COVID-19 Pandemic-Related Perceived Loneliness as a Potential Risk Factor for Worse Outcomes Among People Who are Pregnant or Postpartum.

INTRODUCTION

People in the perinatal period may be especially susceptible to the effects of social isolation and loneliness. We assessed the COVID-19 pandemic-related impact on loneliness and other outcomes in this population.

METHODS

A cross-sectional anonymous survey was completed during August-November, 2020, and January-April, 2021, by people who were pregnant or postpartum in Pennsylvania and Wisconsin, respectively. Wilcoxon rank sum, Fisher exact, or chi-square tests were used to compare mental health, substance use, pregnancy-related and overall health, pandemic's life impact, and social status metrics between 2 groups of respondents: those who screened positive ("Lonely") versus negative ("Not Lonely") for loneliness. Multivariate logistic regression analysis assessed factors associated with Lonely versus Not Lonely status.

RESULTS

Among 613 respondents, 48.8% were categorized as Lonely. Lonely individuals were more likely to be postpartum (P = 0.01); nulliparous (P = 0.04); have more pregnancy complications (P = 0.049); have a diagnosed mood disorder (P < 0.001); receive mental health care (PP < 0.001); have elevated depression (P < 0.001), anxiety (P < 0.001), and stress (P < 0.001) scores; rate their social status as lower (P < 0.001); and endorse a worse pandemic-life impact (P < 0.001). A multivariate analysis identified that being postpartum (OR 0.59; 95% CI, 0.40-0.87) and having worse depression (OR 1.24; 95% CI, 1.13-1.36), stress (OR 0.41; 95% CI, 0.28-0.60), perceived social status (OR 0.83; 95% CI, 0.73-0.95), and pandemic-life impact (OR 1.79; 95% CI, 1.11-2.93) were associated with the Lonely status.

CONCLUSIONS

Early during the COVID-19 pandemic, screening positive for loneliness was associated with a worse biopsychosocial profile and more pregnancy complications among people in the perinatal period. Focusing efforts on preventing loneliness may help improve outcomes critical for maternal-fetal and child health.