Associations Between COVID-19-Related Changes to Pregnant Women’s Work-Plans and Prenatal Depression

Purpose: To identify whether COVID-19-related changes to how long pregnant women planned to work in pregnancy were associated with depression. Methods: : An online convenience sample of pregnant women in the U.S. were recruited in April-May 2020 (N = 1,970) through social media and dissemination to U.S.-based maternal health contacts. We used multivariate logistic regression to evaluate whether COVID-19-related changes to pregnant women’s work-plans were associated with clinically-significant prenatal depression (Edinburgh Postnatal Depression Survey score >=15), adjusting for covariates. Results: : Of the 1,600 eligible participants without missing data, 29.6% of participants (N = 473) reported that they experienced a COVID-19-related work-plan change, while 22.1% (N = 350) of participants had a clinically-significant EPDS score. Women were more likely to report a work-plan change if they were younger (t(1598) = 2.90, p<0.004), had a lower household income (𝛘 2 (2) = 29.63, p<0.001), were less educated (𝛘 2 (2) = 27.48, p<0.001), were farther along in pregnancy (t(1598) = -4.96, p<0.001), and worked outside the home during COVID-19 (𝛘 2 (2) = 59.27, p<0.001). Both COVID-19-related work-plan changes (OR = 1.74 , 95% CI 1.34 – 2.25, p < 0.001) and uncertainty about the nature of these changes (OR = 2.70, 95% CI 1.22 – 5.96, p = 0.014) were associated with significantly higher odds of a clinically-significant depression score. Conclusion: Pregnant women who experienced a work-plan change or who were uncertain about how COVID-19 would impact their work-plans were significantly more likely to experience depression, suggesting a need for universal access to prenatal depression screening and paid maternity leave.