of Turkey, X University Social Sciences and Humanities Research Ethics Committee (Date:16.12.2021 No: 26.03) as well as the relevant institutions and scale authors. Since the questionnaires were administered online, all participants' informed consent was also obtained online. All methods were carried out in accordance with relevant rules and regulations. This study was performed in line with the principles of the Declaration of Helsinki.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData analysis\u003c/h2\u003e \u003cp\u003eData analysis was performed using a statistical software package. The data was assessed to conform to normal distribution and possess evenly distributed variances. Continuous variables were evaluated using t-tests, while categorical variables were compared using chi-square tests. Pearson correlation analysis was conducted to determine the strength and direction of linear relationships between the scales. Descriptive statistics were presented in terms of means and standard deviations or numbers and percentages, and logistic regression prediction multiples were computed. Furthermore, Cronbach's Alpha coefficients were calculated for the scales utilized.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003e110 females aged between 19 and 44 years were enrolled in the research, with a mean age of 29.98\u0026thinsp;\u0026plusmn;\u0026thinsp;5.62. The investigation revealed that 35.50% of the participants had attained an education level of 12 years or below, 80.00% were classified as having a medium to poor income status, and 94.50% resided within a nuclear family structure. Additionally, findings indicated that 20.90% of the female subjects lacked social security, and 55.50% were not engaged in any income-generating occupation. Moreover, it was established that 62.70% of the participants had not undergone Covid-19 testing during their gestation period. Out of the total, 13.60% of the participants tested positive for Covid-19 while pregnant, while 23.60% received negative test results. Furthermore, 73.60% of the participants reported being vaccinated against Covid-19 before childbirth. No distinctions were observed in the characteristics of the participants concerning the average score on the FCV-19S (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The mean EPDS score among the subjects was calculated as 9.73\u0026thinsp;\u0026plusmn;\u0026thinsp;6.00, the mean GAD-7 score as 5.70\u0026thinsp;\u0026plusmn;\u0026thinsp;4.34, and the FCV-19S mean as 14.27\u0026thinsp;\u0026plusmn;\u0026thinsp;6.55 (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). A total of 30.90% of the participants scored\u0026thinsp;\u0026ge;\u0026thinsp;13 points in the EPDS, while 18.20% achieved a score of \u0026ge;\u0026thinsp;10 on the GAD-7 scale. The study investigated the distribution of participants' characteristics in terms of EPDS scores. A statistically significant variance was identified among the groups regarding the encounters between the participants and individuals infected with Covid-19 (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). No statistically significant differences were noted in the participants' other attributes concerning EPDS scores (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05). The distribution of participants' attributes based on GAD-7 scores was also examined. Statistically significant differences were observed in terms of GAD-7 scores based on the presence of chronic health conditions and encounters with Covid-19 patients (p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). However, no significant variations were found among the participants' other features concerning GAD-7 scores (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDistribution of participants' characteristics according to FCV-19S, EPDS and GAD-7 scale scores\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"8\" nameend=\"c10\" namest=\"c3\"\u003e \u003cp\u003eScales\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eFCV-19S\u003csup\u003e+\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eEPDS \u003csup\u003e++\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c10\" namest=\"c8\"\u003e \u003cp\u003eGAD-7\u003csup\u003e+++\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003et\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;13 puan\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;13 puan\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;10 puan\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026ge;\u0026thinsp;10 puan\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eX\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVariables\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u003cb\u003en (%)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003ep\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAge**\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;30 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71 (64.50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0,172\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e50 (65,80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21 (61,80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,166\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e56 (62,20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e15 (75,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1,167\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;30 years old\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,848\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26 (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13 (\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,683\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e34 (37,80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5 (25,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026le;\u0026thinsp;12 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e39 (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1,177\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e27 (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,001\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e33 (36,70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e6 (30,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,318\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;12 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71 (65,50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,242\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49 (64,50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22 (64,70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,981\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e57 (63,30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e14 (70,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,573\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eIncome\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGood\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22 (20,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0,726\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16 (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 (17,60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,170\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e20 (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 (10,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.528*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMiddle - Low\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e88 (80,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.470\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e60 (78,90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28 (82,40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e70 (77,80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e18 (90,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.354\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eFamily type\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNuclear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e104 (94,50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,984\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e73 (96,10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e31 (91,20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1,083*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e86 (95,60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e18 (90,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,979*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eExtended\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,327\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3 (3,90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3 (8,80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,371\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4 (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e2 (10,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,299\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eSocial Security\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e87 (79,10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63 (82,90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24 (70,60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2,151\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e70 (77,80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e17 (85,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,516\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23 (20,90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,836\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13 (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10 (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,142\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e20 (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e3 (15,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eWorking\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49 (\u003cspan citationid=\"CR44\" class=\"CitationRef\"\u003e44\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0,722\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e37 (48,70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12 (\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1,705\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e41 (45,60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e8 (40,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,204\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e61 (55,50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,472\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e39 (51,30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e22 (64,70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,192\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e49 (\u003cspan citationid=\"CR43\" class=\"CitationRef\"\u003e43\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e12 (60,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,651\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eChronic health problem\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10 (09,10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-0,316\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5 (6,60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5 (14,70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1,877*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5 (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5 (25,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e7,486*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100 (90,90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,753\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e71 (93,40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29 (85,30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,279\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e85 (94,40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e15 (75,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0,017\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003ePCR\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e69 (62,70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-1,663\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51 (67,10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18 (52,90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2,016\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e57 (63,30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e12 (60,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,078\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41 (\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,099\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25 (32,90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16 (\u003cspan citationid=\"CR47\" class=\"CitationRef\"\u003e47\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,156\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e33 (36,70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e8 (40,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,78\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eEncounter with a Covid-19 patient\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76 (69,10)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,336\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e48 (63,20)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28 (82,40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4,053\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e57 (63,30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e19 (95,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e7,684\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34 (30,90)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,737\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28 (36,80)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6 (17,60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0,044\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e33 (36,70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1 (5,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e\u003cb\u003e0,006\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eVaccination Covid-19\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI got vaccinated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81 (73,60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1,121\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e55 (72,40)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26 (76,50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,204\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e66 (73,30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e15 (75,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,023\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI have not been vaccinated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29 (\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e, \u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0,265\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21 (27,60)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8 (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e, \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e50\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0,652\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e24 (26,70)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e5 (25,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0,878\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTotal\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e110 (100,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e76(100,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34 (100,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e90 (100,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e20 (100,00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"10\" nameend=\"c10\" namest=\"c1\"\u003e \u003cp\u003e\u003csup\u003ea\u003c/sup\u003e: Chi square test, *: FisherExact Test. **:Age: X̅\u0026plusmn;ss\u0026thinsp;=\u0026thinsp;29,98\u0026thinsp;\u0026plusmn;\u0026thinsp;5,62 (19\u0026ndash;44). +: The Fear of COVID-19 Scale: X̅\u0026plusmn;ss (Min-Max)\u0026thinsp;=\u0026thinsp;14,27\u0026thinsp;\u0026plusmn;\u0026thinsp;6,55 (7\u0026ndash;35). EPDS: Edinburgh Postpartum Depression Scale. ++: EPDS X̅\u0026plusmn;ss (Min-Max)\u0026thinsp;=\u0026thinsp;9,73\u0026thinsp;\u0026plusmn;\u0026thinsp;6,00 (0\u0026ndash;23). GAD-7: Genarel Anxiety Disorder \u0026minus;\u0026thinsp;7. +++: GAD-7 X̅\u0026plusmn;ss (Min-Max)\u0026thinsp;=\u0026thinsp;5,70\u0026thinsp;\u0026plusmn;\u0026thinsp;4,34 (0\u0026ndash;21)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe results of Pearson correlation analysis demonstrate the relationships between EPDS, GAD-7, and FCV-19S scores. The findings suggest a significant positive correlation between EPDS and GAD-7 (r\u0026thinsp;=\u0026thinsp;0.535, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), EPDS and FCV-19S (r\u0026thinsp;=\u0026thinsp;0.371, p\u0026thinsp;\u0026lt;\u0026thinsp;0.01), and GAD-7 and FCV-19S (r\u0026thinsp;=\u0026thinsp;0.213, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) (Table\u0026nbsp;2).\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eTablo 2\u003c/strong\u003e \u003cp\u003eEDD\u0026Ouml;, YAB-7 ve Covid-19 korkusu \u0026ouml;l\u0026ccedil;eklerinin puanlarının korelasyonu\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Taba\" border=\"1\"\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEPDS\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eGAD 7\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFCV-19S\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eEPDS\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eGAD 7\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e,535\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003e\u003cb\u003eFCV-19S\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003er\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e,371\u003csup\u003e**\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,213\u003csup\u003e*\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,025\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e \u003cp\u003e*.p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 level **.p\u0026thinsp;\u0026lt;\u0026thinsp;0.01 level\u003c/p\u003e \u003cp\u003eEPDS: Edinburgh Postpartum Depression Scale, GAD-7: Genarelized Anxiety Disorder \u0026minus;\u0026thinsp;7, FCV-19S: The Fear of COVID-19 Scale\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAccording to Table\u0026nbsp;3, a one point increase in GAD 7 scale score increases EPDS by 1.26 times. One point increase in the FCV-19S score increases PPD by 1.11 times.