Frequency and Severity of Depression amongst Pregnant Healthcare Workers before and during the SARS-CoV-2 Pandemic: an analysis of the 2019-2021 National Health Interview Survey

Background: The COVID-19 pandemic has intensified stressors and worsened mental health outcomes for healthcare workers (HCWs), which is often exacerbated in vulnerable groups such as those who are pregnant. Depression in HCWs is influenced by factors such as fears for personal safety, higher workload, and social isolation. Pregnant HCWs report a higher prevalence of psychological symptoms exacerbated by the COVID-19 pandemic. Despite increased efforts to expand the knowledge of negative health outcomes secondary to the pandemic, depression levels amongst pregnant HCWs during this time remain largely unknown. Thus, the aim of the study is to identify trends of depression frequency, severity, and medication use in pregnant healthcare workers throughout the stages of the COVID-19 pandemic in the United States (2019-2021).

Methods: We analyzed data from the National Health Interview Survey combining the 2019-2021 cycles. Determination of depression frequency, severity, and medication usage were compared between 128 pregnant HCWs and 485 pregnant non-HCWs(n=613). These associations were then categorized in COVID-19 pandemic stages of pre-pandemic (2019), during (2020), and endemic (2021) via multivariable regression controlling for age, income-to-poverty ratio, and additional children in the home.

Results: We found no observable differences in the rates of pregnancy, reported depression or symptomatology between HCW and non-HCW. During the pandemic, pregnant HCWs in 2021 were more likely to report ever having depression compared to pregnant HCWs in 2019 (AOR: 3.33; CI:1.92-5.79). During 2021, HCWs were also more likely to report a moderate to severe level of depression compared to 2019 (AOR: 2.55; CI: 1.54-4.24).

Conclusion: Our findings indicate that rates of pregnancy amongst HCWs and non-HCWs were similar, as well as rates of depression and symptomatology in those who were pregnant. However, our results showed that amongst pregnant healthcare workers, rates of reporting ever having depression and severity was greater during the endemic stage of the COVID-19 pandemic compared to pre-pandemic. As depression in pregnant women may lead to postpartum depression along with other health concerns, exacerbated rates and severity amongst pregnant healthcare workers during the endemic stage should be prioritized to ensure positive maternal and child outcomes plus that they are able to return to the workforce when ready.