Investigation of the effect of COVID-19 phobia on loneliness and depression in the postpartum period

Aim: The reason for the feeling of fear caused by the COVID-19 pandemic in postpartum women who have gone through a very important and difficult period of their life who have just given birth and the risk of depression increases even when there are no extraordinary circumstances such as epidemic, and the lack of adequate support from any of their relatives due to the risk of transmission of the disease at birth and after delivery. It is thought that the feeling of loneliness in which they are alone may increase their depressive mood even more and cause them to have a more difficult time during this period. The aim of this study is to investigate the effect of COVID-19 phobia on depression and loneliness in postpartum women with a 4-8 weeks old baby admitted to primary care. Materials and methods: This study was carried out by including women who applied to 6 Family Health Centers selected from three central districts of Konya (Meram, Selçuklu, Karatay) between 01.06.2021 and 01.09.2021, 4-8 weeks after their birth. Sociodemographic information form to evaluate the sociodemographic characteristics of the participants and their characteristics related to their baby, the "Edinburgh Postpartum Depression Scale" to evaluate the postpartum depression status, the "COVID-19 Phobia Scale" to evaluate the COVID-19 phobia, and the "UCLA Loneliness Scale" for the loneliness levels were applied. SPSS 20.0 (Statistical Package for Social Sciences) program was used for statistical analysis. Statistical significance level was accepted as p<0.05. Results: The mean age of the 425 people participating in the study was calculated as 28.57±4.59 (min=18; max=42) years. 56.4% (n=240) of the participants were university graduates, 48.5% (n=206) were working before birth. The income of 21.9% (n=93) of the participants was more than their expenses, 55.3% (n=235) of them had income equal to their expenses, 22.8% of them had less than their expenses, 95.1% were living in the city center . The last pregnancy of 88.2% of the participants was a desired pregnancy and 22% of them did not receive any help in baby care. It was found that 22.3% of the participants (n=95) had symptoms of postpartum depression. There was a significant relationship between EPDS scores and educational status (p<0.001) and prenatal employment status (p<0.001). Those who did not work before had a higher mean. A statistically significant correlation was found between perceived income level and EPDS total score (p<0.001). The PPD frequency of the participants whose income was less than their expenses was higher than those whose income was equal to their expenses and whose income was more than their expenses. The frequency of PPD was higher in mothers who conceived unplanned (p=0.004) and had prenatal COVID-19 (p=0.001). A statistically significant relationship was found between the number of children (p=0.001), educational status (p<0.001) and prenatal employment status (p=0.004) and the level of loneliness of the participants. A statistically significant correlation was found between perceived income level and UCLA-YÖ total score (p<0.001). The mean of mothers whose income is less than their expenses were higher. There was a significant relationship between the state of wanting to become pregnant and being helped in baby care (p=0.034) and the level of loneliness of the mothers (p=0.012), and mothers who became pregnant unintentionally and were not helped in baby care felt lonelier. The total mean score of C-19FE of the participants was 46.94±13.49 (min:20, max:79). There was no statistically significant relationship between C-19FE total score and all sub-dimension scores, and educational status, occupation, perceived income level, desire to become pregnant, and assistance in baby care. A significant correlation was found between C-19FI psychological sub-dimension score and prenatal employment status (p=0.025), and it was higher in average in those who did not work before birth. A significant correlation was found between the COVID-19 status of the participants and the C-19PI somatic sub-dimension (p=0.002), social sub-dimension (p=0.003), economic sub-dimension scores (p=0.002) and the total score of the scale (p=0.001). When the correlation between the participants' total EPDS score and UCLA-YÖ total score was examined, a strong and statistically significant correlation was found (r=0.615) (p<0.001). There was a moderately significant positive correlation (r=0.300) (p<0.001) in the correlation between the participants' EPDS total score and C19-PI total score. correlation was determined (r=0.150) (p=0.002). Conclusion: It has been concluded that the feeling of fear caused by the COVID-19 pandemic in women in the postpartum period and the feeling of loneliness caused by the lack of support from their relatives at birth and postpartum due to the risk of transmission of the disease further increase the symptoms of postpartum depression. As primary care physicians, mothers who come for control during pregnancy and after delivery should be evaluated in terms of postpartum depression, and we should take early precautions for both mother and baby health, and refer them if necessary. Keywords: Postpartum depression, COVID-19 pandemic, social loneliness