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eTablo 3\u003c/strong\u003e \u003cp\u003eTable of logistic regression estimation coefficients\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"No\" id=\"Tabb\" border=\"1\"\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eB\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eS.E.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eSig.\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eOR\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"4\" nameend=\"c9\" namest=\"c6\"\u003e \u003cp\u003e95% C.I.for EXP(B)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eLower\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003eUpper\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConstant\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e-3,869\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e,765\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e,021\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGAD-7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e,231\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e,065\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1,259\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e1,110\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1,429\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFCV-19S\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e,107\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e,035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e,003\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u003cb\u003e1,113\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e1,038\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1,193\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003eOR: Odds Ratio\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eIn the scholarly literature, socio-demographic factors that could serve as predictors for PPD are discussed. Key predictors include low educational level, unemployment, and low socioeconomic status, which have been consistently associated with higher PPD rates (Howard et al., 2022; Vrcić Amar \u0026amp; Sejfović, 2023). Marital status is another critical factor, with unmarried women showing a higher risk of developing PPD (Smorti et al., 2019). Additionally, dissatisfaction with marriage and lack of social support from partners, family, and friends are significant predictors (G\u0026ouml;k et al., 2023; Molgora et al., 2022). A history of depression or anxiety, both personal and familial, also strongly correlates with PPD, highlighting the importance of mental health history in assessing risk (English et al., 2018; Tsai et al., 2023). Other factors include the number of previous pregnancies and abortions, with increased parity and history of abortion linked to higher PPD rates (Mart\u0026iacute;nez-Borba et al., 2020). Unplanned pregnancies and negative feelings about the pregnancy are also significant predictors (Fiala et al., 2017; Unnisa \u0026amp; Lavanya, 2018). Research in the state of New York, USA, delved into the emotional well-being of womens across various socioeconomic backgrounds. Particularly, amidst the challenges of the pandemic era, it was identified that individuals with lower socioeconomic status experienced elevated EPDS scores (Silverman et al., 2020). In Italy, advanced maternal age and poor physical health were associated with adverse mental health outcomes, while in the Netherlands, this was not observed among mothers with higher educational attainment (Guo et al., 2022). These socio-demographic factors, when identified early, can help in the timely intervention and support for at-risk mothers, potentially mitigating the onset and severity of postpartum depression. In our own investigation, no statistically significant disparities in participants' characteristics were found in relation to EPDS scores (p\u0026thinsp;\u0026gt;\u0026thinsp;0.05) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eDuring the Covid-19 pandemic, reported a 42.2% prevalence of postpartum depressive symptoms (Ostacoli et al., 2020). A study in Spain examining PPD during the pandemic categorized participants into two groups: pre-pandemic and pandemic. The incidence of PPD was notably higher among women who delivered during the epidemic (Mari\u0026ntilde;o-Narvaez et al., 2021). A study in northeastern Italy compared the risk of PPD in mothers who gave birth during the Covid-19 pandemic (study group) with those from 2019 (control group), revealing significantly higher EPDS scores in the Covid-19 study group (Zanardo et al., 2020).\u003c/p\u003e \u003cp\u003eIn a study in T\u0026uuml;rkiye, it was noted that mothers who contracted Covid-19 and gave birth faced elevated risks of PPD, depression, and anxiety during the Pandemic (Işıkalan et al., 2021). The prevalence of PPD in T\u0026uuml;rkiye during the pandemic was determined to be 14.7% (Oskovi-Kaplan et al., 2021) and 34% (Guvenc et al., 2021). In our study found that 30.90% of participant scored 13 points or higher on the EPDS scale (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e), indicating a higher rate compared to pre-pandemic levels in T\u0026uuml;rkiye. The heightened prevalence of PPD in our study is believed to be linked to the pandemic circumstances, wherein maternity patients lacked social support due to restrictions, experienced quarantine measures, separation from their infants, and fears of contracting or transmitting Covid-19. If postpartum depression is indeed a complex condition influenced by biological, psychological, and social factors, it is likely that the current Covid-19 Pandemic has exacerbated all of these risk elements (Zanardo et al., 2020).\u003c/p\u003e \u003cp\u003eAnxiety can be delineated as a broadened anticipation of an impending threat (APA, 2013). In contrast to fear, which exhibits a specific target and is promptly resolved upon the threat's disappearance, anxiety is indistinct and lingers much longer than fear (Leach et al., 2014). The prevalence of anxiety was documented to range between 20\u0026ndash;31% and depression 17\u0026ndash;33% based on extensive sample studies and meta-analyses conducted with the general populace during the pandemic era (Cooke et al., 2020; Jahrami et al., 2021; Rossi et al., 2020; Salari et al., 2020). Researchers identified in their research that the fear of Covid-19 significantly foretells postpartum anxiety in a favorable manner (\u0026Ouml;zşahin et al., 2022). Kurt et al. (2022) observed in their study that the fear of Covid-19 escalates perinatal anxiety (Kurt \u0026amp; \u0026Ccedil;elikay S\u0026ouml;yler, 2022). The investigation by Aktaş et al. (2022) revealed that the anxiety levels of postpartum women amid the Covid-19 pandemic were of moderate intensity (Aktaş \u0026amp; İskender, 2022). According to our study outcomes, individuals scoring 10 points or above on the GAD-7 scale signify that roughly one out of five women undergo generalized anxiety. Additionally, a rise of one point in the GAD-7 scale score leads to a 1.26-fold increase in PPD (Table\u0026nbsp;3). Our research results establish that the fear of Covid-19 and the circumstances of the pandemic, akin to findings in the literature, impact anxiety. Our discoveries hold significant value in comprehending the repercussions of anxiety on PPD.\u003c/p\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eLimitations\u003c/h2\u003e \u003cp\u003eThe study acknowledges several constraints. Primarily, the dynamic nature of the pandemic necessitated the use of online surveys over in-person interviews. This circumstance arose from restricted contact protocols due to the Pandemic. It is imperative to highlight that the respondents who completed the questionnaire constituted a cohort actively engaged with technology, potentially leading to sampling bias. Furthermore, the study should acknowledge the potential impact of factors such as the swift rollout of Covid-19 vaccines in the country, fostering trust, and alleviating anxiety and fears. Nevertheless, the study was not intended to directly assess the efficacy of vaccines or establish causal relationships. Despite these constraints, it is believed that the study could yield valuable insights into postpartum depression. It is anticipated that future research endeavors utilizing diverse methodologies will advance our understanding of this subject matter.\u003c/p\u003e \u003c/div\u003e"},{"header":"Declarations","content":"\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eC.N.K.: conceptualization, methodology, simulations, analysis, writing\u0026mdash;original draft, writing\u0026mdash;review, editing, and validation. H.A.B.: writing\u0026mdash; review, and editing- proofreading, editing, and validation. All authors have read and agreed to the published version of the manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe datasets used and/or analysed during the current study available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eAhorsu, D. K., Lin, C.-Y. Y., Imani, V., Saffari, M., Griffiths, M. D., \u0026amp; Pakpour, A. H. (2022). The Fear of COVID-19 Scale: Development and Initial Validation. \u003cem\u003eInternational Journal of Mental Health and Addiction\u003c/em\u003e, \u003cem\u003e20\u003c/em\u003e(3), 1537\u0026ndash;1545. https://doi.org/10.1007/s11469-020-00270-8\u003c/li\u003e\n \u003cli\u003eAktaş, D., \u0026amp; İskender, \u0026Ouml;. (2022). Investigation of Postpartum Anxiety Levels of Women in the COVID-19 Pandemic Process. \u003cem\u003eJournal of Samsun Health Sciences\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(2), 339\u0026ndash;350. https://doi.org/10.47115/jshs.1022310\u003c/li\u003e\n \u003cli\u003eAlmeida, M. S. de, Nunes, M. A., Camey, S., Pinheiro, A. P., \u0026amp; Schmidt, M. I. (2012). Transtornos mentais em uma amostra de gestantes da rede de aten\u0026ccedil;\u0026atilde;o b\u0026aacute;sica de sa\u0026uacute;de no Sul do Brasil. \u003cem\u003eCadernos de Sa\u0026uacute;de P\u0026uacute;blica\u003c/em\u003e, \u003cem\u003e28\u003c/em\u003e(2), 385\u0026ndash;394. https://doi.org/10.1590/S0102-311X2012000200017\u003c/li\u003e\n \u003cli\u003eAlqahtani, J. S., Almamary, A. S., Alghamdi, S. M., Komies, S., Althobiani, M., Aldhahir, A. M., \u0026amp; Naser, A. Y. (2022). Effect of the COVID-19 pandemic on psychological aspects. In \u003cem\u003eCOVID-19 and the Sustainable Development Goals\u003c/em\u003e (pp. 235\u0026ndash;258). Elsevier. https://doi.org/10.1016/B978-0-323-91307-2.00007-9\u003c/li\u003e\n \u003cli\u003eAPA. (2013). \u003cem\u003eDiagnostic and statistical manual of mental disorder\u003c/em\u003e (5th ed.). DC.\u003c/li\u003e\n \u003cli\u003eBakioğlu, F., Korkmaz, O., \u0026amp; Ercan, H. (2021). Fear of COVID-19 and Positivity: Mediating Role of Intolerance of Uncertainty, Depression, Anxiety, and Stress. \u003cem\u003eInternational Journal of Mental Health and Addiction\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e(6), 2369\u0026ndash;2382. https://doi.org/10.1007/s11469-020-00331-y\u003c/li\u003e\n \u003cli\u003eChua, M., Lee, J., Sulaiman, S., \u0026amp; Tan, H. K. (2020). From the frontline of COVID-19 - how prepared are we as obstetricians? A commentary. \u003cem\u003eBJOG : An International Journal of Obstetrics and Gynaecology\u003c/em\u003e, \u003cem\u003e127\u003c/em\u003e(7), 786\u0026ndash;788. https://doi.org/10.1111/1471-0528.16192\u003c/li\u003e\n \u003cli\u003eCooke, J. E., Eirich, R., Racine, N., \u0026amp; Madigan, S. (2020). Prevalence of posttraumatic and general psychological stress during COVID-19: A rapid review and meta-analysis. \u003cem\u003ePsychiatry Research\u003c/em\u003e, \u003cem\u003e292\u003c/em\u003e, 113347. https://doi.org/10.1016/j.psychres.2020.113347\u003c/li\u003e\n \u003cli\u003eCox, J. L., Holden, J. M., \u0026amp; Sagovsky, R. (1987). Detection of Postnatal Depression. \u003cem\u003eBritish Journal of Psychiatry\u003c/em\u003e, \u003cem\u003e150\u003c/em\u003e(6), 782\u0026ndash;786. https://doi.org/10.1192/bjp.150.6.782\u003c/li\u003e\n \u003cli\u003eDavenport, M. H., Meyer, S., Meah, V. L., Strynadka, M. C., \u0026amp; Khurana, R. (2020). Moms Are Not OK: COVID-19 and Maternal Mental Health. \u003cem\u003eFrontiers in Global Women\u0026rsquo;s Health\u003c/em\u003e, \u003cem\u003e1\u003c/em\u003e. https://doi.org/10.3389/fgwh.2020.00001\u003c/li\u003e\n \u003cli\u003eEngindeniz, A. N., K\u0026uuml;ey, L., \u0026amp; K\u0026uuml;lt\u0026uuml;r, S. (1996). Edinburgh Doğum Sonrası Depresyon \u0026Ouml;l\u0026ccedil;eği T\u0026uuml;rk\u0026ccedil;e formu ge\u0026ccedil;erlilik ve g\u0026uuml;venilirlik \u0026ccedil;alışması. \u003cem\u003eBahar Sempozyumları-1\u003c/em\u003e, 51\u0026ndash;52. https://toad.halileksi.net/olcek/edinburgh-dogum-sonrasi-depresyon-olcegi-2/\u003c/li\u003e\n \u003cli\u003eEnglish, S., Steele, A., Williams, A., Blacklay, J., Sorinola, O., Wernisch, L., \u0026amp; Grammatopoulos, D. K. (2018). Modelling of psychosocial and lifestyle predictors of peripartum depressive symptoms associated with distinct risk trajectories: a prospective cohort study. \u003cem\u003eScientific Reports\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(1), 12799. https://doi.org/10.1038/s41598-018-30874-z\u003c/li\u003e\n \u003cli\u003eFaul, F., Erdfelder, E., Buchner, A., \u0026amp; Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. \u003cem\u003eBehavior Research Methods\u003c/em\u003e, \u003cem\u003e41\u003c/em\u003e(4), 1149\u0026ndash;1160. https://doi.org/10.3758/BRM.41.4.1149\u003c/li\u003e\n \u003cli\u003eFaul, F., Erdfelder, E., Lang, A.-G., \u0026amp; Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. \u003cem\u003eBehavior Research Methods\u003c/em\u003e, \u003cem\u003e39\u003c/em\u003e(2), 175\u0026ndash;191.\u003c/li\u003e\n \u003cli\u003eFiala, A., \u0026Scaron;vancara, J., Kl\u0026aacute;nov\u0026aacute;, J., \u0026amp; Ka\u0026scaron;p\u0026aacute;rek, T. (2017). Sociodemographic and delivery risk factors for developing postpartum depression in a sample of 3233 mothers from the Czech ELSPAC study. \u003cem\u003eBMC Psychiatry\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(1), 104. https://doi.org/10.1186/s12888-017-1261-y\u003c/li\u003e\n \u003cli\u003eGalletta, M. A. K., Oliveira, A. M. da S. S., Albertini, J. G. L., Benute, G. G., Peres, S. V., Brizot, M. de L., \u0026amp; Francisco, R. P. V. (2022). Postpartum depressive symptoms of Brazilian women during the COVID-19 pandemic measured by the Edinburgh Postnatal Depression Scale. \u003cem\u003eJournal of Affective Disorders\u003c/em\u003e, \u003cem\u003e296\u003c/em\u003e, 577\u0026ndash;586. https://doi.org/10.1016/j.jad.2021.09.091\u003c/li\u003e\n \u003cli\u003eG\u0026ouml;k, S., Atıgan, A., \u0026amp; G\u0026ouml;k, B. (2023). Frequency of Postpartum Depression and Investigation of Related Factors. \u003cem\u003eDokuz Eyl\u0026uuml;l \u0026Uuml;niversitesi Tıp Fak\u0026uuml;ltesi Dergisi\u003c/em\u003e, \u003cem\u003e36\u003c/em\u003e(3), 287\u0026ndash;295. https://doi.org/10.18614/deutip.1194640\u003c/li\u003e\n \u003cli\u003eGuo, J., De Carli, P., Lodder, P., Bakermans-Kranenburg, M. J., \u0026amp; Riem, M. M. E. (2022). Maternal mental health during the COVID-19 lockdown in China, Italy, and the Netherlands: a cross-validation study. \u003cem\u003ePsychological Medicine\u003c/em\u003e, \u003cem\u003e52\u003c/em\u003e(15), 3349\u0026ndash;3359. https://doi.org/10.1017/S0033291720005504\u003c/li\u003e\n \u003cli\u003eGuvenc, G., Yesilcinar, İ., Ozkececi, F., \u0026Ouml;ks\u0026uuml;z, E., Ozkececi, C. F., Konukbay, D., Kok, G., \u0026amp; Karasahin, K. E. (2021). Anxiety, depression, and knowledge level in postpartum women during the COVID‐19 pandemic. \u003cem\u003ePerspectives in Psychiatric Care\u003c/em\u003e, \u003cem\u003e57\u003c/em\u003e(3), 1449\u0026ndash;1458. https://doi.org/10.1111/ppc.12711\u003c/li\u003e\n \u003cli\u003eHandelzalts, J. E., Hairston, I. S., Levy, S., Orkaby, N., Krissi, H., \u0026amp; Peled, Y. (2022). COVID-19 related worry moderates the association between postpartum depression and mother-infant bonding. \u003cem\u003eJournal of Psychiatric Research\u003c/em\u003e, \u003cem\u003e149\u003c/em\u003e, 83\u0026ndash;86. https://doi.org/10.1016/j.jpsychires.2022.02.039\u003c/li\u003e\n \u003cli\u003eHoward, K., Maples, J. M., \u0026amp; Tinius, R. A. (2022). Modifiable Maternal Factors and Their Relationship to Postpartum Depression. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e(19), 12393. https://doi.org/10.3390/ijerph191912393\u003c/li\u003e\n \u003cli\u003eIşıkalan, M. M., G\u0026uuml;ndoğan, K. M., Khiavi, P. E., Alp, E. C., \u0026amp; Acar, A. (2021). Does the Risk of Postpartum Depression Increase in Women Who Gave Birth While Infected With SARS-CoV-2? A Preliminary Study in Turkey. \u003cem\u003eKocaeli Medical Journal\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(50), 29\u0026ndash;34. https://doi.org/10.5505/ktd.2021.11129\u003c/li\u003e\n \u003cli\u003eJahrami, H., BaHammam, A. S., Bragazzi, N. L., Saif, Z., Faris, M., \u0026amp; Vitiello, M. V. (2021). Sleep problems during the COVID-19 pandemic by population: a systematic review and meta-analysis. \u003cem\u003eJournal of Clinical Sleep Medicine\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(2), 299\u0026ndash;313. https://doi.org/10.5664/jcsm.8930\u003c/li\u003e\n \u003cli\u003eKara\u0026ccedil;am, Z., \u0026Ccedil;oban, A., Akbaş, B., \u0026amp; Karabulut, E. (2018). Status of postpartum depression in Turkey: A meta-analysis. \u003cem\u003eHealth Care for Women International\u003c/em\u003e, \u003cem\u003e39\u003c/em\u003e(7), 821\u0026ndash;841. https://doi.org/10.1080/07399332.2018.1466144\u003c/li\u003e\n \u003cli\u003eKonkan, R., Şenormancı, \u0026Ouml;., G\u0026uuml;\u0026ccedil;l\u0026uuml;, O., Aydın, E., \u0026amp; Sungur, M. Z. (2013). Yaygın Anksiyete Bozukluğu-7 (YAB-7) Testi T\u0026uuml;rk\u0026ccedil;e Uyarlaması, Ge\u0026ccedil;erlik ve G\u0026uuml;venirliği. \u003cem\u003eN\u0026ouml;ro Psikiyatri Arşivi\u003c/em\u003e, \u003cem\u003e50\u003c/em\u003e(1), 53\u0026ndash;58. https://doi.org/10.4274/npa.y6308\u003c/li\u003e\n \u003cli\u003eKurt, A., \u0026amp; \u0026Ccedil;elikay S\u0026ouml;yler, H. (2022). The Relationship Between Maternal Attachment, Obsessive Compulsive Disorder and Perinatal Anxiety in Women Who Give Birth During the Covi 19 Period. \u003cem\u003eJournal of Social, Humanities and Administrative Sciences\u003c/em\u003e, \u003cem\u003e5\u003c/em\u003e(3), 225\u0026ndash;235. https://doi.org/10.26677/TR1010.2022.930\u003c/li\u003e\n \u003cli\u003eLamus, M. N., Pabon, S., MPoca, C., Guida, J. P., Parpinelli, M. A., Cecatti, J. G., Vidarte, M. F., \u0026amp; Costa, M. L. (2021). Giving women WOICE postpartum: prevalence of maternal morbidity in high-risk pregnancies using the WHO-WOICE instrument. \u003cem\u003eBMC Pregnancy and Childbirth\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e(1), 357. https://doi.org/10.1186/s12884-021-03727-3\u003c/li\u003e\n \u003cli\u003eLayton, H., Owais, S., Savoy, C. D., \u0026amp; Van Lieshout, R. J. (2021). Depression, Anxiety, and Mother-Infant Bonding in Women Seeking Treatment for Postpartum Depression Before and During the COVID-19 Pandemic. \u003cem\u003eThe Journal of Clinical Psychiatry\u003c/em\u003e, \u003cem\u003e82\u003c/em\u003e(4). https://doi.org/10.4088/JCP.21m13874\u003c/li\u003e\n \u003cli\u003eLeach, L. S., Christensen, H., \u0026amp; Mackinnon, A. (2014). Pregnancy and levels of depression and anxiety: A prospective cohort study of Australian women. \u003cem\u003eAustralian \u0026amp; New Zealand Journal of Psychiatry\u003c/em\u003e, \u003cem\u003e48\u003c/em\u003e(10), 944\u0026ndash;951. https://doi.org/10.1177/0004867414533013\u003c/li\u003e\n \u003cli\u003eLiu, T.-C., Peng, H.-C., Chen, C., \u0026amp; Chen, C.-S. (2022). Mode of Delivery Is Associated with Postpartum Depression: Do Women with and without Depression History Exhibit a Difference? \u003cem\u003eHealthcare\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(7), 1308. https://doi.org/10.3390/healthcare10071308\u003c/li\u003e\n \u003cli\u003eMari\u0026ntilde;o-Narvaez, C., Puertas-Gonzalez, J. A., Romero-Gonzalez, B., \u0026amp; Peralta-Ramirez, M. I. (2021). Giving birth during the COVID-19 pandemic: The impact on birth satisfaction and postpartum depression. \u003cem\u003eInternational Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics\u003c/em\u003e, \u003cem\u003e153\u003c/em\u003e(1), 83\u0026ndash;88. https://doi.org/10.1002/ijgo.13565\u003c/li\u003e\n \u003cli\u003eMart\u0026iacute;nez-Borba, V., Suso-Ribera, C., Osma, J., \u0026amp; Andreu-Pej\u0026oacute;, L. (2020). Predicting Postpartum Depressive Symptoms from Pregnancy Biopsychosocial Factors: A Longitudinal Investigation Using Structural Equation Modeling. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(22), 8445. https://doi.org/10.3390/ijerph17228445\u003c/li\u003e\n \u003cli\u003eMolgora, S., Saita, E., Barbieri Carones, M., Ferrazzi, E., \u0026amp; Facchin, F. (2022). Predictors of Postpartum Depression among Italian Women: A Longitudinal Study. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e(3), 1553. https://doi.org/10.3390/ijerph19031553\u003c/li\u003e\n \u003cli\u003eOskovi-Kaplan, Z. A., Buyuk, G. N., Ozgu-Erdinc, A. S., Keskin, H. L., Ozbas, A., \u0026amp; Moraloglu Tekin, O. (2021). The Effect of COVID-19 Pandemic and Social Restrictions on Depression Rates and Maternal Attachment in Immediate Postpartum Women: a Preliminary Study. \u003cem\u003ePsychiatric Quarterly\u003c/em\u003e, \u003cem\u003e92\u003c/em\u003e(2), 675\u0026ndash;682. https://doi.org/10.1007/s11126-020-09843-1\u003c/li\u003e\n \u003cli\u003eOstacoli, L., Cosma, S., Bevilacqua, F., Berchialla, P., Bovetti, M., Carosso, A. R., Malandrone, F., Carletto, S., \u0026amp; Benedetto, C. (2020). Psychosocial factors associated with postpartum psychological distress during the Covid-19 pandemic: a cross-sectional study. \u003cem\u003eBMC Pregnancy and Childbirth\u003c/em\u003e, \u003cem\u003e20\u003c/em\u003e(1), 703. https://doi.org/10.1186/s12884-020-03399-5\u003c/li\u003e\n \u003cli\u003e\u0026Ouml;zşahin, Z., Erdem, N., Aksakal, Z. G., \u0026amp; Filoğlu, N. (2022). COVİD-19 Korkusunun Annenin Doğumu Algılaması ve Doğum Sonu Anksiyeteye Etkisi. \u003cem\u003eTurkish Journal of Family Medicine and Primary Care\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(1), 40\u0026ndash;47. https://doi.org/10.21763/tjfmpc.995666\u003c/li\u003e\n \u003cli\u003ePierce, M., McManus, S., Hope, H., Hotopf, M., Ford, T., Hatch, S. L., John, A., Kontopantelis, E., Webb, R. T., Wessely, S., \u0026amp; Abel, K. M. (2021). Mental health responses to the COVID-19 pandemic: a latent class trajectory analysis using longitudinal UK data. \u003cem\u003eThe Lancet Psychiatry\u003c/em\u003e, \u003cem\u003e8\u003c/em\u003e(7), 610\u0026ndash;619. https://doi.org/10.1016/S2215-0366(21)00151-6\u003c/li\u003e\n \u003cli\u003eRossi, R., Socci, V., Talevi, D., Mensi, S., Niolu, C., Pacitti, F., Di Marco, A., Rossi, A., Siracusano, A., \u0026amp; Di Lorenzo, G. (2020). COVID-19 Pandemic and Lockdown Measures Impact on Mental Health Among the General Population in Italy. \u003cem\u003eFrontiers in Psychiatry\u003c/em\u003e, \u003cem\u003e11\u003c/em\u003e. https://doi.org/10.3389/fpsyt.2020.00790\u003c/li\u003e\n \u003cli\u003eSalari, N., Hosseinian-Far, A., Jalali, R., Vaisi-Raygani, A., Rasoulpoor, S., Mohammadi, M., Rasoulpoor, S., \u0026amp; Khaledi-Paveh, B. (2020). Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis. \u003cem\u003eGlobalization and Health\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(1), 57. https://doi.org/10.1186/s12992-020-00589-w\u003c/li\u003e\n \u003cli\u003eShigemura, J., Ursano, R. J., Morganstein, J. C., Kurosawa, M., \u0026amp; Benedek, D. M. (2020). Public responses to the novel 2019 coronavirus (2019‐nCoV) in Japan: Mental health consequences and target populations. \u003cem\u003ePsychiatry and Clinical Neurosciences\u003c/em\u003e, \u003cem\u003e74\u003c/em\u003e(4), 281\u0026ndash;282. https://doi.org/10.1111/pcn.12988\u003c/li\u003e\n \u003cli\u003eSilva, M. M. de J., Nogueira, D. A., Clapis, M. J., \u0026amp; Leite, E. P. R. C. (2017). Anxiety in pregnancy: prevalence and associated factors. \u003cem\u003eRevista Da Escola de Enfermagem Da USP\u003c/em\u003e, \u003cem\u003e51\u003c/em\u003e. https://doi.org/10.1590/s1980-220x2016048003253\u003c/li\u003e\n \u003cli\u003eSilverman, M. E., Burgos, L., Rodriguez, Z. I., Afzal, O., Kalishman, A., Callipari, F., Pena, Y., Gabay, R., \u0026amp; Loudon, H. (2020). Postpartum mood among universally screened high and low socioeconomic status patients during COVID-19 social restrictions in New York City. \u003cem\u003eScientific Reports\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(1), 22380. https://doi.org/10.1038/s41598-020-79564-9\u003c/li\u003e\n \u003cli\u003eSmorti, M., Ponti, L., \u0026amp; Pancetti, F. (2019). A Comprehensive Analysis of Post-partum Depression Risk Factors: The Role of Socio-Demographic, Individual, Relational, and Delivery Characteristics. \u003cem\u003eFrontiers in Public Health\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e. https://doi.org/10.3389/fpubh.2019.00295\u003c/li\u003e\n \u003cli\u003eSpitzer, R. L., Kroenke, K., Williams, J. B. W., \u0026amp; L\u0026ouml;we, B. (2006). A Brief Measure for Assessing Generalized Anxiety Disorder. \u003cem\u003eArchives of Internal Medicine\u003c/em\u003e, \u003cem\u003e166\u003c/em\u003e(10), 1092. https://doi.org/10.1001/archinte.166.10.1092\u003c/li\u003e\n \u003cli\u003eStepowicz, A., Wencka, B., Bieńkiewicz, J., Horzelski, W., \u0026amp; Grzesiak, M. (2020). Stress and Anxiety Levels in Pregnant and Post-Partum Women during the COVID-19 Pandemic. \u003cem\u003eInternational Journal of Environmental Research and Public Health\u003c/em\u003e, \u003cem\u003e17\u003c/em\u003e(24). https://doi.org/10.3390/ijerph17249450\u003c/li\u003e\n \u003cli\u003eTsai, J.-M., Tsai, L.-Y., Tsay, S.-L., \u0026amp; Chen, Y.-H. (2023). The prevalence and risk factors of postpartum depression among women during the early postpartum period: a retrospective secondary data analysis. \u003cem\u003eTaiwanese Journal of Obstetrics and Gynecology\u003c/em\u003e, \u003cem\u003e62\u003c/em\u003e(3), 406\u0026ndash;411. https://doi.org/10.1016/j.tjog.2023.03.003\u003c/li\u003e\n \u003cli\u003eUnnisa, S., \u0026amp; Lavanya, P. S. (2018). The predictors of post-partum depression in a tertiary centre. \u003cem\u003eInternational Journal of Reproduction, Contraception, Obstetrics and Gynecology\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(6), 2218. https://doi.org/10.18203/2320-1770.ijrcog20182323\u003c/li\u003e\n \u003cli\u003eVrcić Amar, A., \u0026amp; Sejfović, H. (2023). Perceived social support, newborn temperament and socioeconomic status in postpartum depression: report from southwest Serbia. \u003cem\u003eArchives of Psychiatry and Psychotherapy\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(1), 33\u0026ndash;41. https://doi.org/10.12740/APP/152779\u003c/li\u003e\n \u003cli\u003eWHO. (2020). \u003cem\u003eCOVID-19: operational guidance for maintaining essential health services during an outbreak: interim guidance, 25 March 2020\u003c/em\u003e. World Health Organization. https://iris.who.int/handle/10665/331561\u003c/li\u003e\n \u003cli\u003eZanardo, V., Manghina, V., Giliberti, L., Vettore, M., Severino, L., \u0026amp; Straface, G. (2020). Psychological impact of COVID-19 quarantine measures in northeastern Italy on mothers in the immediate postpartum period. \u003cem\u003eInternational Journal of Gynaecology and Obstetrics: The Official Organ of the International Federation of Gynaecology and Obstetrics\u003c/em\u003e, \u003cem\u003e150\u003c/em\u003e(2), 184\u0026ndash;188. https://doi.org/10.1002/ijgo.13249\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Covid 19, Fear, Pandemic, Anxiety, Postpartum Depression, Midwifery","lastPublishedDoi":"10.21203/rs.3.rs-4693602/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4693602/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003ePurpose\u003c/h2\u003e \u003cp\u003eThis study aimed to determine the effect of fear of Covid-19 on anxiety and postpartum depression in postpartum women.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe research, which is cross-sectional, was conducted online between December 2021 and May 2022 on 110 postpartum women who were between 2 and 4 weeks postpartum. Data were collected using a personal data collection form, Fear of Covid-19 Scale (FCV-19S), General Anxiety Disorder 7 (GAD 7) and Edinburgh Postpartum Depression Scale (EPDS). In the analysis of the data, minimum-maximum values, percentages and numbers were given, and the relationship between the scale scores was examined with Pearson correlation analysis. Logistic regression analysis was performed to determine the factors affecting postpartum depression.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe average age of women is 29.98\u0026thinsp;\u0026plusmn;\u0026thinsp;5.62. 13.60% of the participating postpartum women were diagnosed with Covid-19 during their pregnancy, and 69.10% of them were diagnosed with Covid-19 by a relative of the pregnant woman. It was determined that 73.60% of the participants in the research had received the Covid-19 vaccine. The prevalence of postpartum depression was found to be 30.90%. It was determined that 18.20% of the participants suffered from general anxiety. The average score of the fear of Covid-19 scale was determined as 14.27\u0026thinsp;\u0026plusmn;\u0026thinsp;6.55.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eIt was determined that an increase in the GAD 7 and FCV-19S scale scores increased the postpartum depression score.\u003c/p\u003e","manuscriptTitle":"The Effect of Fear of Covid-19 on Anxiety and Postpartum Depression in Postpartum Women: Cross-sectional study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-07-31 15:12:22","doi":"10.21203/rs.3.rs-4693602/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"75cd8589-3adb-42bf-b051-81af9037b991","owner":[],"postedDate":"July 31st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":35364954,"name":"Health sciences/Health care"},{"id":35364955,"name":"Health sciences/Diseases/Psychiatric disorders/Anxiety"},{"id":35364956,"name":"Health sciences/Diseases/Psychiatric disorders/Depression"}],"tags":[],"updatedAt":"2025-01-10T01:38:22+00:00","versionOfRecord":[],"versionCreatedAt":"2024-07-31 15:12:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4693602","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4693602","identity":"rs-4693602","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}